Omeprazole and regulation of cytokine profile in Helicobacter pylori-infected patients with duodenal ulcer disease.

BACKGROUND/AIMS: To estimate the cytokine profile in Helicobacter pylori-positive patients with duodenal ulcers treated with omeprazole.

METHODOLOGY: The subjects were 22 patients with endoscopically defined active duodenal ulcers and H. pylori infection treated with omeprazole for 3 months after initial 1-week triple therapy. Peripheral blood CD3+ CD4+ and CD8+ T lymphocytes, percentage of HLA-DR+ peripheral blood lymphocytes, and cytokine levels (GM-CSF, IL-6 and IL-2) were measured in the supernatants from PHA-cultured peripheral blood lymphocytes at baseline conditions and after 3-months' omeprazole treatment.

RESULTS

The H. pylori eradication triple regimen cured H. pylori infection in 86.4% of our patients. Peripheral blood CD3+ CD4+ and CD8+ T lymphocytes were not affected by omeprazole treatment (P > 0.05), whereas the percentage of HLA-DR+ peripheral blood lymphocytes increased significantly post-treatment (P < 0.05). All cytokine levels measured in the supernatants showed a significant decrease after treatment (P < 0.001).

CONCLUSIONS

The significant decrease in the two pro-inflammatory cytokines (GM-CSF, IL-6) and the major inflammatory cytokine IL-2, implies that the potential cytokine synthesis of the Th1 pattern from peripheral blood lymphocytes is highly suppressed after treatment. This effect on cytokine regulation seems to be a result of the positive H. pylori infection outcome at the immunological level, which leads to "normalization" of cytokine production.