effect of helicobacter pylori eradication on gastric apoptosis in cirrhotic patients

ABSTRACT

Helicobacter [H] pylori was found to be present in a high percentage of cirrhotic patients, H. pylori colonized stomach contain more apoptotic epithelial cells than normal stomach. The aim of this work was to evaluate efficacy and safety of a triple therapy [Lanzoprazole, Tinidazole and Clarithromycin] in eradication of H. pylori and the effect of H. pylori eradication on the gastric mucosal apoptosis among cirrhotic patients. Fifty patients were classified into two groups Group [I] Twenty-five patients with liver cirrhosis and H. pylori positive. Group [II] Twenty-five non-cirrhotic patients with manifestations of peptic disease and H. pylori positive. All patients were enrolled in a 7 days triple therapy with Lanzoprazole [30 mg], Tinidazole [500 mg] and Clarithromycin [250 mg], each twice / day. Apoptosis was determined before and after 4-6 weeks of H. pylori eradications. Eradication of H. pylori was achieved in 21 patients [84%] in cirrhotic patients, while it was eradicated in 22 patients [88%] in non-cirrhotic patients. The highest apoptotic figure was recorded in-group I before eradication [14.62 +/- 2.08]; it is significantly decreased after eradication of H. pylori [4.34 +/- 1.34, P <0.01]. In-group II a significant reduction of the apoptotic index from [12.2 +/- 10.6 to 2.75 +/- 1.06, P <0.01] after eradication of H. pylori. In conclusion, one-week triple therapy by Lanzoprazole, Tinidazole and Clarithromycin was effective and safe in eradication of the H. pylori in cirrhotic and non-cirrhotic patients. Hepatic cirrhosis increased gastric apoptosis. H. pylori eradication reduced gastric apoptosis among cirrhotic and non-cirrhotic patients