AGE AND HELICOBACTER-PYLORI DECREASE GASTRIC-MUCOSAL SURFACE HYDROPHOBICITY INDEPENDENTLY

Background-Gastric mucosal surface hydrophobicity (GMSH) is an essenti al component of the mucosal defence system that is decreased by Helico bacter pylori and non-steroidal anti-inflammatory drugs (NSAIDs). Gast ric ulcers occur predominantly in elderly subjects, and may thus refle ct diminished mucosal resistance. Aims-To investigate whether aging de creases GMSH. Patients-One hundred and twenty patients without peptic ulcer disease were divided into three age groups: I (41 years or below ); II (41-64 years); and III (65 years or above). Methods-Biopsy speci mens were taken from the antrum, corpus, and cardia for histology (Syd ney system), urease testing for ii pylori, and for contact angle measu rement of GMSH with a goniometer. The presence of specific H pylori an tibodies was checked by immunoblotting. Results-Fifty two patients (:4 3%) were infected, and 68 were uninfected with Il pylori. GMSH at all biopsy sites was lower in H pylori infected subjects (p=0.0001), but a lso decreased with age independently of infection status (p=0.0001). T he most notable decrease in GMSH occurred between age groups I and II in those with, and between age groups II and III in those without, H p ylori infection. GMSH was greater in antral than in corpus mucosa in b oth infected (p=0.0001.) and uninfected patients (p=0.0003). Conclusio ns-A physiological decrease in GMSH with aging may contribute to the r isk of ulcer development in the elderly, and may act synergistically w ith H pylori and/or NSAIDs on gastric mucosal defence.