Gastric inflammation and neutrophil-activating and cytotoxin-producing Helicobacter pylori strains

Background: Some Helicobacter pylori strains activate human neutrophils without opsonins and/or produce vacuolating cytotoxin. Methods: Human gastric isolates of H. pylori were studied for their ability to nonopsonized induce an oxidative burst in human neutrophils as measured by chemiluminescence and for the production of vacuolating cytotoxin. In all 80 strains were examined, and the type and grade of inflammation in the gastric biopsy specimens from the antrum and corpus of these patients were assessed in accordance with the Sydney system. Results: CL+ (rapid, strong response in chemiluminescence) strains (p < 0.0001) and Tox+ I:cytotoxin-producing) strains (p < 0.0001) were associated with higher acute inflammation scores in gastric ulcer patients. CL+ (p = 0.0002) and Tox+ (p < 0.0001) strains were also associated with higher chronic inflammation scores in gastric ulcer patients. Conclusions: CL+ and Tox+ strains seem to cause more severe inflammation in the gastric mucosa during H. pylori infection.