Gastrinemia e expressão imunohistoquímica das células G, D e enterocromafim-like no estômago de pacientes usadores crônicos de inibidores de bomba de prótons infectados ou não pelo Helicobacter pylori

Abstract

Background: Acid inhibition from chronic proton pump inhibitor use and a possible increase in gastrin can lead to changes in the regulation of hydrochloric acid production. However, it has not known whether such chronic use changes the presence of G, D, and enterochromaffin-like cells in the stomach or the relationship between G and D cells. Objective: To analyze the number of gastrin-producing G cells, somatostatin-producing D cells, and histamine-producing ECL cells in patients who are chronic proton pump inhibitor users (more than 6 months), with or without related Helicobacter pylori infection. Materials and Methods: Biopsies from 105 patients, including 81 chronic PPI users and 24 controls, were processed immunohistochemically and subjected to counting of G, D, and ECL cells in high-magnification microscopic fields and in 10 glands. Results: G cell, D cell, and ECL cell counts were similar across the groups, and appeared to be unaffected by Helicobacter pylori infection. The ratio between G/D cells was higher in the chronic PPI users group than in controls. Conclusion: Chronic PPI use does not affect G cell, D cell, and ECL cell counts significantly, but may alter the ratio between G cells and D cells. Longer-term studies, especially inclusive of patients who have used PPIs for >3 years, are needed to define the period of use that may lead to significant shift in stomach mucosal cell populations.