[Does Helicobacter pylori have a direct proteolytic effect in ulcerative disease?].

Helicobacter pylori (H.p.), has been shown, experimentally, to exert a proteolytic activity against mucous fractions. Aim of this study was to assess the prevalence of H.p. in peptic ulcer and to analyze its possible influence on gastric mucus components, on peptic activity in gastric juice and the possible action on peptic secretion. 223 patients undergoing upper gastrointestinal endoscopy were analyzed for the presence of H.p. in the mucosa: 99 duodenal ulcer patients (D.U.), 58 gastric ulcer patients (D.U.) and 66 dyspeptic subjects. In each patients, three contiguous gastric biopsies were taken at the antrum: the first was evaluated for gastritis (Whitehead Criteria), the two other analyzed for H.p. with a rapid urease test. In a subgroup of 25 D.U. and 18 G.U. patients, two other biopsies were taken at the fundus corpus of the stomach, to evaluate peptic secretion. To determinate mucous components (acid and neutral glycoproteins, galactose and N-acetylneuraminic acid), gastric juice samples were collected during endoscopy. H.p. was present in 89% of antral biopsies in D.U., in 56% of G.U. and in 51% of D., and was associated to antral gastritis. As regard gastric juice components, we observed an increase and a decrease of acid glycoproteins, respectively, in D.U. and G.U. patients with H.p. infection. An increase of peptic activity has been found in the gastric juice of both gastric and duodenal ulcer patients H.p. positive (G.U. p less than 0.05). On the contrary, no significant differences were observed on peptic activity in the fundus-corpus biopsies between H.p. positive and H.p. negative patients.(ABSTRACT TRUNCATED AT 250 WORDS)