ROLE OF HELICOBACTER-PYLORI IN THE PATHOGENESIS OF ATROPHIC GASTRITIS

Background: Atrophic gastritis is defined as a loss of the glandular s tructures and a collapse elf the reticulin skeleton of the stomach muc osa. It is often accompanied by intestinal metaplasia. Both conditions result from long-term persistent chronic active gastritis and signifi cantly increase the risk for gastric cancer. Methods: Review of the ro le of Helicobacter pylori in the pathogenesis of atrophic gastritis. S pecific attention is given to the classifications and histologic featu res of atrophic gastritis, the frequency with which atrophic gastritis occurs in H. pylori-infected subjects, the factors that influence the process of development of atrophic gastritis in the presence of infec tion, and the various mechanisms by which this bacterial infection may induce atrophic gastritis. In addition, the possible role of H. pylor i in the etiology of auto-immune atrophic gastritis and pernicious ane mia is discussed. Conclusions: H. pylori infection eventually causes a trophic gastritis in a considerable number of infected subjects. In di fferent populations, the prevalence of atrophic gastritis increases by 1 to 3% per annum. Factors that may increase the risk for atrophy are infection at an early age, cytotoxin production by the infecting stra in, and lowering of acid output. The association between H. pylori inf ection and the development of atrophic gastritis significantly support s the role of this infection in gastric carcinogenesis.