Effect of antihelicobacter therapy on cellular homeostasis (Ki-67, Bcl-2 and apoptosis) of stomach epithelial cells at peptic ulcer of duodenum

Aim of investigation. To increase efficacy of antihelicobacter therapy and improve cellular homeostasis of epithelial cells of stomach mucosa (SM) in patients with peptic ulcer of duodenum (PUD).

Stuff and methods. 172 patients were investigated: 100 of them had PUD, 30 – chronic non-atrophic gastritis (CNG), 30 – chronic atrophic gastritis (CAG) and 12 generally healthy persons. Only patients with Н. pylori infection proved by morphological investigation of the stomach mucosa were included in PUD, CNG, CAG groups. PUD patients were separated into 2 equal groups: in the first group eradication H. pylori was carried out according to established 7-day’s mode with application of omeprazole on 20 mg bid, clarithromycin 500 mg bid and amoxicillin 1000 mg bid, in the second group taurine 500 mg bid was added to conventional algorithm of eradication. Then the first group continued to receive omeprazole for 6 wks followed by maintenance therapy. The second group has continued treatment by omeprazole in combination to taurine for 6 wks, and then – maintenance therapy. Comparison groups have been presented by patients with CNG, CAG and practically healthy persons. Along with endoscopy control in 2 and 4 wks for all patients with CNG and PUD regulatory molecules (Ki67, Bcl2) and apoptotic activity of antral epithelial cells prior to treatment and in 6 wks after Н. pylori eradication was studied.

Results. At patients with CNG slight increase of apoptotic activity of stomach epithelial cells was determined and proportionally – expression Ki67 and Bcl2. CAG development is pathogenically related to high proliferative and antiapoptotic activity of epithelial cells of the stomach mucosa at moderate increase of their apoptotic potential. CAG and CNG are complicated by PUD at significant increase of apoptotic potential of epitheliocytes. Н. pylori eradication in patients with PUD reduces proliferation of SM epithelial cells and – in higher degree – their apoptotic activity. It is known, that addition of taurine to eradication therapy algorithm significantly increases elimination rate, reduces terms of healing of duodenal ulcers. At taurine application for 6 wks expression of Ki67, Bcl2 and apoptotic activity of epithelial cells are restored in the much greater degree, than at isolated application of omeprazole.

Conclusions. Addition of taurine to eradication therapy H. pylori increases its efficacy and improves parameters of epithelial cell regeneration of SM at patients with PUD.

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