Biomarkers in Various Types of Atrophic Gastritis and Their Diagnostic Usefulness

Abstract

Atrophic gastritis has been shown to involve either the oxyntic gland area, resulting in hypergastrinemia and hypopepsinogenemia I, the antral gland area, causing hypogastrinemia without change in serum pepsinogen I (diffuse antral gastritis; DAG), or the entire gastric mucosa (multifocal atrophic gastritis; MAG), resulting in both hypogastrinemia and hypopepsinogenemia I; and rare atrophic gastritis limited to the oxyntic gland area, with antibodies against oxyntic cells and/or intrinsic factor (autoimmune metaplastic atrophic gastritis; AMAG). This study was performed on 126 patients with various forms of gastritis and on 126 age- and gender-matched controls, who were subjected to endoscopy with biopsy, H. pylori testing (13C-UBT, serology), assays for serum gastrin and pepsinogen I, and testing for basal and pentagastrin-induced gastric acid secretion. The following groups of patients were examined: group I (N = 22), with AMAG; group II (N = 53), with DAG; group III (N = 51), with MAG; and group IV (N = 126), age- and gender-matched controls without gastritis. The following changes were found. In group I very high serum gastrin and very low pepsinogen I were observed, and all patients were achlorhydric and H. pylori negative. In group II, with low serum gastrin and normal pepsinogenemia and gastric chlorhydria, all patients were H. pylori positive. In group III, with lower serum gastrin and lower pepsinogen I levels and reduced chlorhydria, all patients were also H. pylori positive. And all group IV controls, with normal serum gastrin and pepsinogen I and normal gastric acid secretion without antral or fundic gastritis, were H. pylori negative. We conclude that measurements of serum gastrin and pepsinogen I and gastric acid secretion as well as testing for H. pylori infection may be useful in noninvasive diagnosis of various types of atrophic gastritis and in identification of patients with premalignant gastritis and a high risk of gastric cancerogenesis.

Reduced Pepsin A Processing of Sonic Hedgehog in Parietal Cells Precedes Gastric Atrophy and Transformation

“…The current study presents new insight into the mechanism resulting in decreased PgA expression and the risk of gastric cancer (3)(4)(5)(6). Specifically, loss of PgA correlates with gastric atrophy, i.e.…”

“…Prior to the development of dysplasia, the gastric mucosa is typically atrophic in which the acid-producing parietal cells are drastically reduced or absent (2). In human subjects, the presence of an atrophic stomach can be confirmed by documenting a loss of gastric acidity or serologically by measuring the pepsinogen (Pg) A to C ratio (3)(4)(5)(6). It has been suggested that the presence of gastric atrophy is a reliable indicator of pre-neoplastic changes in the stomach (2).…”

Implications of Oral Helicobacter pylori for the Outcome of its Gastric Eradication Therapy

“…16,[24][25][26] Initially, 2 baseline breath air samples were obtained for assessment of basal urease activity. Next, gelatin capsules containing 38 mg of 13 C-urea was swallowed with 25 mL of water.…”

“…The gastrin was measured by radioimmunoassay as described previously using the antiserum, recognizing equally a-amidated G-17 and G-34 (the antiserum was kindly donated by Professor J. Rehfeld, Copenhagen, Denmark) and used for several decades in our laboratory at final dilution of 1:500000. 25 Pepsinogen I (PgI) was also determined by ELISA using kits kindly provided by BIOHIT Diagnostic, Laipattie, Finland as a marker of atrophy of oxyntic gland area as described before. 25 Plasma ghrelin was also measured by specific radioimmunoassay using commercially available kits purchased from Peninsula Lab Inc, CA as described previously.…”

Immune Homeostasis of Human Gastric Mucosa in Helicobacter pylori Infection

“…The observed age dependence of the pathology and infection of the gastric mucosa (>60% cancers occur in people above 65) indicates that HbP can be a cause of carcinogenesis induction [13]. It is known that cancer can involve the cardia (upper portion of the stomach), fundus, or pylorus.…”