Skip to main content
Log in

Effect of eradication ofHelicobacter pylori infection on gastric epithelial cell proliferation

  • Esophageal, Gastric, and Duodenal Disorders
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Helicobacter pylori infection has been linked with gastric carcinoma. Epithelial cell proliferation is an indicator of cancer risk. The aim of this study was to assess gastric epithelial cell proliferation before and after eradication therapy and to assess the efficacy of treatment ofH. pylori infection using lanzoprazole and clarithromycin. Twenty-three patients withH. pylori-associated gastritis were treated with lanzoprazole 30 mg daily for four weeks and clarithromycin 500 mg three times a day for two weeks. Antral mucosal biopsies were taken for gastric epithelial cell proliferation analysis using thein vitro bromodeoxyuridine (BrdU) immunohistochemical technique before and four weeks after eradication therapy. Labeling index percent (LI%) was calculated as the percent ratio of proliferating cells to the total number of cells in the gastric pit. Efficacy of treatment was assessed in 16 subjects. Eight were negative forH. pylori infection 28 days after therapy and in eight patientsH. pylori infection was not eradicated. The eradication rate for the regimen was 50%. Cell kinetics were assessed in 19 subjects who completed treatment. Patients withH. pylori infection had a significantly higher LI% compared to normal (N=19, LI%: 5.01±0.3 vs 3.2±0.2,N=29). Eradication ofH. pylori infection significantly reduced epithelial cell proliferation (N=9, LI%:5.2±0.4 to 3.2 ±0.8,P<0.001), whereas it was unaltered in those whose infection was not eradicated (N=10, LI%: 4.8±0.4 to 5.5±0.5,P=0.18). Eradication ofH. pylori reduces gastric epithelial cell proliferation to normal levels and may reduce the long-term the risk of gastric carcinoma.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Correa P, Haenszel W, Cuello C, Zavala D, Fontham E, Zarama G, Tannenbaum S, Collazos T, Ruiz B: Gastric precancerous process in a high risk population cohort follow-up. Cancer Res 50:4737–4740, 1990

    Google Scholar 

  2. Gilvarry J, Leen E, Sant S, Sweeney E, O'Morain C: The long term effect ofHelicobacter pylori on gastric mucosa. Eur J Gastroenterol Hepatol 6:43–45, 1994

    Google Scholar 

  3. Parsonnet J, Vandersteen D, Goates J, Sibley RK, Pritkin J, Chang Y:Helicobacter pylori and intestinal-and diffuse-type gastric adenocarcinoma. J Natl Cancer Inst 83:640–643, 1991

    Google Scholar 

  4. Guarner J, Mohar A, Parsonnet J, Halperin D: The association ofHelicobacter pylori and gastric cancer and preneoplastic gastric lesions in Chiapas, Mexico. Cancer 71:297–301, 1993

    Google Scholar 

  5. Parsonnet J, Friedman GD, Vandersteen DP, Chang Y, Vogelman JH, Orentreich N, Sibley RK:Helicobacter pylori infection and the risk of gastric carcinoma. N Engl J Med 325:1127–1131, 1991

    Google Scholar 

  6. Forman D, Newell DG, Fullerton F, Yarnell JWG, Stacey AR, Wald N, Sitas F: Association between infection withHelicobacter pylori and risk of gastric cancer: Evidence from a prospective investigation. BMJ 302:1302–1305, 1991

    Google Scholar 

  7. Correa P, Fox J, Fontham E, Fonthem DPH, Ruiz B, Lin Y, Zavala D, Taylor N, Mackinlet D, deLima E, Portilla H, Zarama G:Helicobacter pylori and gastric carcinoma: Serum prevalence in populations with contrasting cancer risks. Cancer 66:2569–2574, 1990

    Google Scholar 

  8. Eurogast Study Group. An international association betweenHelicobacter pylori infection and gastric cancer. Lancet 341:1359–1362, 1993

    Google Scholar 

  9. Deschner EE, Winawer SJ, Lipkin M: Patterns of nucleic acid and protein synthesis in normal gastric mucosa and atrophic gastritis. J Natl Cancer Inst 48:1567–1574, 1972

    Google Scholar 

  10. Cahill RJ, Sant S, Beattie S, Hamilton H,O'Morain C:Helicobacter pylori and increased cell proliferation: A risk factor for cancer. Eur J Gastroenterol Hepatol 6:1123–1127, 1994

    Google Scholar 

  11. Peterson WL, Graham DY, Marshall B, Blaser MJ, Genta RM, Klein PD, Stratton CW, Drnee J, Prokocimer P, Siepman N: Clarithromycin as monotherapy for eradication ofHelicobacter pylori: A randomised, double-blind trial. Am J Gastroenterol 88:1860–1864, 1993

    Google Scholar 

  12. Graham DY, Opekun AR, Klein PD: Clarithromycin for the eradication ofHelicobacter pylori. J Clin Gastroenterol 16:292–294, 1993

    Google Scholar 

  13. Whitehead R, Truelove SC, Gear MWL: The histological diagnosis of chronic gastritis on fibreoptic gastroscope biopsy specimens. J Clin Pathol 25:1–11, 1972

    Google Scholar 

  14. Dixon MF, O'Connor HJ, Axon ATR, King RFJG, Johnston D: Reflux gastritis: Distinct histological entiry. J Clin Pathol 39:524–530, 1986

    Google Scholar 

  15. Taha AS, Nakshabendu I, Lee FD, Sturrock RD, Russell RJ: Chemical gastritis andHelicobacter pylori related gastritis in patients receiving non-steroidal anti-inflammatory drugs—comparison and correlation with peptic ulceration. J Clin Pathol 45:135–139, 1992

    Google Scholar 

  16. Cahill RJ, O'Sullivan KR, Mathias PM, Beattie S, Hamilton H, O'Morain C: Effects of vitamin antioxidant supplementation on cell kinetics of patients with adenomatous polyps. Gut 34:963–967, 1993

    Google Scholar 

  17. Megraud F, Boyanova L, Lamouliatte H: Activity of lansoprazole againstHelicobacter pylori. Lancet 337:1486, 1991

    Google Scholar 

  18. Logan RPH, Gummett PA, Hegarty BT, Walker MM, Baron JH, Misiewicz JJ: Calrithromycin and omeprazole forHelicobacter pylori. Lancet 340:239, 1992

    Google Scholar 

  19. O'Riordan T, Mathai E, Tobin E, McKenna D, Keane C, Sweeney E, O'Morain C: Adjuvant antibiotic therapy in duodenal ulcers treated with colloidal bismuth subcitrate. Gut 31:999–1002, 1990

    Google Scholar 

  20. European Study Group on Antibiotic Susceptibility ofHelicobacter pylori: Results of a multicentre European survey in 1991 of metronidazole resistance inHelicobacter pylori. Eur J Clin Microbiol Infect Dis 11:777–781, 1992

    Google Scholar 

  21. Xia HX, Daw MA, Beattie S, Keane CT, O'Morain CA: Prevalence of metronidazole-resistantHelicobacter pylori in dyspeptic patients. J Med Sci 162:91–94, 1993

    Google Scholar 

  22. Brenes F, Ruiz B, Correa P, Hunter F, Khamakrishnan T, Fontham E, Shi T:Helicobacter pylori causes hyperproliferation of the gastric epithelium: Pre-and post-eradication indices of proliferating cell nuclear antigen. Am J Gastroenterol 88:1870–1875, 1993

    Google Scholar 

  23. Lacy ER, Kuwayama H, Cowart KS, King JS, Deutz AH, Sistrunk S: A rapid accurate immunohistochemical method to label proliferating cells in the digestive tract. A comparison with tritiated thymidine. Gastroenterology 100:259–262, 1991

    Google Scholar 

  24. Risio M, Coverlizza S, Ferrari A, Candelaresi L, Rossini FP: Immunohistochemical study of epithelial cell proliferation in hyperplastic polyps, adenomas, and adenocarcinomas of the large bowel. Gastroenterology 94:899–906, 1988

    Google Scholar 

  25. Roncucci L, Scalmati A, Ponz de Leon M: Pattern of cell kinetics in colorectal mucosa of patients with different types of adenomatous polyps of the large bowel. Cancer 68:873–878, 1991

    Google Scholar 

  26. Bleiberg H, Bussey M, Galand P: Cell kinetic indicators of premalignant stages of colorectal cancer. Cancer 56:124–129 1985

    Google Scholar 

  27. Lipkin M, Correa P, Mikol YB, Higgins PJ, Cuello C, Guillermo Z, Fantham E, Zavala D: Proliferative and antigenic modifications in human epithelial cells in chronic atrophic gastritis. J Natl Cancer Inst 75:613–619, 1985

    Google Scholar 

  28. Brito MJ, Filipe MI, Morris RW: Cell proliferation study on gastric carcinoma and non-involved gastric mucosa using a bromodeoxyuridine (BrdU) labelling index. Eur J Cancer Prev 1:429–435, 1992

    Google Scholar 

  29. Ames BN, Gold LS. Too many rodent carcinogens. Mitogenesis increased mutagensis. Science 249:970–971, 1990

    Google Scholar 

  30. Sobala GM, Crabtree JE, Dixon MF, Schorah CJ, Taylor JD, Rathbone BJ, Heatley RV, Axon ATR: AcuteHelicobacter pylori infection: Clinical features, local and systemic immune response, gastric mucosal histology, and gastric juice ascorbic acid concentrations. Gut 32:1415–1418, 1991

    Google Scholar 

  31. Sobala GM, Schorah CJ, Shires S, Lynch DAF, Gallacher B, Dixon MF, Axon ATR: Effect of eradication ofHelicobacter pylori on gastric juice ascorbic acid concentrations. Gut 34:1038–1041, 1993

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

We wish to thankLederle for their support with this trial.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cahill, R.J., Xia, H., Kilgallen, C. et al. Effect of eradication ofHelicobacter pylori infection on gastric epithelial cell proliferation. Digest Dis Sci 40, 1627–1631 (1995). https://doi.org/10.1007/BF02212681

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02212681

Key Words

Navigation