Autoimmune pancreatitis associated with high prevalence of gastric ulcer independent of Helicobacter pylori infection status

Pancreas. 2009 May;38(4):442-6. doi: 10.1097/MPA.0b013e31819b5f3c.

Abstract

Objectives: The relationship between Helicobacter pylori status and host tumor necrosis factor alpha (TNF-alpha) promoter susceptibility in ulcers inautoimmune pancreatitis (AIP) is unknown. We sought to study the frequency of peptic ulcer, the association of peptic ulcer with H. pylori and host TNF-alpha promoter haplotype in AIP and nonautoimmune chronic pancreatitis.

Methods: Esophagogastroduodenoscopy (EGD) was performed in 40 patients with AIP and 113 patients with nonautoimmune chronic pancreatitis (CP). The status of H. pylori infection was determined. Genotyping and 5-locus haplotype assembly of the TNF-alpha promoter were performed. The correlation between clinical characteristics, endoscopic findings, Helicobacter pylori infection status, and TNF-alpha promoter polymorphism and haplotype was analyzed.

Results: The frequencies of gastric ulcer (GU) was higher in patients with AIP compared with patients with nonautoimmune CP (22.5% vs 4.4%, P = 0.001). Duodenal ulcer (DU) was more prevalent than GU in both patients with AIP and patients with nonautoimmune CP. There was no difference in the positive status of H. pylori and TNF-alpha promoter polymorphism/haplotype.

Conclusions: Our results demonstrated that GU was more prevalent in AIP compared with nonautoimmune CP. Positive H. pylori status and host TNF-alpha promoter susceptibility could not explain the pathogenesis of higher GU prevalence and pathogenesis of AIP in our population.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Autoimmune Diseases / complications
  • Autoimmune Diseases / diagnosis*
  • Autoimmune Diseases / genetics
  • Base Sequence
  • Duodenal Ulcer / complications
  • Duodenal Ulcer / diagnosis
  • Duodenal Ulcer / genetics
  • Endoscopy, Digestive System
  • Female
  • Gene Frequency
  • Genotype
  • Haplotypes
  • Helicobacter Infections / complications
  • Helicobacter Infections / diagnosis*
  • Helicobacter pylori / physiology
  • Host-Pathogen Interactions
  • Humans
  • Immunoglobulin G / immunology
  • Male
  • Middle Aged
  • Pancreas / metabolism
  • Pancreas / microbiology
  • Pancreas / pathology
  • Pancreatitis / complications
  • Pancreatitis / diagnosis*
  • Pancreatitis / genetics
  • Polymorphism, Genetic
  • Promoter Regions, Genetic / genetics
  • Stomach Ulcer / complications
  • Stomach Ulcer / diagnosis*
  • Stomach Ulcer / genetics
  • Tumor Necrosis Factor-alpha / genetics

Substances

  • Immunoglobulin G
  • Tumor Necrosis Factor-alpha