Role of apoptosis induced by Helicobacter pylori infection in the development of duodenal ulcer

Background-Helicobacter pylori affects gastric epithelium integrity by acce leration of apoptosis. However, it remains unclear what product of the bact eria causes apoptosis, or whether or not the apoptosis is involved in the d evelopment of ulcers, Aims To elucidate the factor from H pylori that causes acceleration of apop tosis and the role of apoptosis in the development of duodenal ulcer in H p ylori infection; Patients-Five H pylori negative healthy volunteers, 47 H pylori positive pa tients with duodenal ulcer, and 35 H pylori positive patients with gastric ulcer. Methods-An endoscopic examination was carried out to diagnose ulcers and de termine their clinical stage. To analyse apoptosis, a cell cycle analysis w as performed using biopsy specimens. Results-There was a significant correl ation between the urease activity of the H pylori strain and the level of a poptosis induced by this bacterial strain. Moreover, in duodenal ulcer pati ents infected with H pylori, the patients;with an active ulcer exhibited a significantly higher level of apoptosis than those with ulcers at both the healing and scarring stages. Conclusion-These findings suggest that acceleration of apoptosis in the ant ral mucosa caused by the urease of H pylori plays a crucial role in the dev elopment of ulcers in the duodenum.