PDF | https://doi.org/10.46613/congastro2023-200
This work is licensed under CC BY 4.0
Latorre G1, Rodriguez D1, Uribe J1, Martinez F1, Binder V1, Silva F1, Bustamante M1, Pizarro M1, Corvalan A1, Torres J1, Roa J1, Achurra P1, Serrano C1, Bizama C1, Candia R1, Espino A1, Vargas J1, Guzman A1, Shah S2, Riquelme A1
1Pontificia Universidad Católica de Chile, Santiago, Chile
2San Diego Healthcare System, San Diego, California, Estados Unidos (EEUU)
Background. Chronic atrophic gastritis (CAG) and gastric intestinal metaplasia (IM) are considered gastric premalignant conditions. The main cause of CAG is chronic inflammatory process driven by Helicobacter pylori (Hp) infection. However, some autoimmune inflammatory process may be related to progression and extension of CAG/IM.
Aim. Toassess the autoimmunity process related to progression and extension of CAG/IM in patients with Hp infection.
Methods. A cross-sectional study of 220 patients attending to an esophagogastroduodenoscopy (EGD) was conducted. EGD was performed with mapping gastric biopsies collection and a blood sample was obtained. ELISA assay for anti-parietal cell antibodies (PCA) and anti-intrinsic factor antibodies (IFA) were performed. A case-control design was conducted comparing patients with normal or chronic superficial gastritis (CSG), CAG/IM and gastric cancer (GC). Titers of PCA/IFA were compared between study groups with Mann-Whitney test and logistic-regressions were performed adjusting by age and sex.
Results. 121 patients with normal histology or CSG, 74 with CAG/IM and 25 with CG were analyzed. Higher titers of PCA and IFA were observed in patients with corporal extended CAG (p<0.001) and IM (p=0.0004), but not in antral restricted CAG (p=0.88) and IM (p=0.93), in patients with Hp related gastritis. After excluding from the analysis patients with autoimmune gastritis, frequency of a positive PCA was higher in patients with corpus-extended CAG (58% vs. 26%; p<0.001), corpus-extended IM (58% vs. 26%; p=0.013) and OLGA III-IV patients (56% vs. 26%; p=0.013), compared to normal/CSG patients.
Conclusion. PCA antibodies exhibited a statistically significant association with the extension of CAG and intestinal metaplasia (IM) in non-autoimmune Hp-related gastritis. These results imply a potential involvement of immunity in the corpus extension of CAG and IM in the presence of Hp infection, further suggesting PCA antibodies’ potential utility as a biomarker in this particular clinical context.
