Effects of Helicobacter pylori infection and long-term proton pump inhibitor use on enterochromaffin-like cells

Mehmet Bektas; Nursen Sarac; Hulya Cetinkaya; Murat Toruner; Esra Erdemli; Onur Keskin; Irfan Soykan; Esen Ismet Oktay; Esin Korkut; Yusuf Ustun; Kadir Bahar

Authors Mehmet Bektas, Nursen Sarac, Hulya Cetinkaya, Murat Toruner, Esra Erdemli, Onur Keskin, Irfan Soykan, Esen Ismet Oktay, Esin Korkut, Yusuf Ustun, Kadir Bahar.

Abstract

Background Excessive release of gastrin leads to hypertrophy and hyperplasia of enterochromaffin-like cells (ECL) and prolonged stimulation of these cells causes functional impairment. The purpose of this study was to investigate the effect of Helicobacter pylori (H. pylori) infection and long-term proton pump inhibitors (PPI) use on ECL cells.

Methods Fifteen patients who underwent endoscopy because of dyspeptic symptoms were enrolled in the present study. Biopsies were taken from corpus and antrum and existence of H. pylori was investigated with culture, cytology and CLOtest. The patients were divided into 3 groups. Group-A: H. pylori-negative, never treated previously with PPI; Group-B: H. pyloripositive, never treated previously with PPI; and group-C: H. pylori-negative and continuously treated with PPI for more than 6 months before the subject recruitment period. The features of ECL cell in oxyntic glands were examined with electron microscopy on biopsy specimens.

Results ECL cells were completely normal in Group A. In group B, moderate hyperplasia and vacuolization was seen in ECL cells. In group C, ECL cell hyperplasia was observed and vacuoles with greater amounts of granules in enlarged vesicles were found more intensely in cytoplasm.

Conclusion The use of PPI for a long period of time and presence of H. pylori infection are risk factors for ECL hyperplasia.

Keywords Enterochromaffin-like cells, proton pump inhibitors, Helicobacter pylori infection
Ann Gastroenterol 2012; 25 (2): 123-127