INFLUENCE OF BACTERIAL CAGA STATUS ON GASTRITIS, GASTRIC FUNCTION INDEXES, AND PATTERN OF SYMPTOMS IN H-PYLORI-POSITIVE DYSPEPTIC PATIENTS

Objective: To date, little is known about a possible relationship betw een H. pylori-related disturbances of gastric function and the bacteri al virulence. The aim of this study was to assess whether certain gast ric function indices as well as the pattern of symptoms in nonulcer dy spepsia (NUD) are related to CagA status. Methods: A total of 56 conse cutive patients with NUD (38 H. pylori-positive and 18 H. pylori-negat ive) were studied. Dyspeptic symptoms were categorized according to th e predominant complaints and scored for severity and frequency. In all subjects, basal and pentagastrin-stimulated acid secretion, fasting a nd meal-induced gastrin release, fasting serum pepsinogen I(PG I) leve ls, and gastric emptying of solids were determined. CagA status was de termined by assaying serum CagA IgG antibodies by western blotting. Re sults: Eighteen of 38 (47%) H. pylori-positive dyspeptics were CagA se ropositive. Type and severity of dyspeptic symptoms did not significan tly differ between CagA-positive and CagA-negative dyspeptics nor betw een H. pylori-positive and negative patients. Among the gastric functi on indices studied, only meal-stimulated gastrin was significantly inf luenced by CagA status (peak gastrin 129.9 [44.1] vs 99.1 [48.6] pg/ml in CagA-positive and negative NUD, respectively), but this was not ac companied by any significant modification of basal or stimulated acid secretion or gastric emptying of solids. The activities of both antral and corpus gastritis in NUD harboring CagA-positive strains were sign ificantly higher than those of CagA-negative NUD. Accordingly, serum P G I levels were significantly higher in CagA-positive than CagA-negati ve or H. pylori-negative dyspeptics. Conclusions: These findings suppo rt a role for CagA status in influencing the activity and perhaps the distribution of gastritis in NUD, as well as the degree of gastrin res ponse to a meal; however, this is not accompanied by disturbances of a cid secretion or gastric emptying or by differences in the type and se verity of symptoms. (C) 1998 by Am. Cell. of Gastroenterology.