Increased thrombin generation and circulating levels of tumour necrosis factor-α in patients with chronic Helicobacter pylori-positive gastritis

Abstract

Background: Conflicting data have been reported concerning the relationship between Helicobacter pylori infection and coronary heart disease. Aim: To evaluate clotting system activation and plasma levels of tumour necrosis factor-α, a procoagulant cytokine, in patients with H. pylori-positive and - negative gastritis. Methods: Three groups of patients were identified: 38 with H. pylori-positive gastritis. 18 with H. pylori-negative gastritis, and 40 H. pylori-negative controls with normal gastric mucosa. Plasma levels of prothrombin fragment 1 + 2 (F1 + 2) and tumour necrosis factor-α were assayed. Patients were also controlled after 2 and 6 months following standard H. pylori eradication treatment. Results: At baseline, fragment 1 + 2 and tumour necrosis factor-α levels in H. pylori-positive patients were significantly higher than those in H. pylori-negative patients with gastritis (P < 0.05 and P < 0.01, respectively). After H. pylori eradication, fragment 1 + 2 and tumour necrosis factor-α levels showed a significant decrease at 2 months (P = 0.03 and P = 0.02, respectively) and a further reduction at 6 months, reaching levels observed in H. pylori-negative patients and controls. Conclusions: The increase thrombin generation rate and the correlation of plasma fragment 1 + 2 and tumour necrosis factor-α levels in H. pylori-positive patients suggest a role for inflammation in mediating the relationship between H. pylori infection and activation of the clotting system.