J. Kountouras et al., Omeprazole and regulation of cytokine profile in Helicobacter pylori-infected patients with duodenal ulcer disease, HEP-GASTRO, 47(35), 2000, pp. 1301-1304
Background/Aims: To estimate the cytokine profile in Helicobacter pylori-po
sitive patients with duodenal ulcers treated with omeprazole.
Methodology: The subjects were 22 patients with endoscopically defined acti
ve duodenal ulcers and H. pylori infection treated with omeprazole for 3 mo
nths after initial 1-week triple therapy. Peripheral blood CD3(+) CD4(+) an
d CD8(+) T lymphocytes, percentage of HLA-DR+ peripheral blood lymphocytes,
and cytokine levels (GM-CSF, IL6 and IL-2) were measured in the supernatan
ts from PHA-cultured peripheral blood lymphocytes at baseline conditions an
d after 3-months' omeprazole treatment.
Results: The H. pylori eradication triple regimen cured H. pylori infection
in 86.4% of our patients. Peripheral blood CD3(+) CD4(+) and CD8(+) T lymp
hocytes were not affected by omeprazole treatment (P>0.05), whereas the per
centage of HLA-DR+ peripheral blood lymphocytes increased significantly pos
t-treatment (P<0.05). Al cytokine levels measured in the supernatants showe
d a significant decrease after treatment (P<0.001).
Conclusions: The significant decrease in the two pro-inflammatory cytokines
(GM-CSF, IL-6) and the major inflammatory cytokine IL-2, implies that the
potential cytokine synthesis of the Th1 pattern from peripheral blood lymph
ocytes is highly suppressed after treatment. This effect on cytokine regula
tion seems to be a result of the positive H. pylori infection outcome at th
e immunological level, which leads to "normalization" of cytokine productio
n.