Brief Article
Copyright ©2010 Baishideng. All rights reserved.
World J Gastroenterol. Jan 7, 2010; 16(1): 83-88
Published online Jan 7, 2010. doi: 10.3748/wjg.v16.i1.83
Association of autoimmune type atrophic corpus gastritis with Helicobacter pylori infection
Lea Irene Veijola, Aino Mirjam Oksanen, Pentti Ilmari Sipponen, Hilpi Iris Kaarina Rautelin
Lea Irene Veijola, Aino Mirjam Oksanen, Herttoniemi Hospital, City of Helsinki, Kettutie 8, 00800 Helsinki, Finland
Lea Irene Veijola, Hilpi Iris Kaarina Rautelin, Department of Bacteriology and Immunology, Haartman Institute, University of Helsinki, Haartmanink. 3, 00014 Helsinki, Finland
Pentti Ilmari Sipponen, Repolar Oy, Box 26, 02101 Espoo, Finland
Hilpi Iris Kaarina Rautelin, HUSLAB, Helsinki University Central Hospital Laboratory, Haartmanink 3, 00014 Helsinki, Finland; Department of Medical Sciences, University of Uppsala, Dag Hammarskjölds väg 17, SE-75185 Uppsala, Sweden
Author contributions: Veijola LI, Rautelin HIK and Oksanen AM planned the study; Veijola LI and Oksanen AM interviewed and examined the patients, and performed the gastroscopies; Sipponen PI examined the histology of the biopsy materials; Veijola LI analyzed the data; Veijola LI and Rautelin HIK wrote the article; all authors participated in the revision of the manuscript.
Correspondence to: Lea Irene Veijola, MD, PhD, Herttoniemi Hospital, City of Helsinki, Kettutie 8, 00800 Helsinki, Finland.
Telephone: +358-9-3105511 Fax: +358-9-19126382
Received: September 27, 2009
Revised: November 16, 2009
Accepted: November 23, 2009
Published online: January 7, 2010

AIM: To study the association between Helicobacter pylori (H. pylori) infection and autoimmune type atrophic gastritis.

METHODS: Twenty-three patients with different grades of atrophic gastritis were analysed using enzyme immunoassay-based serology, immunoblot-based serology, and histology to reveal a past or a present H. pylori infection. In addition, serum markers for gastric atrophy (pepsinogen I, pepsinogen I/II and gastrin) and autoimmunity [parietal cell antibodies (PCA), and intrinsic factor (IF), antibodies] were determined.

RESULTS: Of the 14 patients with severe gastric atrophy, as demonstrated by histology and serum markers, and no evidence for an ongoing H. pylori infection, eight showed H. pylori antibodies by immunoblotting. All eight had elevated PCA and 4/8 also had IF antibodies. Of the six immunoblot-negative patients with severe corpus atrophy, PCA and IF antibodies were detected in four. Among the patients with low to moderate grade atrophic gastritis (all except one with an ongoing H. pylori infection), serum markers for gastric atrophy and autoimmunity were seldom detected. However, one H. pylori negative patient with mild atrophic gastritis had PCA and IF antibodies suggestive of a pre-atrophic autoimmune gastritis.

CONCLUSION: Signs of H. pylori infection in autoimmune gastritis, and positive autoimmune serum markers in H. pylori gastritis suggest an etiological role for H. pylori in autoimmune gastritis.

Keywords: Helicobacter pylori, Autoimmune gastritis, Gastric atrophy, Vitamin B12 deficiency