Role of apoptosis induced by Helicobacter pylori infection in the development of duodenal ulcer

• Published in: Gut Vol. 44; no. 4; pp. 456 - 462
• Main Authors: Kohda, K, Tanaka, K, Aiba, Y, Yasuda, M, Miwa, T, Koga, Y
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Society of Gastroenterology 01-04-1999; BMJ; BMJ Publishing Group LTD
• Subjects: Acids; Adolescent; Adult; Aged; Apoptosis; Apoptosis - physiology; Biological and medical sciences; Biopsy; Cell cycle; Disease; duodenal ulcer; Duodenal Ulcer - microbiology; Duodenal Ulcer - pathology; Endoscopy; Female; gastric ulcer; Gastroenterology. Liver. Pancreas. Abdomen; Helicobacter Infections - pathology; Helicobacter Pylori; Helicobacter pylori - enzymology; Helicobacter pylori - physiology; Humans; Hypotheses; Infections; Male; Medical sciences; Middle Aged; Other diseases. Semiology; Physiology; Pyloric Antrum - microbiology; Pyloric Antrum - pathology; Stomach Ulcer - microbiology; Stomach Ulcer - pathology; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Ulcers; urease; Urease - physiology; Human; Spirillales; Duodenum; Pathogenesis; Spirillaceae; Gastritis; Infection; Antrum pyloricum; Helicobacter pylori; Cell death; Bacteriosis; Digestive diseases; Bacteria; Intestinal disease; Complication; Ulcer; Comparative study; Gastric disease; Apoptosis
• ISSN: 0017-5749; 1468-3288; 1458-3288
• DOI: 10.1136/gut.44.4.456

BACKGROUND Helicobacter pylori affects gastric epithelium integrity by acceleration of apoptosis. However, it remains unclear what product of the bacteria causes apoptosis, or whether or not the apoptosis is involved in the development of ulcers. AIMS To elucidate the factor from H pylori that causes acceleration of apoptosis and the role of apoptosis in the development of duodenal ulcer in H pylori infection. PATIENTS FiveH pylori negative healthy volunteers, 47H pylori positive patients with duodenal ulcer, and 35 H pylori positive patients with gastric ulcer. METHODS An endoscopic examination was carried out to diagnose ulcers and determine their clinical stage. To analyse apoptosis, a cell cycle analysis was performed using biopsy specimens. RESULTS There was a significant correlation between the urease activity of theH pylori strain and the level of apoptosis induced by this bacterial strain. Moreover, in duodenal ulcer patients infected with H pylori, the patients with an active ulcer exhibited a significantly higher level of apoptosis than those with ulcers at both the healing and scarring stages. CONCLUSION These findings suggest that acceleration of apoptosis in the antral mucosa caused by the urease of H pylori plays a crucial role in the development of ulcers in the duodenum.