Serum tumour necrosis factor-alpha is increased in patients with Helicobacter pylori infection and CagA antibodies

Background. Helicobacter pylori causes gastric inflammation secondary to th e mucosal release of cytokines and tumour necrosis factor-alpha. Aims. To i nvestigate whether serum levels of tumour necrosis factor-alpha correlate w ith Helicobacter pylori infection, Ca-gA antibodies, C-13-urea breath rest results, endoscopic, and histological findings. Methods. Endoscopy (with gastric biopsies), C-13-urea breath test, and sero logical assay of CagA antibodies and tumour necrosis factor-alpha were perf ormed in 172 dyspeptic patients. Results. A total of 126 patients (73.2%) were infected; of the 126 patients , 84 with CagA antibodies (66.7%) showed a higher prevalence rate of duoden al ulcer (p=0.03), more severe neutrophil infiltration (p=0.03) and higher bacterial colonization (p=0.03) than those without antibodies. CagA(+) and CagA(-) groups differed also in C-13-urea breath test results (p=0.03). A s ignificant difference in serum tumour necrosis factor-alpha levels was obse rved between infected and uninfected individuals (p=0.03) as well as betwee n CagA(+) and CagA(-) patients (p=0.002). Conclusions. Helicobacter pylori infection is associated with increased ser um levels of tumour necrosis factor-alpha Subjects who harbour CagA positiv e strains have more severe mucosal damage, higher bacterial colonization, h igher probability of developing duodenal ulcer and higher serum levels of t umour necrosis factor-alpha than those infected with CagA(-) strains.