HELICOBACTER-PYLORI GENOTYPES INFLUENCE SERUM PEPSINOGEN-C LEVELS

Background. Infection from Helicobacter pylori significantly influence s pepsinogen A (PGA) and C (PGC) levels in serum. Increased PGA and PG C serum levels are observed in H. pylori positive patients, while a si gnificant decrease is observed after eradication. Little is known abou t the relative role of H. pylori cytotoxic strains in this phenomenon. The aim of our study was to assess the influence of cagA genotype on circulating levels of PGA and PGC. Materials and Methods. We studied 8 1 consecutive H. pylori positive patients, 64 H. pylori negative patie nts and 18 healthy controls. H. pylori was evaluated histologically in two antral and two body biopsies (Giemsa and/or Warthin Starry staini ng). Extracted DNA was then submitted for PCR amplification of both th e urease A and cagA genes. A serum obtained from each patient before e ndoscopy was used for specific radioimmunoassay measurement of PGA and PGC. Results. The urease A gene was found in all H. pylori positive p atients, the cagA gene was detected in 55 H. pylori positive patients and in none of the H. pylori negative patients. PGA and PGC levels wer e significantly higher in H. pylori positive than in H. pylori negativ e patients. A significant association was found between cagA and raise d serum PGC levels in patients with antral gastritis but not in patien ts with peptic ulcer. Serum PGA levels were not affected by cagA. Conc lusions. Our results indicate that cagA positivity may influence the c irculating PGC levels, probably because it causes a higher grade of mu cosal inflammation.