ENHANCEMENT OF NEUTROPHIL INFILTRATION IN THE CORPUS AFTER FAILURE OFHELICOBACTER-PYLORI ERADICATION

Neutrophil accumulation plays an important role in Helicobacter pylori -associated gastric mucosal injury. In this study, the mucosal content of myeloperoxidase (MPO), which is a measure of neutrophil accumulati on and interleukin-8 (IL-8) was assayed and changes in MPO and IL-8 co ntent were determined before and after H. pylori eradication therapy. Thirty-seven H. pylori-positive patients (11DU/26GU) underwent H. pylo ri eradication therapy with lansoprazole (30 mg/day, 6 weeks) and amox icillin (2 g/day, 2 weeks), followed by famotidine (20 mg/day, 8 weeks ). H. pylori-infection status was evaluated by routine endoscopic exam inations (culture, CLO, histology). Immediately and 8 weeks after cess ation of the anti-H. pylori therapy, these tests were repeated, Intrag astric urease activity was estimated by Delta(13)CO(2), which was obta ined by the [C-13]urea breath test (UBT). Mucosal samples were taken a nd tissue MPO and IL-8 contents were assayed by EIA and ELISA, respect ively, Histologic examination was also performed. Among the 37 patient s, 21 cases of H. pylori infection were eradicated (56.8%). Intragastr ic urease activity was dramatically reduced immediately after the anti -H. pylori therapy, whereas it was re-elevated 8 weeks later in the re lapsed cases. Antral MPO content was decreased in the eradicated and r elapsed cases. MPO in the corpus was also decreased in the eradicated cases. Nevertheless, it was enhanced (3.5-fold) in the relapsed cases at 8 weeks after therapy. Changes in mucosal IL-8 content were similar to those of MPO, In eradicated cases, neutrophil infiltration is impr oved in both the antrum and corpus. However, failure of eradication th erapy results in the enhancement of neutrophil accumulation in the cor pus, Further study is necessary to clarify the mechanism of neutrophil accumulation after therapy for H. pylori.