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

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

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

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

Substances

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