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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
Open AccessArticle

Pepsinogen testing for evaluation of the success of Helicobacter pylori eradication at 4 weeks after completion of therapy

1
Faculty of Medicine, University of Latvia, Riga, Latvia
2
Riga East University Hospital, Riga, Latvia
3
Digestive Diseases Centre GASTRO, Riga, Latvia
4
Department of Modelling and Simulation, Riga Technical University, Riga, Latvia
5
Institute of Internal Medicine, Siberian Branch, Russian Academy of Medical Sciences, Novosibirsk, Russia
6
Department of Therapy No. 2, Vitebsk State Medical University, Vitebsk, Belarus
7
Riga Stradins University, Riga, Latvia
*
Author to whom correspondence should be addressed.
Medicina 2014, 50(1), 8-13; https://doi.org/10.1016/j.medici.2014.05.001
Received: 20 July 2013 / Accepted: 11 January 2014 / Published: 5 June 2014
Background and objective: Pepsinogen levels in plasma are increased by inflammation in the gastric mucosa, including inflammation resulting from Helicobacter pylori infection. A decrease in pepsinogen II level has been suggested as a reliable marker to confirm the successful eradication of infection. The aim of our study was to evaluate the potential role of pepsinogens I and II, gastrin-17 and H. pylori antibodies in confirming successful eradication.
Material and methods: Altogether 42 patients (25 women, 17 men), mean age 45 years (range 23–74), were enrolled. Pepsinogens I and II, gastrin-17 and H. pylori IgG antibodies were measured in plasma samples using an ELISA test (Biohit, Oyj., Finland) before the eradication and 4 weeks after completing the treatment. The success of eradication was determined by a urea breath test.
Results: Eradication was successful in 31 patients (74%) and unsuccessful in 11 patients (26%). Pepsinogen II decreased significantly in both the successful (P = 0.029) and unsuccessful (P = 0.042) eradication groups. Pepsinogen I decreased significantly in the successful (P = 0.025) but not the unsuccessful (P = 0.29) eradication group. The pepsinogen I/II ratio increased in the successful eradication group (P = 0.0018) but not in the group in which treatment failed (P = 0.12). There were no differences in gastrin-17 or H. pylori antibody values.
Conclusions: A decrease in pepsinogen II levels cannot be used as a reliable marker for the successful eradication of H. pylori 4 weeks after the completion of treatment. The increase in pepsinogen I/II ratio reflects differences in pepsinogen production following the eradication irrespective of improvement in atrophy.
Keywords: Pepsinogen; Gastrin-17; Eradication; Helicobacter pylori; Efficacy Pepsinogen; Gastrin-17; Eradication; Helicobacter pylori; Efficacy
MDPI and ACS Style

Leja, M.; Lapina, S.; Polaka, I.; Rudzite, D.; Vilkoite, I.; Daugule, I.; Belkovets, A.; Pimanov, S.; Makarenko, J.; Tolmanis, I.; Lejnieks, A.; Boka, V.; Rumba-Rozenfelde, I.; Vikmanis, U. Pepsinogen testing for evaluation of the success of Helicobacter pylori eradication at 4 weeks after completion of therapy. Medicina 2014, 50, 8-13.

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