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Digestive Diseases and Sciences

, Volume 51, Issue 10, pp 1791–1795 | Cite as

Usefulness of Serum Pepsinogens in Helicobacter pylori Chronic Gastritis: Relationship With Inflammation, Activity, and Density of the Bacterium

  • Francesco Di Mario
  • Lucas Giovanni Cavallaro
  • Ali Mahamat Moussa
  • Pietro Caruana
  • Roberta Merli
  • Andrea Maini
  • Simone Bertolini
  • Nadia Dal Bó
  • Massimo Rugge
  • Giulia Martina Cavestro
  • Giovanni Aragona
  • Mario Plebani
  • Angelo Franzé
  • Giorgio Nervi
Original Paper

Abstract

We sought to study the relationship between serum pepsinogens and different histopathologic features of Helicobacter pylori-related chronic gastritis. One hundred forty-nine consecutive dyspeptic patients underwent endoscopy with biopsies; serum pepsinogens I and II were measured by immunoassay. Serum levels of pepsinogens (sPG) were significantly correlated with H. pylori density both of the corpus (sPGI: r = 0.32, P < .001; sPGII: r = 0.56, P < .001) and antrum (sPGI: r = 0.41, P < .001; sPGII: r = 0.43, P < .001) as well as with chronic inflammation (sPGI: r = 0.26, P < .001; sPGII: r = 0.49, P < .001) and activity (sPGI: r = 0.38, P < .001; sPGII: r = 0.50, P < .001) in the antrum. Only sPGII was correlated with chronic inflammation (r = 0.44, P < .001) and activity (r = 0.40, P < .001) in the corpus. SPGI was inversely correlated with atrophy (r = –0.33, P < .001) and intestinal metaplasia (r = –0.37, P < .001) in the corpus. sPGII levels could be considered as markers of gastric inflammation all over in the stomach. sPGI levels are inversely related to atrophic body gastritis.

Keywords

Activity Atrophy Chronic inflammation Helicobacter pylori density Serum pepsinogens 

References

  1. 1.
    Kudo M, Asaka M, Kato M, Katagiri M, Kagaya H, Nishikawa K, Koshiyama T, Hokari K, Meguro T, Takeda H, Yoshida J, Inoue K (1995) Role of Helicobacter pylori in chronic gastritis: a prospective study. J Clin Gastroenterol 2(Suppl 1):S174–S178Google Scholar
  2. 2.
    Yoshida N, Granger DN, Evans DJ Jr, Graham DY, Anderson DC, Wolf RE, Kvietys PR (1993) Mechanisms involved in Helicobacter pylori-induced inflammation. Gastroenterology 105:1431–1440PubMedGoogle Scholar
  3. 3.
    Rugge M, Correa P, Dixon MF, Fiocca R, Hattori T, Lechago J, Leandro G, Price AB, Sipponen P, Solcia E, Watabe H, Genta RM (2002) Gastric mucosal atrophy: interobserver consistency using new criteria for classification and grading. Aliment Pharmacol Ther 16:1249–1259PubMedCrossRefGoogle Scholar
  4. 4.
    Marshall BJ, Goodwin CS, Warren JR, Murray R, Blincow ED, Blackbourn SJ (1998) Prospective double-blind trial of duodenal ulcer relapse after eradication of Campylobacter pylori. Lancet 2:1437–1442Google Scholar
  5. 5.
    Uemura N, Okamoto S, Yamamoto S, Matsumura N, Yamagushi S, Yamakido M, Taniyama K, Sasaki N, Schlemper RJ (2001) Helicobacter pylori infection and the development of gastric cancer. N Engl J Med 345:784–789PubMedCrossRefGoogle Scholar
  6. 6.
    Parsonnet J, Hansen S, Rodriguez L, Gelb AB, Warnke RA, Jellum E, Orentreich N, Vogelman JH, Friedman GD (1994) Helicobacter pylori infection and gastric lymphoma. N Engl J Med 330:1267–1271PubMedCrossRefGoogle Scholar
  7. 7.
    Carpenter HA, Talley N (1995) Gastroscopy is incomplete without biopsy: clinical relevance of distinguishing gastropathy from gastritis. Gastroenterology 108:917–924PubMedCrossRefGoogle Scholar
  8. 8.
    Samloff MI, Varis K, Ihamaki T, Siurala M, Rotter IJ (1982) Relationship among serum pepsinogen I, serum pepsinogen II and gastric mucosal histology. A study of relatives of patients with pernicious anemia. Gastroenterology 83:204–209Google Scholar
  9. 9.
    Di Mario F, Vianello F, Plebani M (1985) Peptic secretion, clinical and pathophysiological features. Padova, PiccinGoogle Scholar
  10. 10.
    Westerveld BD, Pals G, Lamers CB, Defize J, Pronk JC, Frants RR, Ooms EC, Kreuning J, Kostanse PJ, Eriksson AW, et al (1987) Clinical significance of pepsinogen A isozymogens, serum pepsinogen A and C levels, and serum gastrin levels. Cancer 59:952–958PubMedCrossRefGoogle Scholar
  11. 11.
    Kekki M, Samloff IM, Varis K, Ihamàki T (1991) Serum pepsinogens and serum gastrin in screening of severe atrophic corpus gastritis. Scand J Gastroenterol 186:109–116Google Scholar
  12. 12.
    Wagner S, Haruma K, Gladziwa U, Soudah B, Gebel M, Bleck J, Schmidt H, Manns M (1994) Helicobacter pylori infection and serum pepsinogen A, pepsinogen A, and gastrin in gastritis and peptic ulcer: significance of inflammation and effect of bacterial eradication. Am J Gastroenterol 89:211–218Google Scholar
  13. 13.
    Kekki M, Samloff IM, Varis K, Ihamaki T (1991) Serum pepsinogen I and serum gastrin in the screening of severe atrophic corpus gastritis. Scand J Gastroenterol Suppl 186:109–116PubMedGoogle Scholar
  14. 14.
    Price AB (1991) The Sydney system: histological division. J Gastronterol Hepatol 6:209–222Google Scholar
  15. 15.
    Khulusi S, Mendall MA, Patel P, Levy J, Badva S, Northfield TC (1995) Helicobacter pylori infection density and gastric inflammation in duodenal ulcer and non-ulcer subjects. Gut 37:319–324PubMedGoogle Scholar
  16. 16.
    Yamaoka Y, Kita M, Kodama T, Sowai N, Koshima K, Imanishi J (1997) Induction of various cytokines and development of severe mucosal inflammation by cag-A gene-positive Helicobacter pylori strains. Gut 41:442–451PubMedCrossRefGoogle Scholar
  17. 17.
    Yamaoka Y, Kita M, Imanishi J, Kashima K, Graham DY (1999) Relation between clinical presentation, Helicobacter pylori density, interleukin 1β and 8 production, and cag-A status. Gut 45:804–811PubMedCrossRefGoogle Scholar
  18. 18.
    Plebani M, Basso D, Cassaro M, Brigato L, Scrigner M, Toma A, Di Mario F, Rugge M (1996) Helicobacter pylori serology in patients with chronic gastritis. Am J Gastroenterol 91:954–958PubMedGoogle Scholar
  19. 19.
    Plebani M, Basso D, Navaglia F, Di Mario F (1997) Helicobacter pylori genotypes influence serum pepsinogen C levels. Helicobacter 2:172–175PubMedGoogle Scholar
  20. 20.
    Kaji T, Ishihara S, Ashizawa N, Hamamoto N, Endo H, Fukuda R, Adachi K, Watanabe M, Nakao M, Kinoshita Y (2002) Adherence of Helicobacter pylori to gastric epithelial cells and mucosal inflammation. J Lab Med 139:244–250CrossRefGoogle Scholar
  21. 21.
    Plebani M, Basso D, Scrigner M, Toma A, Di Mario F, Dal Bò N, Samloff IM (1996) Serum pepsinogen C: an useful marker of Helicobacter pylori eradication? J Clin Lab Analysis 10:1–5CrossRefGoogle Scholar
  22. 22.
    Chittajallu RS, Dorrian CA, Ardill JE, McColl KE (1992) Effect of Helicobacter pylori on serum pepsinogen I and plasma gastrin in duodenal ulcer patients. Scand J Gastroenterol 27:20–24PubMedGoogle Scholar
  23. 23.
    Lorente S, Doiz O, Trinidad Serrano M, Castillo J, Lanas A (2002) Helicobacter pylori stimulates pepsinogen secretion from isolated human peptic cells. Gut 50:13–18PubMedCrossRefGoogle Scholar
  24. 24.
    Bodger K, Wyatt JI, Heatley RV (2001) Variation in serum pepsinogens with severity and topography of helicobacter pylori-associated chronic gastritis in dyspeptic patients referred for endoscopy. Helicobacter 6:216–224PubMedCrossRefGoogle Scholar
  25. 25.
    Graham DY, Go MF, Lew GM, Genta RM, Rehfeld JF (1993) Helicobacter pylori infection and exaggerated gastrin release: effects of inflammation and progastrin processing. Scand J Gastroenterol 28:690–694PubMedGoogle Scholar
  26. 26.
    El Omar EM, Penman ID, Ardill JE, Chittajallu RS, Howie C, McColl KE (1995) Helicobacter pylori infection and abnormalities of acid secretion in patients with duodenal ulcer disease. Gastroenterology 109:681–691PubMedCrossRefGoogle Scholar
  27. 27.
    Kuipers EJ, Uyterlinde AM, Pena AS, Roosendaal R, Pals G, Nelis GF, Festen HP, Meuwissen SG (1995) Long term sequelae of Helicobacter pylori gastritis. Lancet 345:1525–1528PubMedCrossRefGoogle Scholar
  28. 28.
    Sanduleanu S, Bruine ADE, Biemond I, Stridsberg M, Jonkers D, Lundqvist G et al (2003) Ratio between serum IL-8 and pepsinogen A/C: a marker for atrophic body gastritis. Eur J Clin Invest 33:147–154PubMedCrossRefGoogle Scholar
  29. 29.
    Rohrer GV, Welsh JD (1967) Correlative study: gastric secretion and histology. Gastroenterology 52:185–191PubMedGoogle Scholar
  30. 30.
    El-Omar EM, Oien K, El-Nujumi A, Gillen D, Wirz A, Dahill S, Williams C, Ardill JE, McColl KE (1997) Helicobacter pylori infection and chronic gastritis hyposecretion. Gastroenterology 113:15–24PubMedCrossRefGoogle Scholar
  31. 31.
    Gutierrez O, Melo M, Segura AM, Angel A, Genta RM, Graham DY (1997) Cure of Helicobacter pylori infection improves gastric acid secretion in patients with corpus gastritis. Scand J Gastroenterol 32:664–668PubMedCrossRefGoogle Scholar
  32. 32.
    Wallace JL, Cucala M, Mugridge K, Parente L (1991) Secretagogue-specific effects of interleukin 1 on gastric secretion. Am J Physiol 261:G559–G564PubMedGoogle Scholar
  33. 33.
    Furuta T, Baba S, Takashima M, Futami H, Arai H, Kajimura M, Hanai H, Kaneko E (1998) Effect of Helicobacter pylori infection on gastric Juice pH. Scand J Gastroenterol 33:357–363PubMedCrossRefGoogle Scholar
  34. 34.
    Furuta T, El-Omar EM, Fang X, Shirai N, Takashima M, Sugimurra H (2002) Interleukin 1-β polymorphisms increase risk of hypochlorhydria and atrophic gastritis and reduce risk of duodenal ulcer recurrence in Japan. Gastroenterology 123:92–105PubMedCrossRefGoogle Scholar
  35. 35.
    Sipponen P, Ranta P, Helske T, Kaariainen I, Maki T, Linnala A, Suovaniemi O, Alanko A, Harkonen M (2002) Serum levels of Amidaded Gastrin-17 and pepsinogen I in atrophic gastritis: An observational case-control study. Scand J Gastroenterol 37:785–791PubMedGoogle Scholar
  36. 36.
    Vaananen H, Vauhkonen M, Helske T, Kaariainen I, Rausmussen M, Tunturi-Hihnala H, Koskenpato J, Sotka M (2003) Non endoscopic diagnosis of atrophic gastritis with a blood test. Correlation between gastric histology and serum levels of gastrin-17 and pepsinogen I: a multicentre study. Scand J Gastroenterol 15:885–891Google Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Francesco Di Mario
    • 1
  • Lucas Giovanni Cavallaro
    • 1
  • Ali Mahamat Moussa
    • 1
  • Pietro Caruana
    • 2
  • Roberta Merli
    • 1
  • Andrea Maini
    • 1
  • Simone Bertolini
    • 1
  • Nadia Dal Bó
    • 3
  • Massimo Rugge
    • 4
  • Giulia Martina Cavestro
    • 1
  • Giovanni Aragona
    • 1
  • Mario Plebani
    • 1
    • 5
  • Angelo Franzé
    • 6
  • Giorgio Nervi
    • 6
  1. 1.Chair of Gastroenterology, Department of Clinical SciencesUniversity of ParmaParmaItaly
  2. 2.Pathologic InstituteUniversity of ParmaParmaItaly
  3. 3.Gastroenterology UnitHospital of TrevisoTrevisoItaly
  4. 4.Department of PathologyUniversity Hospital of PadovaPadovaItaly
  5. 5.Department of Laboratory Medicine, Laboratory MedicineUniversity Hospital of PadovaPadovaItaly
  6. 6.Gastroenterology UnitHospital of ParmaParmaItaly

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