Etiologic Role of Helicobacter pylori in the Pathogenesis of Histological Chronic Gastritis
조직학적 만성위염의 병인으로서 Heliocbacter pylori의 역할

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Jung, Hyun-Chae; Kim, Woo-Ho; Song, In-Sung; Kim, Chung-Yong
Issue Date
Seoul National University College of Medicine
Seoul J Med 1990;31(4):231-246
Helicobacter pyloriHistological chronic gastritisAcid glycine extract antigenELISAImmunonoblotNegligible antigen-antibody reaction
The aims of this study were 1) to investigate the prevalence rate of H.pyloriassociated
chronic gastritis in patients with non-ulcer dyspepsia (NUD), 2) to observe
the effect of eradication of H.pylori on the improvement in histological findings of chronic
gastritis, 3) to detect and measure the specific antibody to H.pylori in patients'
sera with ELISA, and 4) finally to study the immune response of serum IgG against
H.pylori according to the severity of histological gastritis with immunoblot. Out of total
77 patients, 54 had H.pylori in their gastric antral mucosa. 48 had moderate-to-severe
chronic gastritis, and the remaining 6 had normal-to-mild. In contrast, out of 23 patients
without H.pylori, 17 had normal-to-mild chronic gastritis. and only 6 had moderateto-
severe. After treatment with colloidal bismuth subcitrate (CBS) alone or CBS and
amoxicillin, H.pylori cleared up in 61.5% and 83.3% of the patients, respectively. In
the placebo group, however, not a single case lost H.pylori. When H.pylori was successfully
eradicated. improvement in histological gastritis was found in 88.8%. while it was
30% when not eradicated (P(0.002) in repeated biopsies. The detection rate of antiH.
pylori by ELISA in patients with H.pylori was significantly higher (90.7%) than in
patients without H.pylori (21.7%) (P(0.001). Moreover, the levels of IgG antibody in
patients with H.pylori were significantly different between the patients with normal-tomild
(median:0.52) and those with moderate-to-severe gastritis (median: 1.28) (P(0.005).
Major protein bands of acid glycine extract of H.pylori on SDS-PAGE were 62 kD,
33 kD. 25 kD. 20 kD. and 14 kD, while protein bands reacting with patient's sera
were 62 kl). 33 kD, and 14 kD. Sera from patients with H.pylori and severe gastritis
commonly reacted with 62 kl), 33 kD, and 14 kD antigen. However. sera from patients
with H.pylori and normal-to-mild gastritis showed a faint band with only 62 kD.
In conclusion. it was strongly suggested that H.pylori playa causative role in the
pathogenesis of histological chronic gastritis. ELISA in this study using acid glycine
extract of H.pylori may be useful in the diagnosis of H.pylori-associated histologically
moderate-to-severe gastritis. In some cases. H.pylori was detected from normal gastric
mucosa, where negligible antigen-antibody reaction between serum IgG and H.pylori
was identified by immunoblot.
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Medicine (의학과)The Seoul Journal of MedicineThe Seoul Journal of Medicine Vol. 31 No.4 (1990)
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