The effect of Helicobacter pylori on the morphological picture of the gastric mucosa in patients with chronic gastritis

Helicobacter pylori (H. pylori) is one of the most common infections worldwide. According to modern ideas, it is the main cause of a number of diseases of the stomach and duodenum (peptic ulcer, chronic gastritis, MALT lymphoma) and the leading risk factor for stomach cancer. In the hospital therapy clinic of the Kirov Military Medical Academy, we observed 118 patients. The study groups included patients with various types of chronic gastritis (atrophic and non-atrophic). The patients were comparable in gender and age. Infection H. pylori was verified in 22 patients (68.8%) suffering from chronic non-atrophic gastritis and in 34 patients (37.2%) suffering from chronic atrophic gastritis. In the course of the study, the relationship between the contamination of H. pylori and the presence of dysregenerative changes in the gastric mucosa was evaluated. It was found that H. pylori infection does not significantly affect the development and progression of atrophy in the mucous membrane of the antrum of the stomach. Also, no convincing data on the effect of H. pylori on dysregenerative processes (intestinal metaplasia and dysplasia) in the gastric mucosa. At the same time, the presence of pathogenicity factors H. pylori Vac A and Cag A significantly affects the progression of atrophic changes in the gastric mucosa. At the stage of formed atrophy, the intensity of H. pylori invasion is significantly reduced.

chronic atrophic gastritis, chronic non-atrophic gastritis, atrophy, intestinal metaplasia, dysplasia, stomach cancer, precancerous changes in the gastric mucosa, Helicobacter pylori, the degree of contamination of the gastric mucosa

1. Smirnova O.V., Sinyakov A. A. Influence of Helicobacter pylori on cytokine regulation in chronic atrophic gastritis.Russian Journal of Infection and Immunity = Infektsiya i immunitet. 2020;10(1):87-192. (in Russ.) doi: 10.15789/2220-7619-IOH-1167.@@ Смирнова В. В., Синяков А. А. Влияние Helicobacter pylori на особенности цитокиновой регуляции при хроническом атрофическом гастрите. Инфекция и иммунитет. 2020; 10(1): 187-92. doi: 10.15789/2220-7619-IOH-1167.

2. Petryszyn P., Chapelle N., Matysiak-Budnik T. Gastric cancer: Where are we heading? Digestive Diseases. 2020; 38(4):280-285. doi: 10.1159/000506509.

3. Hooi J. K.Y., Lai W. Y., Ng W. K. et al. Global Prevalence of Helicobacter pylori Infection: Systematic Review and Meta-Analysis. Gastroenterology. 2017; 153(2): 420-29. doi: 10.1053/j.gastro.2017.04.022.

4. Zamani M., Ebrahimtabar F., Zamani V., Miller W. H., Alizadeh-Navaei R., Shokri-Shirvani J., Derakhshan M. H. Systematic review with meta-analysis: The worldwide prevalence of Helicobacter pylori infection. Aliment Pharmacol Ther. 2018; 47(7): 868-76. doi: 10.1111/apt.14561.

5. Smith S., Fowora M., Pellicano R. Infections with Helicobacter pylori and challenges encountered in Africa. World J Gastroenterol. 2019; 25(25): 3183-95. doi: 10.3748/wjg.v25.i25.3183.

6. Šterbenc A., Jarc E., Poljak M. Helicobacter pylori virulence genes. World J Gastroenterol. 2019; 25(33): 4870-84. doi: 10.3748/wjg.v25.i33.4870.

7. Whitmire J.M., Merrell D. S. Helicobacter pylori Genetic Polymorphisms in Gastric Disease Development. Adv Exp Med Biol. 2019; 1149: 173-94. doi: 10.1007/5584_2019_365.

8. Backert S., Blaser M. J. The Role of CagA in the Gastric Biology of Helicobacter pylori. Cancer Res. 2016; 76(14): 4028-31. doi: 10.1158/0008-5472.CAN-16-1680.

9. McClain M.S., Beckett A. C., Cover T. L. Helicobacter pylori Vacuolating Toxin and Gastric Cancer. Toxins (Basel). 2017; 9(10): 316. doi: 10.3390/toxins9100316.

10. Pavlovich I. M., Pegasheva I. L., Zhirkov I. I. et al. [The influence of pathogenicity factors Helicobacter pylori Cag A and Vac A on the development of the inflammatory process in the gastric mucosa in patients with chronic atrophic gastritis]. Hospital medicine: science and practice. 2021;4(3):77-81. (in Russ.) doi: 10.34852/GM3CVKG.2021.24.15.001@@ Павлович И. М., Пегашева И. Л., Жирков И. И., Яковлев В. В. и др. Влияние факторов патогенности Helicobacter pylori Cag A и Vac A на развитие воспалительного процесса в слизистой оболочке желудка у больных хроническим атрофическим гастритом. Госпитальная медицина: наука и практика. - 2021. - Т. 4, № 3. - С. 77-81. doi: 10.34852/GM3CVKG.2021.24.15.001.

11. Pavlovich I. M., Pugacheva I. L., Alper G. A., Yudin V. A. Modern approach to the management and treatment of patients with precancerous conditions and changes in the gastric mucosa. Bulletin of the Russian Military Medical Academy. 2020;22(2):222-226. doi: 10.17816/brmma50077.@@ Павлович И. М., Пегашева И. Л., Альпер Г. А., Юдин В. А. Современный подход к ведению и лечению пациентов с предраковыми состояниями и изменениями слизистой оболочки желудка. Вестник Российской Военно-медицинской академии. - 2020. - № 4 (72). - С. 222-226. doi: 10.17816/brmma50077.

12. Pavlovich I. M., Gordienko A. V., Batskov S. S., Alper G. A. [Diagnostic significance of indicators of acid-forming and pepsin-forming functions of the stomach in identifying pre-tumor potential in patients with chronic atrophic gastritis]. Medical-biological and social-psychological problems of safety in emergency situations. 2012. No. 3, pp. 29-32. (in Russ.) EDN: QZGVLF@@ Павлович И. М., Гордиенко А. В., Бацков С. С., Альпер Г. А. Диагностическая значимость показателей кислотообразующей и пепсинообразующей функции желудка в выявлении предопухолевого потенциала у больных с хроническим атрофическим гастритом. Медико-биологические и социально-психологические проблемы безопасности в чрезвычайных ситуациях. - 2012. - № 3. - С. 29-32. EDN: QZGVLF