HELICOBACTER-PYLORI AND PLASMA AMMONIA LEVELS IN CIRRHOTICS - ROLE OFUREASE INHIBITION BY ACETOHYDROXAMIC ACID

Citation
A. Zullo et al., HELICOBACTER-PYLORI AND PLASMA AMMONIA LEVELS IN CIRRHOTICS - ROLE OFUREASE INHIBITION BY ACETOHYDROXAMIC ACID, Italian Journal of Gastroenterology and Hepatology, 30(4), 1998, pp. 405-409
Citations number
34
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Gastroenterology & Hepatology
ISSN journal
1125-8055
Volume
30
Issue
4
Year of publication
1998
Pages
405 - 409
Database
ISI
SICI code
1125-8055(1998)30:4<405:HAPALI>2.0.ZU;2-#
Abstract
Background and Aims, The role of Helicobacter pylori as a cause of hyp erammonaemia in cirrhotics has still not been fully clarified. This st udy was aimed at evaluating the effect of acute Helicobacter pylori ur ease inhibition by oral acetohydroxamic acid administration on blood a mmonia levels in cirrhotic patients. Methods. Twenty-nine cirrhotics ( 14 males, 15 females; mean age: 63 years; Child-Pugh class: 14 A, 9 B, and 6 C) undergoing upper gastrointestinal endoscopy were enrolled in the study. The presence of Helicobacter pylori infection was assessed by rapid urease test and histology. A semi-quantitative grading of ba cterial density was also performed at histology. All patients received oral acetohydroxamic acid 750 mg, and blood samples for assessment of ammonia levels were taken before and at 15, 30, 60 and 90 minutes aft er administration. Results. Helicobacter pylori infection was detected in 20 patients, while 9 patients were uninfected. Acetoydroxamic acid administration led to a significant reduction in blood ammonia levels at 15 and 30 minutes (mean +/- SD, 113 +/- 44 vs 101 +/- 43 and 93 +/ - 38 mu g/dl, respectively; p=0.002) only in patients with Helicobacte r pylori infection. Moreover the reduction was statistically significa nt only in Child-Pugh B/C class patients and in those with moderate/ma rked Helicobacter pylori density in gastric mucosa. Basal ammonia leve ls did not differ between Helicobacter pylori positive and negative pa tients, nor in patients with mild and moderate/marked Helicobacter pyl ori density in gastric mucosa, while Child-Pugh class B/C cirrhotics h ad higher basal ammonia levels than class A cirrhotics, in both Helico bacter pylori positive and negative groups. Conclusions. Our data show ed that Helicobacter pylori urease inhibition by acetahydroxamic acid administration significantly reduces blood ammonia levels in patients with more advanced liver cirrhosis and in those with a high bacterial density in gastric mucosa.