Helicobacter pylori eradication therapy modulates acidity and interleukin-1β mRNA levels in un-operated stomach and in remnant stomach after gastrectomy in gastric cancer patients

Summary

Background

A number of studies have indicated that Helicobacter pylori eradication therapy helps prevent secondary cancers in the stomach.

Aim

To investigate the risk of secondary cancer in the residual stomach after gastrectomy by comparing molecular biomarkers from stomach mucosa biopsies and the pH of gastric juice between H. pylori patients with and without gastrectomy.

Methods

Conventional H. pylori eradication therapy was administered to 22 patients who had undergone gastrectomy and to 37 un-operated patients. We measured pH levels of gastric juice, and collected stomach mucosa biopsy specimens by gastrointestinal fiberscopy. The mRNA expression levels of interleukin-1β, interleukin-8 and cyclo-oxygenase 2 in the biopsy tissues were measured by real-time polymerase chain reaction.

Results

Interleukin-1β levels in the antrum of un-operated H. pylori-positive patients showed a reverse correlation with pH levels in the gastric lumen (correlation coefficient: −0.50, P = 0.007). After eradication, pH levels were strongly associated with interleukin-1β mRNA levels, r = 0.83, P = 0.01, which, in the remnant stomach mucosa, decreased from 22.5 to 4.6 in the anastomosis and from 3.1 to 2.4 in the upper corpus, with a simultaneous and statistically significant decrease in pH.

Conclusions

Interleukin-1β mRNA levels correlated with pH levels in the remnant stomach. This indicates that eradication therapy may contribute not only to a reduction in these cancer-associated cytokines, but also to an improvement in the internal environment of the remnant stomach.