Tobacco smoking and vitamin C concentration in gastric juice in healthy subjects and patients with Helicobacter pylori infection

Low gastric juice total vitamin C concentration in the presence of Helicoba cter pylori infection probably plays a role in gastric carcinogenesis. Vita min C plays a role in the neutralization of various pathogenic factors conn ected with H. pylori infection, including the destruction of free radicals, which damage tissues and cell DNA, and inhibition of the formation of N-ni troso compounds, which have a strong carcinogenic activity. The aim of the study was to determine whether tobacco smoking had any effect on gastric ju ice vitamin C concentration in healthy subjects and in patients infected wi th H. pylori, Eighty-six patients with dyspeptic symptoms undergoing routin e endoscopy entered the study after giving informed consent. In all patient s plasma and gastric juice total vitamin C levels were measured by a spectr ophotometric method. They were entered into four groups: group I (controls) - H. pylori-negative non-smokers (n = 17), group II - H. pylori-negative s mokers (n = 16), group III - non-smokers with H. pylori infection (n = 21), and group IV - H. pylori-infected smokers (n = 32), In the control group ( I) the mean gastric juice total vitamin C concentration was 17.1 mug/ml (ra nge 5.3-40.0 mug/ml), which was significantly higher (P < 0.05) than in gro up II (12.6 <mu>g/ml, range 5.1-21.0 mug/ml), group III (5.8 mug/ml range 2 .1-13.7 mug/ml) and group IV (3.9 mug/ml, range 1.1-10.6 mug/ml) (P < 0.001 ). Statistically significant differences also were noted between groups II and III (P < 0.01) and groups II and IV (P < 0.001) and between groups III and IV (P < 0.05). These results demonstrate that the concentration of vita min C in gastric juice is significantly lower in smokers than in non-smoker s. This was observed in healthy subjects as well as H. pylori-infected pati ents. This phenomenon may be one of the mechanisms whereby smoking contribu tes to the production of gastric lesions, impairs healing of peptic ulcers and also increases the recurrence rate of peptic ulcers in cases with H. py lori infection. (C) 2000 Lippincott Williams & Wilkins.