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Helicobacter pylori infection and gastric juice vitamin C levels

Impact of eradication

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Abstract

H. pylori has recently been recognized as a novel risk factor of gastric cancer, but its precise role in gastric carcinogenesis is as yet unknown. The aim of the present study was to assess the relationship betweenH. pylori infection and vitamin C levels in gastric juice and also to examine whether eradication ofH. pylori could have any impact on these levels. Gastric juice and plasma vitamin C levels were measured in 88 dyspeptic patients who had an upper gastrointestinal endoscopy. In the subgroup ofH. pylori-positive patients, eradication was attempted with triple therapy. This subgroup was studied on two occasions, ie, before and after treatment. There were 58H. pylori-positive and 30 -negative patients. Gastric juice vitamin C levels inH. pylori-positive patients were statistically lower (P<0.001) than the levels in theH. pylori-negative patients. Triple therapy achieved eradication in 45 patients (77.6%) of the 58H. pylori-positive patients. BeforeH. pylori was eradicated in these 45 patients gastric juice vitamin C levels were significantly (P<0.001) lower than those after eradication, the latter being no different than the group of 30H. pylori-negative patients. There was a significant (P<0.001) improvement of gastritis after eradication, which paralleled the elevation of gastric juice vitamin C levels. No difference was noted in plasma vitamin C levels betweenH. pylori-negative and -positive patients or in the latter before and afterH. pylori treatment. In 13 of the 58H. pylori-positive patients where eradication was not successful there was no difference in gastric juice vitamin C levels before and after eradication and the same was observed for the degree of gastritis. It is concluded thatH. pylori-infected patients have lower gastric juice vitamin C levels in comparison toH. pylori-negative patients.H. pylori eradication restores gastric juice vitamin C levels, which may prove potentially important in the prevention of gastric cancer.

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References

  1. Bjelke E: Epidemiological studies of cancer of stomach, colon and rectum, with special reference on the role of diet. Scand J Gastroenterol 9(suppl 31):1–235, 1974

    PubMed  Google Scholar 

  2. Haenszel W, Kyrihara M, Segi M, Lee RK: Stomach cancer among Japanese in Hawaii. J Natl Cancer Inst 49:969–988, 1972

    PubMed  Google Scholar 

  3. Haenszel W, Kyrihara M, Locke FB, Shimizu K, Segi M: Stomach cancer in Japan. J Natl Cancer Inst 56:265–274, 1976

    PubMed  Google Scholar 

  4. Trichopoulos D, Ouranos G, Day NE, Tzonou A, Manousos O, Papadimitriou C, Trichopoulos A: Diet and cancer of the stomach. A case-control study in Greece. Int J Cancer 36:291–295, 1985

    PubMed  Google Scholar 

  5. Buiatti E, Palli D, Decarli A, Amadori D, Avellini C, Bianchi S, Bonaguri C, Cipriani F, Cocco P, Giacosa A: A case-control study of gastric cancer and diet in Italy: II. Association with Nutrients. Int J Cancer 45:896–901, 1990

    PubMed  Google Scholar 

  6. Mirvish SS: Formation ofN-nitroso compounds: Chemistry, kinetics andin vivo occurrence. Toxicol Appl Pharmacol 31:325–351, 1975

    PubMed  Google Scholar 

  7. Calmels S, Ohshima H, Vincent P, Gounot AM, Bartsch H: Screening of microorganisms for nitrosation catalysis at pH 7 and kinetic studies on nitrosamine formation from secondary amines byE. coli strains. Carcinogenesis 6:911–915, 1985

    PubMed  Google Scholar 

  8. Mirvish SS, Wallcave L, Eagen M, Shubic P: Ascorbate-nitrite reaction: Possible means of blocking the formation of carcinogenicN-nitroso compounds. Science 177:65–68, 1972

    PubMed  Google Scholar 

  9. Ohshima H, Bartsch H: Quantitive estimation of endogenous nitrosation in humans byN-nitrosoproline excreted in urine. Cancer Res 41:3658–3662, 1981

    PubMed  Google Scholar 

  10. Mirvish SS: Effects of vitamin C and E onN-nitroso compound formation, carcinogenesis and cancer. Cancer 58(suppl):1842–1850, 1986

    PubMed  Google Scholar 

  11. Kyrtopoulos SA: Ascorbic acid and the formation ofN-nitroso compounds: Possible role of ascorbic acid in cancer prevention. Am J Clin Nutr 45:1344–1350, 1987

    PubMed  Google Scholar 

  12. Strauss RM, Wang TC, Kelsey RB, Compton CC, Ferraro MJ, Perez-Perez G, Parsonnet J, Biaser MJ: Association ofCampylobacter pylori infection with dyspeptic symptoms in patients undergoing gastroduodenoscopy. Am J Med 89:464–469, 1990

    PubMed  Google Scholar 

  13. Marshall BJ, McGechie DB, Rogers PA, Glancy RJ: Pyloric campylobacter infection and gastroduodenal disease. Med J Aust 142:439–444, 1985

    PubMed  Google Scholar 

  14. Rokkas T, Sladen G: Infection with campylobacter pylori. J R Coll Physicians London 22:97–100, 1988

    Google Scholar 

  15. Rokkas T:Campylobacter pylori and non-ulcer dyspepsia. Am J Gastroenterol 82:1149–1152, 1987

    PubMed  Google Scholar 

  16. Rokkas T, Pursey C, Uzoechina E, Dorrington L, Simmons NA, Filipe MI, Sladen GE: Non-ulcer dyspepsia and short term De-Nol therapy: A placebo controlled trial with particular reference to the role ofCampylobacter pylori. Gut 29:1386–1391, 1988

    PubMed  Google Scholar 

  17. Graham D:Campylobacter pylori and peptic ulcer disease. Gastroenterology 96:615–625, 1989

    PubMed  Google Scholar 

  18. Raws EA, Tytgat GN: Cure of duodenal ulcer associated with eradication ofHelicobacter pylori. Lancet 335:1233–1235, 1990

    PubMed  Google Scholar 

  19. Graham D: Pathogenic mechanisms leading toHelicobacter pylori-induced inflammation. Eur J Gastroenterol Hepatol 4(suppl 2):S9-S16, 1992

    Google Scholar 

  20. Forman D, Newell DG, Fullerton F, Yarnell JWG, Stacey AR, Wald N, Sitas F: Association between infection withH. pylori and risk of gastric cancer. Evidence from a prospective investigation. BMJ 302:1302–1305, 1991

    PubMed  Google Scholar 

  21. Parsonnet J, Friedman GD, Vandersteen DP, Chang Y, Vogelman JH, Orentreich N, Sibley RK:H. pylori infection and the risk of gastric carcinoma. N Engl J Med 325:1127–1135, 1991

    PubMed  Google Scholar 

  22. Nomura A, Stemmerman GN, Chyou PH, Kato I, Perez-Perez GI, Blaser MJ:H. pylori and gastric carcinoma among Japanese Americans in Hawaii. N Engl J Med 325:1132–1136, 1991

    PubMed  Google Scholar 

  23. Talley NJ, Zinsmeister AR, Weaver A, Dimagno EP, Carpenter HA, Perez-Perez GI, Blaser MJ: Gastric adenocarcinoma andH. pylori infection. J Natl Cancer Inst 83:1734–1739, 1991

    PubMed  Google Scholar 

  24. The Eurogast Study Group. An international association betweenHelicobacter pylori infection and gastric cancer: An international study. Lancet 341:1359–1362, 1993

    Google Scholar 

  25. Hansson LE, Engstrand L, Nyren O, Evans DJ, Lindren A, Betgstrom R, Andersson B, Athlin L, Bendtsen O, Tracz P:Helicobacter pylori infection: Independent risk indicator of gastric adenocarcinoma. Gastroenterology 105:1098–1103, 1993

    PubMed  Google Scholar 

  26. Sobala GM, Crabtree LE, Dixon MF, Schorah CJ, Taylor JD, Rathbone BJ, Heatley RV, Axon ATR: AcuteHelicobacter infection: Clinical features, local and systemic immune response, gastric mucosal histology and gastric juice ascorbic acid concentration. Gut 32:1415–1418, 1991

    PubMed  Google Scholar 

  27. Rokkas T, Papatheodorou G, Kalogeropoulos N:Helicobacter pylori infection and gastric juice ascorbic acid levels. Ir J Med Sci 161(suppl):24, 1992

    Google Scholar 

  28. Rokkas T, Papatheodorou G, Karameris A, Mavrogeorgis A, Kalogeropoulos N, Giannikos N: CanH. pylori eradication restore vitamin C levels in gastric juice? Gastroenterology 104(suppl):A181, 1993

    Google Scholar 

  29. Banerjee S, Hawsksby K, Miller S, Beattle AD, McColl KEL: Effect ofH. pylori and its eradication on gastric juice ascorbic acid. Gastroenterology 104(suppl):A37, 1993

    Google Scholar 

  30. Sobala GM, Schorah CJ, Shives S, Lynch DAS, Gallacher B, Dixon MF, Axon ATR: Effect of eradication ofHelicobacter pylori on gastric juice ascorbic acid concentrations. Gut 34:1038–1041, 1993

    PubMed  Google Scholar 

  31. Ruiz B, Rood JC, Fontharm ETH, Malcom GT, Huntrer FM, Sobhan M, Johnson WD, Correa P: Vitamin C concentration in gastric juice before and after anti-Helicobacter pylori treatment. Am J Gastroenterol 88:533–539, 1994

    Google Scholar 

  32. Borody T: Possibilities ofHelicobacter pylori suppression/eradication. Eur J Gastroenterol Hepatol 4(suppl 2):S37-S40, 1992

    Google Scholar 

  33. Lowry OH, Lopez JA, Bessey OA: The determination of ascorbic acid in small amounts of blood serum. J Biol Chem 160:609–615, 1945

    Google Scholar 

  34. Roe JH, Kuether CA: The determination of ascorbic acid in whole blood and urine through a 2,4-dinitrophenylhydrazine derivative of dehydroascorbic acid. J Biol Chem 147:399–407, 1943

    Google Scholar 

  35. Newill A, Habibzedah N, Brshop N, Schorah CL: Plasma levels of vitamin C components innormal and diabetic subjects. Ann Clin Biochem 21:488–490, 1984

    PubMed  Google Scholar 

  36. Potters HVPJ, Loffeld RJLF, Stobbering E, Van Spreeuwel JP, Arends JW: Rapid staining ofCampylobacter pyloridis. Histopathology 11:1223, 1987

    Google Scholar 

  37. Marshall BJ, Francis G, Langton S, Goodwin CS, Blincow ED: Rapid urease test in the management ofCampylobacter pyloridis associated gastritis. Am J Gastroenterol 3:200–210, 1987

    Google Scholar 

  38. Rokkas T, Pursey C, Simmons NA, Filipe MI, Sladen G: Rapid urease test in the diagnosis ofCampylobacter pyloridis infection. Hell J Gastroenterol 1(suppl 1):85, 1988

    Google Scholar 

  39. Whitehead R: Mucosal biopsy of the gastrointestinal tract.In Major Problems in Pathology, Vol III, 2nd ed. JL Bennington (ed). Philadelphia, WB Saunders, 1979

    Google Scholar 

  40. Brown PW, Hollander M: Statistics: A Biomedical Introduction. Wiley Series in Probability and Mathematical Statistics. New York, John Wiley, 1977

    Google Scholar 

  41. O'Connor HJ, Schorah CJ, Habibzedan N, Axon ATR, Cockel R: Vitamin C in the human stomach: Relation to gastric pH, gastroduodenal disease, and possible sources. Gut 30:436–442, 1989

    PubMed  Google Scholar 

  42. Sobala GM, Schorah CJ, Sanderson M, Dixon MF, Tomkins DS, Godwin P, Axon ATR: Ascorbic acid in the human stomach. Gastroenterology 97:357–363, 1989

    PubMed  Google Scholar 

  43. Breidenbach AW, Kay FE: Gastric ascorbic acid in the gastric guinea pig. Science 118:557, 1953

    Google Scholar 

  44. Rathbone BJ, Johnson AW, Jones C, Kelleher J, Heathey RV: Gastric juice “secretion” of ascorbic acid. Proc Nutr Soc 45:69A, 1986

    Google Scholar 

  45. Sobala GM, Pignatelli B, Schorah CL, Bartsch H, Sanderson M, Dixon MF, Shires S, King RF, Axon AT: Levels of nitrite, nitrate, N-nitroso compounds, ascorbic acid and total bile acids in gastric juice of patients with and without precancerous conditions of the stomach. Carcinogenesis 12:193–198, 1991

    PubMed  Google Scholar 

  46. Hafkesbring R, Freeman JT, Cadwell EK: Comparative study of ascorbic acid levels in gastric secretion, blood, urine and saliva. II saturation studies. Am J Med Sci 224:324–328, 1952

    PubMed  Google Scholar 

  47. Mai VE, Perez-Perez GI, Wahl LM, Wahl SM, Blaser MJ, Smith DD: Soluble surface proteins fromHelicobacter pylori activate monocytes/macrophages by lipopolysaccharide-independent mechanism. J Clin Invest 87:894–900, 1991

    PubMed  Google Scholar 

  48. Sipponen P: Long-term consequences of gastroduodenal inflammation. Eur J Gastroenterol Hepatol 4(suppl 2):S25-S29, 1992

    Google Scholar 

  49. Filipe MI, Jass JR: Intestinal metaplasia subtypes and cancer risk.In Gastric Carcinoma. MI Filipe, JR Jass (eds). Edinburgh, Churchill Livingstone, 1986

    Google Scholar 

  50. Rokkas T, Filipe MI, Sladen G: Detection of an increased incidence of early gastric cancer in patients with intestinal metaplasia type III who are closely followed up. Gut 32:1110–1113, 1991

    PubMed  Google Scholar 

  51. Correa P, Haenszel W, Cuello C, Archer M, Tannenbaum S: A model for gastric cancer epidemiology. Lancet 2:58–60, 1975

    PubMed  Google Scholar 

  52. Correa P: Is gastric cancer an infectious disease? N Engl J Med 325:1170–1171, 1991

    PubMed  Google Scholar 

  53. Munoz N, Oliver W, Sobala GM, de Sanjose S, Cano E, Peraza S: Prevalence ofHelicobacter pylori infection and effect of anti-oxidants in a high risk population for gastric cancer in Venezuela. Ital J Gastroenterol 23(suppl 2):15, 1991

    PubMed  Google Scholar 

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Authors and Affiliations

  1. From the Gastroenterology Unit, Biochemistry Laboratory and Histopathology Department, 401 Army General Hospital, Athens, Greece

    Theodoros Rokkas MD, PhD, Georgios Papatheodorou DSc, Andreas Karameris MD, Anastasios Mavrogeorgis MD, Nikolaos Kalogeropoulos MD & Nikolaos Giannikos MD

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  1. Theodoros Rokkas MD, PhD
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  2. Georgios Papatheodorou DSc
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  3. Andreas Karameris MD
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  4. Anastasios Mavrogeorgis MD
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  5. Nikolaos Kalogeropoulos MD
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  6. Nikolaos Giannikos MD
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Additional information

This work was presented in part during the V Workshop on Gastroduodenal Pathology andHelicobacter pylori; Dublin, July 5–7, 1992, and published as an abstract (Irish Journal of Medical Sciences 161(suppl 10):25, 1992) and during the American Gastroenterological Association meeting in Boston, Massachusetts, May 15–21, 1993, and published as an abstract (Gastroenterology 104(suppl) A181, 1993).

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Rokkas, T., Papatheodorou, G., Karameris, A. et al. Helicobacter pylori infection and gastric juice vitamin C levels. Digest Dis Sci 40, 615–621 (1995). https://doi.org/10.1007/BF02064380

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