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Medicina (Kaunas). 2014;50(1):8-13. doi: 10.1016/j.medici.2014.05.001. Epub 2014 Jun 5.

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

Author information

1
Faculty of Medicine, University of Latvia, Riga, Latvia; Riga East University Hospital, Riga, Latvia; Digestive Diseases Centre GASTRO, Riga, Latvia. Electronic address: cei@latnet.lv.
2
Faculty of Medicine, University of Latvia, Riga, Latvia; Riga East University Hospital, Riga, Latvia.
3
Department of Modelling and Simulation, Riga Technical University, Riga, Latvia.
4
Faculty of Medicine, University of Latvia, Riga, Latvia.
5
Faculty of Medicine, University of Latvia, Riga, Latvia; Institute of Internal Medicine, Siberian Branch, Russian Academy of Medical Sciences, Novosibirsk, Russia.
6
Department of Therapy No. 2, Vitebsk State Medical University, Vitebsk, Belarus.
7
Digestive Diseases Centre GASTRO, Riga, Latvia.
8
Faculty of Medicine, University of Latvia, Riga, Latvia; Riga East University Hospital, Riga, Latvia; Riga Stradins University, Riga, Latvia.

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.

KEYWORDS:

Efficacy; Eradication; Gastrin-17; Helicobacter pylori; Pepsinogen

PMID:
25060199
DOI:
10.1016/j.medici.2014.05.001
[Indexed for MEDLINE]
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