Changes in gastrin and serum pepsinogens in monitoring of Helicobacter pylori response to therapy

The aims of this study in 50 patients with H. pylori infection and duodenal ulcer were to examine the effect of eradication therapy on the serum levels of gastrin, pepsinogen I, and pepsinogen II and to investigate whether monitoring of the serum changes in these peptides after treatment could predi...

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Bibliographic Details
Published in:Digestive diseases and sciences 1997-08, Vol.42 (8), p.1734-1740
Main Authors: PEREZ-PARAMO, M, ALBILLOS, A, CALLEJA, J. L, SALAS, C, DEL CARMEN MARIN, M, MARCOS, M. L, CACHO, G, ESCARTIN, P, ORTIZ-BERROCAL, J
Format: Article
Language:English
Subjects:
Adult
Aged
Bacterial diseases
Bacterial diseases of the digestive system and abdomen
Biological and medical sciences
Breath Tests
Duodenal Ulcer - complications
Duodenal Ulcer - diagnosis
Duodenal Ulcer - drug therapy
Duodenal Ulcer - microbiology
Female
Gastrins - blood
Gastritis - diagnosis
Gastritis - drug therapy
Gastritis - microbiology
Helicobacter Infections - complications
Helicobacter Infections - diagnosis
Helicobacter Infections - drug therapy
Helicobacter Infections - microbiology
Helicobacter pylori - isolation & purification
Human bacterial diseases
Humans
Infectious diseases
Male
Medical sciences
Middle Aged
Pepsinogens - blood
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Summary:The aims of this study in 50 patients with H. pylori infection and duodenal ulcer were to examine the effect of eradication therapy on the serum levels of gastrin, pepsinogen I, and pepsinogen II and to investigate whether monitoring of the serum changes in these peptides after treatment could predict patient outcome. H. pylori status was assessed at entry and one and six months after therapy by culturing and microscopic analysis of the gastric mucosa and by [14C]urea breath test. Significant decreases were observed in the serum levels of gastrin (-11.4 +/- 3%), pepsinogen I (-28.9 +/- 4%), and pepsinogen II (-40.4 +/- 3%) in the 45 patients whose infection was eradicated, but not in the patients without eradication. Serum values of these peptides were unchanged in an additional group of 10 patients that only received omeprazol, none of whom had H. pylori eradicated. The best cutoff point of the percentage of each peptide to predict patient outcome was 10% for gastrin and pepsinogen I, and 15% for pepsinogen II. A pepsinogen II decrease > 15% resulted in the best marker of H. pylori clearance, accurately identifying patient outcome 86.6% of the time, whereas the diagnostic accuracy of gastrin and pepsinogen I was 61.7% and 76.6%, respectively. Significant correlations were found between the bacterial load assessed by histology with the serum concentrations of pepsinogen I and II and with the urease activity as measured by the amount of 14CO2 excreted. In conclusion, eradication of H. pylori infection is followed by a significant drop in serum levels of gastrin, pepsinogen I, and pepsinogen II. Changes in the latter are the most uniform and may be used as an indirect tool to predict treatment outcome.
ISSN:0163-2116
1573-2568
DOI:10.1023/A:1018873717985