Pepsinogen testing for evaluation of the success of Helicobacter pylori eradication at 4 weeks after completion of therapy.

Abstract

BACKGROUND AND OBJECTIVE:

Pepsinogen levels in plasma are increased by inflammation in the gastric mucosa, including inflammation resulting from Helicobacter pylori infection. A decrease in pepsinogen II level has been suggested as a reliable marker to confirm the successful eradication of infection. The aim of our study was to evaluate the potential role of pepsinogens I and II, gastrin-17 and H. pylori antibodies in confirming successful eradication.

MATERIAL AND METHODS:

Altogether 42 patients (25 women, 17 men), mean age 45 years (range 23-74), were enrolled. Pepsinogens I and II, gastrin-17 and H. pylori IgG antibodies were measured in plasma samples using an ELISA test (Biohit, Oyj., Finland) before the eradication and 4 weeks after completing the treatment. The success of eradication was determined by a urea breath test.

RESULTS:

Eradication was successful in 31 patients (74%) and unsuccessful in 11 patients (26%). Pepsinogen II decreased significantly in both the successful (P=0.029) and unsuccessful (P=0.042) eradication groups. Pepsinogen I decreased significantly in the successful (P=0.025) but not the unsuccessful (P=0.29) eradication group. The pepsinogen I/II ratio increased in the successful eradication group (P=0.0018) but not in the group in which treatment failed (P=0.12). There were no differences in gastrin-17 or H. pylori antibody values.

CONCLUSIONS:

A decrease in pepsinogen II levels cannot be used as a reliable marker for the successful eradication of H. pylori 4 weeks after the completion of treatment. The increase in pepsinogen I/II ratio reflects differences in pepsinogen production following the eradication irrespective of improvement in atrophy.

• Authors: Marcis Leja, Sanita Lapina, Inese Polaka, Dace Rudzite, Ilona Vilkoite, Ilva Daugule, Anna Belkovets, Sergey Pimanov, Jelena Makarenko, Ivars Tolmanis, Aivars Lejnieks, Viesturs Boka, Ingrida Rumba-Rozenfelde, Uldis Vikmanis
• Journal: Medicina (Kaunas, Lithuania) (Medicina (Kaunas)) Vol. 50 Issue 1 Pg. 8-13 ( 2014) ISSN: 1648-9144 [Electronic] Switzerland
• PMID: 25060199 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

Chemical References

• Antibodies, Bacterial
• Biomarkers
• Gastrins
• gastrin 17
• Pepsinogen C
• Pepsinogen A

Topics

• Adult
• Aged
• Antibodies, Bacterial (blood)
• Biomarkers (blood)
• Female
• Gastric Mucosa (microbiology)
• Gastrins (blood)
• Helicobacter Infections (blood, diagnosis, drug therapy)
• Helicobacter pylori (immunology, isolation & purification)
• Humans
• Male
• Middle Aged
• Pepsinogen A (blood)
• Pepsinogen C (blood)
• Treatment Outcome
• Young Adult