Adherence of Helicobacter pylori to the gastric epithelium is believed to be an important step in the induction of active
inflammation of the mucosal layer. However, structural evidence showing a quantitative relationship between the adherence of H. pylori and severity of gastric mucosal
inflammation is lacking. We therefore investigated the correlations between severity of
gastritis and adherence of morphologically different forms of H. pylori. Fifty-seven biopsy specimens from the gastric bodies of patients with H. pylori-induced
gastritis were examined. The severity of
gastritis and the adherence and structure of H. pylori were determined with the use of light and scanning electron microscopy. We also investigated the ability of H. pylori organisms with different structural features to induce
interleukin-8 secretion by human gastric
adenocarcinoma (AGS) cells in vitro because production of
interleukin-8 is related to H. pylori-associated
gastritis. Furthermore, serum
pepsinogen concentrations and
cytotoxin-associated
protein status in relation to adherence of H. pylori to the epithelial surface were examined. The results indicated that H. pylori organisms, which adhered firmly to the epithelial surface, were consistently long, tightly coiled bacilli. Histologically, those gastric mucosa samples with H. pylori firmly attached showed severe
gastritis. H. pylori bacilli of greater length induced higher levels of
interleukin-8 secretion. The serum
pepsinogen I/II ratio showed a significant negative correlation with the grade of H. pylori adhesion (r = -0.401, P <.01). We also noted a significant correlation between
cytotoxin-associated
protein status and the adherence of H. pylori (r = 0.344, P <.05). A quantitative correlation was found between adherence of H. pylori and gastric
inflammation. Both adherence and the induction of
inflammation were found to be related to the structure of H. pylori.