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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 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

Faculty of Medicine, University of Latvia, Riga, Latvia
Riga East University Hospital, Riga, Latvia
Digestive Diseases Centre GASTRO, Riga, Latvia
Department of Modelling and Simulation, Riga Technical University, Riga, Latvia
Institute of Internal Medicine, Siberian Branch, Russian Academy of Medical Sciences, Novosibirsk, Russia
Department of Therapy No. 2, Vitebsk State Medical University, Vitebsk, Belarus
Riga Stradins University, Riga, Latvia
Author to whom correspondence should be addressed.
Medicina 2014, 50(1), 8-13;
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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