Effect of acid-suppressive therapy on Helicobacter pylori production of interleukin-8 in the gastric mucosa

BACKGROUND: Recent studies have shown that acid-suppressive therapy increas es the severity of Helicobacter pylori-associated gastritis in the corpus. PURPOSE: To evaluate interleukin (IL)-8 production in the gastric corpus mu cosa before and during acid-suppressive therapy in H pylori-infected patien ts. PATIENTS AND METHODS: Ten patients with reflux esophagitis (five H pylori-p ositive and five H pylori-negative) were treated with omeprazole 20 mg. Ser um gastrin concentrations, H pylori colonization density and mucosal IL-8 l evels in the corpus were investigated at entry and two weeks after starting therapy. IL-8 levels were measured by ELISA. The organism density was dete rmined, and scored according to area occupied by the bacterial colonies. Th e presence of H pylori was assessed by rapid urease testing and histologica l finding of gastric biopsy specimens. RESULTS: In H pylori-positive patients, concentrations of IL-8 during thera py significantly exceeded those before therapy (36.2+/-6.8 versus 18.3+/-3. 8 pg/mg protein; P<0.05) without altering H pylori density. In H pylori-neg ative patients, IL-8 levels were similar before and during therapy (6.1+/-2 .7 versus 6.3+/-3.0 pg/mg protein). Concentrations of gastrin during therap y were significantly higher than those before therapy in all patients. CONCLUSIONS: The results suggest that acid suppression increases mucosal IL -8 levels in H pylori-infected patients with reflux esophagitis.