Significance of tissue kallikrein in chronic atrophic gastritis.

Seventy patients were diagnosed to have chronic atrophic gastritis, because an atrophic border was distinguished by the endoscopic Congo red method. The atrophic border was furthermore classified into the closed type and the open type. Specimens of the gastric mucosa were obtained by biopsy to measure tissue kallikrein as a marker of inflammation. The sandwich-type ELISA showed that kallikrein significantly increased with the extension of the atrophic area. Histopathological investigations also revealed that kallikrein markedly increased with the appearance of intestinal metaplasia. The peroxidase-antiperoxidase method located (1) a large amount of kallikrein in the mucous granules which filled the goblet cells found in the mucosa showing intestinal metaplasia and (2) a small amount discharged into lumens. These findings suggested that atrophy of the gastric mucosa might be an inflammatory change, and that the kallikrein-kinin system might be associated with gastric inflammation regardless of the pathological stage.