Importance of Cytokines in Peptic Ulcer Disease: Implications for Treatment

Condition(s) targeted: Peptic Ulcer

Intervention: Endoscopy of upper GI tract (Procedure)

Phase: N/A

Status: Recruiting

Sponsored by: University of Athens

Official(s) and/or principal investigator(s):
Evangelos J. Giamarellos-Bourboulis, MD, PhD, Study Chair, Affiliation: 4th Department of Internal Medicine, ATTIKON University Hospital, 124 62 Athens, Greece
Vassileios Koussoulas, MD, PhD, Principal Investigator, Affiliation: Department of Endoscopy, Sismanoglion General Hospital, 151 26 Athens, Greece

Overall contact:
Evangelos J Giamarellos-Bourboulis, MD, PhD, Phone: 00302105831000, Ext: 994, Email: giamarel@ath.forthnet.gr

Although all PPIs are effective, there are some differences in their clinical performance, particularly in terms of the degree and speed of gastric acid suppression. Few data are also available about their effect of the pathophysiological mechanisms of gastritis and peptic ulcer disease. Aim of the present study is to investigate the effect of therapy with esomaprazole or rabeprazole on the mechanism of pathogenesis of gastritis and particularly on the pattern of release of pro- and anti- inflammatory cytokines associated to peptic ulcerative process by the gastric mucosa.

Official title: A Clinical Study of the Efficacy of Esomeprazole or Rabeprazole on the Pattern of Release of Pro- and Anti-Inflammatory Cytokines From Gastric Mucosa of Patients With Peptic Ulcer Disease

Study design: Natural History, Longitudinal, Defined Population, Prospective Study

Detailed description: Although all PPIs are effective, there are some differences in their clinical performance, particularly in terms of the degree and speed of gastric acid suppression. Few data are also available about their effect of the pathophysiological mechanisms of gastritis and peptic ulcer disease.

Triggering receptor expressed on myeloid cells (TREM)-1 is a recently discovered receptor expressed on the surface of neutrophils and monocytes. Engagement of TREM-1 has been reported to trigger the synthesis of proinflammatory cytokines. A soluble form of TREM-1, named sTREM-1, was observed and identified at significant levels in serum samples from patients with disease of the gastrointestinal tract inflammatory bowel disease. rendering interest about the implication of sTREM-1 in their pathogenesis.

sTREM-1 was also found elevated in the gastric juice of patients with peptic ulcer disease being correlated to the degree of the infiltration of the gastric mucosa by neutrophils.

Published data of our group elicit that sTREM-1 secretion is a crucial parameter for evolution from chronic gastritis to peptic ulcer disease. Samples of biopsies of gastric mucosa were cultured in the absence/presence of endotoxins showing that the inflamed mucosa was a potent secretor of sTREM-1 whatever ceased to exist post-antisecretory treatment.

Aim of the present study is to investigate the effect of therapy with esomaprazole or rabeprazole on the mechanism of pathogenesis of gastritis and particularly on the pattern of release of pro- and anti- inflammatory cytokines associated to peptic ulcerative process by the gastric mucosa.

Minimum age: 18 Years. Maximum age: N/A. Gender(s): Both.

Criteria:

Inclusion Criteria:

- Written informed consent.

- Abdominal pain or discomfort and/or

- Epigastric pain with nausea and vomiting and/or

- Dyspepsia.

Exclusion Criteria:

- Recent upper GI bleeding

- Gastric carcinoma

- Diabetes mellitus

- Liver cirrhosis

- Acute or chronic renal failure

- The ingestion of any antimicrobial or antisecretory medication for at least 15 days

prior to endoscopy.

Evangelos J Giamarellos-Bourboulis, MD, PhD, Phone: 00302105831000, Ext: 994, Email: giamarel@ath.forthnet.gr

Department of Endoscopy, Sismanoglion General Hospital, Athens 151 26, Greece; Recruiting
Vassileios Koussoulas, MD, PhD, Phone: 00302108039111, Ext: 798, Email: kous73@yahoo.gr
Vassileios Koussoulas, MD, PhD, Principal Investigator

Related publications:

Tzivras M, Koussoulas V, Giamarellos-Bourboulis EJ, Tzivras D, Tsaganos T, Koutoukas P, Giamarellou H, Archimandritis A. Role of soluble triggering receptor expressed on myeloid cells in inflammatory bowel disease. World J Gastroenterol. 2006 Jun 7;12(21):3416-9.

Koussoulas V, Vassiliou S, Demonakou M, Tassias G, Giamarellos-Bourboulis EJ, Mouktaroudi M, Giamarellou H, Barbatzas C. Soluble triggering receptor expressed on myeloid cells (sTREM-1): a new mediator involved in the pathogenesis of peptic ulcer disease. Eur J Gastroenterol Hepatol. 2006 Apr;18(4):375-9.

Starting date: February 2007
Ending date: May 2008
Last updated: September 21, 2007