Improvement of gastric inflammation and resolution of epithelial damage one year after eradication of Helicobacter pylori.

Abstract

Aims-To investigate the effect of eradication of Helicobacter pylori infection on gastric epithelial damage and gastritis, scored according to the Sydney system. Methods-Gastritis scores and epithelial damage were assessed in gastric biopsy specimens before, and five weeks and one year after anti-H pylori therapy in 66 patients with H pylon related gastritis. Results-The mean initial levels of activity, inflammation, atrophy, intestinal metaplasia, and H pylon scores were higher in the antrum than in the corpus or fundus. Eradication ofHpyloni resulted in an improvement in the mean inflanumatory score in antral biopsy specimens from 2-23 before treatment to 1*32 and 1-06, respectively, five weeks and one year after treatment. Corresponding values for fundic biopsy specimens were 1*30, 036 and 0-35. Activity scores improved from 1P41 before treatment to 0-13 and zero, respectively, five weeks and one year after treatment in antral biopsy specimens and from 0-60 before treatment to zero in fundic biopsy specimens. Before treatment, epithelial damage was present in 51% of biopsy specimens taken from the antrum and 23% of those from the corpus. Five weeks after eradication of H pyloni none of the biopsy specimens revealed evidence of epithelial damage. Conclusion-Eradication ofHpylon is followed by a rapid, significant improvement in the gastritis score and resolution of epithelial damage in antral and fundic mucosa.(J7 Clin Pathol 1995;48:250-256)

Histopathological analysis of chronic gastritis and correlation of pathological features with each other and with endoscopic findings

“…There was no correlation between chronic inflammation and intestinal metaplasia and glandular atrophy. This was also seen by Witteman et al [12]. Again presence of neutrophils meant a higher density of H. pylori, chronic inflammatory infiltrate, more surface epithelial damage and lymphoid follicles.…”

“…Chronic inflammatory infiltrates were present in all the cases with the majority (70%) having only mild inflammation while 27% had moderate inflammation. A study done by Witteman et al [12] observed chronic infiltrate in all biopsies but the majority had moderate inflammation. In 33% of our cases, an activity was seen, which is in accordance with a study published by Misra et al [13].…”

Effects of Helicobacter pylori Infection on the Histology, Cellular Phenotype, K-ras Mutations, and Cell Kinetics in Gastric Intestinal Metaplasia in Patients with Chronic Gastritis and Gastric Cancer

“…H. pylori eradication dramatically improved the inflammation scores, i.e. neutrophils and mononuclear cells, but not the degree of GIM, thus confirming the findings of previous studies in which the effect of H. pylori eradication therapy led to an improvement in the severity of inflammation (Witteman et al, 1995;van der Hulst et al, 1997). However, no significant improvement in the inflammation scores was found in patients with gastric cancer (Group DYS).…”

“…Although there are many reports regarding the histological changes including metaplasia and dysplasia following eradication of H. pylori, the results have been conflicting (Table 1) Table 1. Summary of studies on changes of GIM scores after successful H. pylori eradication Some reported that the histologic grade of GIM had improved after eradication (Genta et al, 1993;Uemura et al, 1997;Nardone et al, 1999;Sung et al, 2000;Ohkusa et al, 2001;Kokkola et al, 2002;Correa et al, 2000;Ley et al, 2004;Mera et al, 2005;You et al, 2006) but the others did not find any change (Witteman et al, 1995;Forbes et al, 1996;van der Hulst et al, 1997;Hibi et al, 1997;Satoh et al, 1998;Tucci A et al, 1998;Tepes et al, 1999;El-Omar et al, 2000 ;Kim et al, 2000 ;Kuipers et al, 2004 ;Tanaka et al, 2006). Some of the reasons for these discrepancies may be ethnic variations, completeness of eradication of the disease and the stage of the disease when treatment is initiated and short follow-up (most studies up to 1 year) (Kokkola et al, 2002;Forbes et al, 1996;Tucci A et al, 1998;Tepes et al, 1999;Kim et al, 2000;Tanaka et al, 2006).…”

Molecular Epidemiology of Helicobacter pylori in Brazilian Patients with Early Gastric Cancer and a Review to Understand the Prognosis of the Disease

“…In the same way, other randomized studies identified that H. pylori eradication in intestinal metaplasia could be important in the regression of this precancerous lesion [76,[109][110][111]119,120]. Oppositely, other trials, both follow-up and randomized control, had not identified regression of intestinal metaplasia when H. pylori eradication was administrated [121][122][123][124][125][126][127][128][129].…”