Importance of Cytokines in Peptic Ulcer Disease: Implications for Treatment
Importance of Cytokines in Peptic Ulcer Disease: Implications for Treatment
Although all PPIs are effective, there are some differences in their clinical performance,
 particularly in terms of the degree and speed of gastric acid suppression. Few data are also
 available about their effect of the pathophysiological mechanisms of gastritis and peptic
 ulcer disease. Aim of the present study is to investigate the effect of therapy with
 esomeprazole or rabeprazole on the mechanism of pathogenesis of gastritis and particularly on
 the pattern of release of pro- and anti- inflammatory cytokines associated to peptic
 ulcerative process by the gastric mucosa.
Although all PPIs are effective, there are some differences in their clinical performance,
 particularly in terms of the degree and speed of gastric acid suppression. Few data are also
 available about their effect of the pathophysiological mechanisms of gastritis and peptic
 ulcer disease.

 Triggering receptor expressed on myeloid cells (TREM)-1 is a recently discovered receptor
 expressed on the surface of neutrophils and monocytes. Engagement of TREM-1 has been reported
 to trigger the synthesis of proinflammatory cytokines. A soluble form of TREM-1, named
 sTREM-1, was observed and identified at significant levels in serum samples from patients
 with disease of the gastrointestinal tract inflammatory bowel disease. rendering interest
 about the implication of sTREM-1 in their pathogenesis.

 sTREM-1 was also found elevated in the gastric juice of patients with peptic ulcer disease
 being correlated to the degree of the infiltration of the gastric mucosa by neutrophils.

 Published data of our group elicit that sTREM-1 secretion is a crucial parameter for
 evolution from chronic gastritis to peptic ulcer disease. Samples of biopsies of gastric
 mucosa were cultured in the absence/presence of endotoxins showing that the inflamed mucosa
 was a potent secretor of sTREM-1 whatever ceased to exist post-antisecretory treatment.

 Aim of the present study is to investigate the effect of therapy with esomeprazole or
 rabeprazole on the mechanism of pathogenesis of gastritis and particularly on the pattern of
 release of pro- and anti- inflammatory cytokines associated to peptic ulcerative process by
 the gastric mucosa.
Inclusion Criteria:

 -  Written informed consent.

 -  Abdominal pain or discomfort and/or

 -  Epigastric pain with nausea and vomiting and/or

 -  Dyspepsia.

 Exclusion Criteria:

 -  Recent upper GI bleeding

 -  Gastric carcinoma

 -  Diabetes mellitus

 -  Liver cirrhosis

 -  Acute or chronic renal failure

 -  The ingestion of any antimicrobial or antisecretory medication for at least 15 days
 prior to endoscopy.