Cell damage and proliferation in human gastric mucosa infected by Helicobacter pylori - A comparison before and after H pylori eradication in non-atrophic gastritis

Helicobacter pylori (HP) is believed to be involved in the transition from normal gastric mucosa to atrophic gastritis and intestinal metaplasia. Infe ction with the organism is one of the risk factors for development of intes tinal-type gastric adenocarcinoma, possibly through altered cell turnover, Medical eradication of HP is widely performed for the treatment of peptic u lcers and other upper gastrointestinal disorders. Eradication of HP may aff ect altered cell turnover of the gastric mucosa caused by the infection, bu t there are few reports comparing sterilized mucosa with HP-infected and no n-infected mucosa. In this study, we examined cell damage using terminal de oxynucleotidyl transferase-mediated dUTP-biotin nickend labeling (TUNEL), i n situ nick translation (ISNT), and cell proliferation by Ki 67 immunohisto chemistry staining in gastric mucosa before and after HP eradication and in non-infected gastric mucosa. We then compared these findings using endosco pic gastric biopsy specimens. Labeling indices of TUNEL (2.46 +/- 1.22), IS NT (1.13 +/- 0.42), and Ki67 (21.8 +/- 6.14) in tissue from which HP had be en eradicated were significantly lower than those of HP-infected mucosa (6. 36 +/- 2.26, 4.00 +/- 1.62, 45.8 +/- 5.35, for TUNEL, ISNT, and Ki67, respe ctively). There were no significant differences between formerly infected a nd non-infected mucosa (TUNEL: 2.26 +/- 0.69, ISNT: 1.29 +/- 0.63, Ki67: 23 .5 +/- 8.20). These results indicate that medical HP eradication results in decreased cell proliferation and damage, restoring the condition seen in n on-infected mucosa. Thus, HP eradication may be effective, not only in the treatment of gastric ulcers or gastric symptoms, but also in the prevention of gastric carcinoma. Copyright (C) 1999 by W.B. Saunders Company.