Apoptosis in different compartments of antrum and corpus mucosa in chronicHelicobacter pylori gastritis. An 18-year follow-up study

Background: The association of apoptosis was analysed in three different co mpartments (foveolar cells-FC, proliferating zone-PZ and glandular part-GP) of antrum and corpus mucosa specimens with development of atrophy and the extent of apoptosis as depending on grade of chronic inflammation, activity of gastritis and Helicobacter pylori colonization at two time points of an 18-year follow-up in an adult population from Saaremaa, Estonia, with a hi gh prevalence of H. pylori infection were compared. Methods: A total of 68 persons (31 men, 37 women; median age, 39 years in 1979) from a primary sam ple of 304 subjects, endoscoped in 1979 and reinvestigated by endoscopy and biopsy in 1997, were included in the study. The state of the gastric mucos a and the presence of H. pylori in the antrum and corpus mucosa were assess ed in accordance with the Sydney system. The dynamics of apoptotic index (A I) between two time points in 1979 and 1997 was evaluated in antrum biopsie s of 39 persons and in corpus biopsies of 64 persons. Apoptosis was measure d using tcmminal deoxyuridine nucleotide nick end labelling (TUNEL) histoch emistry. Results: The antrum as well as the corpus of 2/68 persons were H. pylori negative at both time points. Atrophy developed in 9/68 persons in t he antrum and in 23/68 in the corpus. In PZ and GF of the corpus mucosa as well as in GP of the antrum mucosa, AI decreased significantly during 18 ye ars compared with initial values (P < 0.05), which was riot associated with development of atrophy. In all compartments of thr antrum and corpus mucos a, studied at the initial and end points of observation, AI did not reveal a difference in persons with and without development of atrophy (P > 0.05). In the samples of 1979 thr highest independent effect on the value of AI i n the FC compartment for the antrum was exerted by grade of activity of gas tritis (P = 0.01) and in GP by degree of chronic inflammation (P = 0.03), w hile in the samples of 1997 the highest effect was exerted by grade of H. p ylori colonization (P = 0.02 and 0.03 in FC and GP, respectively). For the corpus mucosa AI was most strongly affected also by grade of activity of ga stritis in FC compartment (P = 0.02) and by degree of chronic inflammation in PZ (P = 0.01), but not by grade of H. pylori colonization. Conclusion: A I was not associated with development of atrophy, but was largely dependent on grade of activity of gastritis and degree of chronic inflammation; in t he antrum mucosa Al depended also on grade of H. pylori colonization.