Morphological and functional restoration of parietal cells in Helicobacterpylori associated enlarged fold gastritis after eradication

Background/Aim-Helicobacter pylori infections are associated with hypochlor hydria in patients with pangastritis. It has previously been shown that era dication of H pylori leads to an increase in acid secretion in H pylori ass ociated enlarged fold gastritis, suggesting that H pylori infection affects parietal cell function in the gastric body. The aim of this study was to e valuate the effects of H pylori infection on parietal cell morphology and f unction in hypochlorhydric patients. Patients/Methods The presence of H pylori infection, mucosal length, and in flammatory infiltration were investigated in six patients with enlarged fol d gastritis and 12 patients without enlarged folds. Parietal cell morpholog y was examined by immunohistochemistry using an antibody against the a subu nit of H+, K+-ATPase and electron microscopy. In addition, gastric acid sec retion and fasting serum gastrin concentration were determined before and a fter the eradication of H pylori. Results-In the H pylori positive patients with enlarged fold gastritis, fol d width, foveolar length, and inflammatory infiltration were increased. In addition, the immunostaining pattern of H+, K+-ATPase was less uniform, and the percentage of altered parietal cells showing dilated canaliculi with v acuole-like structures and few short microvilli was greatly increased compa red with that in H pylori positive patients without enlarged folds. After e radication, fold width, foveolar length, and inflammatory infiltrates decre ased and nearly all parietal cells were restored to normal morphology. On t he other hand, altered parietal cells were negligible in H pylori negative patients. In addition, the basal acid output and tetragastrin stimulated ma ximal acid output increased significantly from 0.5 (0.5) to 4.1 (1.5) mmol/ h and from 2.5 (1.2) to 13.8 (0.7) mmol/h (p<0.01), and fasting serum gastr in concentrations decreased significantly from 213.5 (31.6) to 70.2 (7.5) p g/ml (p<0.01) after eradication in patients with enlarged fold gastritis. Conclusion-The morphological changes in parietal cells associated with H py lori infection may be functionally associated with the inhibition of acid s ecretion seen in patients with enlarged fold gastritis.