Al-Marhoon, M.S.; Nunn, S.; Denyer, M.E.; Kelly, S.M.; Rielly, A.; Soames, R.W.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA79
Academic Journal
Background and Aims: Infection with cytotoxin associated gene A cagA) H pylori is associated with increased risk of distal gastric cancer. There are contradictory opinions concerning the effect of H pylori on the gastric mucus layer thickness. The present study explores whether cagA positive (cagA+) H pylori increases gastric mucus layer thickness. Methods: Fifty patients, not on acid suppressive drugs, NSAIDs, or with gastric ulcer or cancer, were recruited from endoscopy clinics. Six biopsies were obtained from each patient. 18 pm thick cryostat sections were cut and stained using the modified Periodic Acid Schiff/ AIcian Blue technique. Mucus thickness measurements were made using light microscopy and computer software. H pylori diagnosis was based on histology, CLOtest, and culture, whereas cagA strain was determined by PCR. Results: There were 18 (36%) H pylori positive (HP+) and 32 (64%) H pylori negative (HP-) patients with mean (±SD) mucus thickness of 68.2 ± 36.9 µm and 77.7±54.8 pm, respectively. In the HP+ group 5 were cagA+ and 11 cagA-, with a mean mucus thickness of 93.7 ± 61.0 pm and 53.8 ± 14.8 µm, respectively. There was no significant difference in mucus thickness between cagA+ and HP-controls (p = 0.63 Mann-Whitney U test). Age and sex matching between the HP+ and HP-groups revealed no difference in mucus thickness or between cagA+ and cagA-(p = 0.46), however in patients younger than age 50 a significant difference in mucus thickness between cagA+ (101.3 ± 18.9 pm) and cagA-(54.3 ± 9.5 pm) was observed (p < 0.05). Excluding older age and atrophy from the analysis showed no difference in mucus thickness between cagA+ and cagA-groups. Conclusions: In H pylori infected patients less than 50 years old those with cagA+ strains have a significantly greater mean gastric mucus layer thickness than those with cagA-, suggesting that cagA+ strains may be more virulent as they are protected by...


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