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World J Gastroenterol. Dec 7, 2005; 11(45): 7183-7187
Published online Dec 7, 2005. doi: 10.3748/wjg.v11.i45.7183
Effects of Helicobacter pylori infection on gastric epithelial cell kinetics in patients with chronic renal failure
Selim Aydemir, Binnaz Handan Ozdemir, Gurden Gur, Ibrahim Dogan, Ugur Yilmaz, Sedat Boyacioglu
Selim Aydemir, Department of Gastroenterology, Zonguldak Karaelmas University Faculty of Medicine, Zonguldak 67800, Turkey
Binnaz Handan Ozdemir, Department of Pathology, Baskent University Faculty of Medicine, Ankara 06000, Turkey
Gurden Gur, Ugur Yilmaz, Sedat Boyacioglu, Department of Gastroenterology, Baskent University Faculty of Medicine, Ankara 06000, Turkey
Ibrahim Dogan, Department of Gastroenterology, Gazi University Faculty of Medicine, Ankara 06000, Turkey
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. Selim Aydemir, Department of Gastroenterology, Zonguldak Karaelmas University Faculty of Medicine, Zonguldak 67800, Turkey. selimaydemir@hotmail.com
Telephone: +90-372-2576169 Fax: +90-372-2610155
Received: March 15, 2005
Revised: April 15, 2005
Accepted: April 18, 2005
Published online: December 7, 2005
Abstract

AIM: To evaluate the effects of Helicobacter pylori infection on gastric epithelial cell kinetics in patients with chronic renal failure (CRF).

METHODS: Forty-four patients were enrolled in this study and divided into four groups with respect to their Helicobacter pylori (H pylori) and CRF status. Groups were labeled as follows: 1a: normal renal function, H pylori negative (n = 12), 1b: normal renal function, H pylori positive (n = 11), 2a: CRF, H pylori negative (n = 10), 2b: CRF, H pylori positive (n = 11). Upper gastrointestinal endoscopy was done in all the patients involved in the study. During endoscopical investigation, antral biopsy specimens were taken from each patient. In order to evaluate the cell apoptosis and proliferation in gastric epithelial cells, Bax and proliferating cell nuclear antigen (PCNA) labeling indexes (LI) were assessed with immunohistochemical staining method.

RESULTS: For groups 1a, 1b, 2a, and 2b, mean Bax LI was identified as 34.4±13.7, 44.1±16.5, 46.3±20.5, 60.7±13.8, respectively and mean PCNA LI was identified as 36.2±17.2, 53.6±25.6, 59.5±25.6, 67.2±22, respectively. When the one-way ANOVA test was applied, statistically significant differences were detected between the groups for both Bax LI (P = 0.004 <0.01) and PCNA LI (P = 0.009 <0.01). When groups were compared further in terms of Bax LI and PCNA LI with Tukey’s HSD test for multiple pairwise comparisons, statistically significant difference was observed only between groups 1a and 2b (P = 0.006 <0.01).

CONCLUSION: In gastric epithelial cells, expression of both the pre-apoptotic protein Bax and the proliferation marker PCNA increase with H pylori infection. This increase is more evident in patients with uremia. These findings suggest that uremia accelerates apoptosis and proliferation in gastric epithelial cells.

Keywords: Helicobacter pylori; Chronic renal failure; Bax; Proliferating cell nuclear antigen