Differential target of oxidative damage in Helicobacter Pylori-related and autoimmune atrophic gastritis: a single center study

Filippo Pelizzaro¹Romilda Cardin^2*Gemma Maddalo³Michela Palo²Milena Minotto²Chiara Carlotto²Matteo Fassan⁴Fabio Farinati²Fabiana Zingone²

• ¹Azienda ULSS 6 Euganea, Padova, Italy
• ²Department of Surgery, Oncology and Gastroenterology,, Padua University, Padua, Italy
• ³ULSS2 Marca Trevigiana, Treviso, Italy
• ⁴Department of Medicine, Surgical Pathology Unit, Padua University, Padua, Italy

Oxidative stress, which characterizes inflammatory and autoimmune diseases, is involved in atrophic gastritis progression. We aimed at comparing presence and patterns of oxidative stress in autoimmune atrophic gastritis (AAG) and multifocal atrophic gastritis (MAG), investigating its role in disease progression and in the development of genomic damage.In this study, 120 consecutive patients with atrophic gastritis (70 AAG and 50 MAG) were collected. Serum/plasma reactive oxygen metabolites (dROMs test-spectrophotometry), nitric oxide (NO-ELISA), Advanced Oxidation Protein products (AOPP-spectrophotometry), tissue levels of cytokines (IL10 and TNFα -ELISA) and 8-hydroxydeoxyguanosine (8-OHdG) (HPLC-ED) were evaluated.Results: No significant differences in dROMs, NO and AOPP levels were demonstrated between AAG and MAG. In AAG patients, those with early atrophy showed higher levels of dROMs levels compared to advanced stages (p=0.03), and those with early ECL-hyperplasia (ECL-H) showed higher dROMs and AOPP levels as compared with advanced hyperplasia (p=0.02). 8-OHdG levels were significantly higher in MAG than in AAG (p=0.001). A ROC curve showed that patients with low 8OHdG levels had a very low OR of belonging to the MAG group. .A positive linear correlation was detected among serological biomarkers of atrophy and dROMs (p=0.004). IL10 was higher in MAG vs. AAG (p=0.008), also when patients were sub-grouped according to OLGA stages (p=0.01).CONCLUSIONS: Inflammatory responses and oxidative stress characterize atrophic gastritis, irrespective of etiology. However, a boost in inflammatory-induced genomic damage is observed only in MAG, since AAG showed significantly lower 8-OHdG levels. Therefore, oxidative stress does not seem to play a minor role in the development of carcinoid and gastric cancer in AAG, and this may explain the lower risk of tumors in these patients.