Relationship between pepsinogen I&II and H-pylori infection considered with grade of atrophy and gastroduodenal diseases

There are some reports the gastric atrophy induces the downregulation of PG I and, contrariwise, that H. pylori (Hp) infection induces PG I. The aim of this study is to clarify this discrepancy and the relationship between Hp infection and PG I&II. Biopsy specimens and sera were obtained from 207 patients with dyspeptic symptoms undergoing diagnostic endoscopy for Hp infection, atrophic pattern, and estimation of anti-Hp antibodies (Ab) and PG I&II. PG I&II levels were compared before and after eradication in both successful and unsuccessful cases in 53 peptic ulcer patients. In all, 164 cases were Hp positive and 27 cases were Hp negative. For atrophic pattern, the 27 Hp-negative patients were classified into the C1 (N = 26) and C2 patterns (N = 1), and the 164 Hp positive patients were classified into C1 (N = 27), C2 (N = 34), C3 (N = 28), O1 (N = 41), O2 (N = 22), and O3 patterns (N = 12). PG I&II decreased according to the atrophic grade among Hp-positive patients. There are substantial associations between Hp status and PG I&II levels in the C1 pattern, and PG I&II levels are statistically lower in successful cases after eradication. In conclusion, Up-regulation of PG I&II is strongly associated with Hp infection and may lead to ulcer formation.