Helicobacter pylori eradication restored sonic hedgehog expression in the stomach

Background/Aims: Sonic hedgehog (Shh) is a morphogen involved in many aspects of patterning of the gut during embryogenesis and in gastric fundic gland homeostasis in the adult. Shh expression is reported-ly to be reduced in Helicobacter pylori-associated gastritis. The aim of this study was to assess the restoration of Shh expression after H. pylori eradication. Methodology: Twenty H. pylori-positive patients who underwent upper gastrointestinal endoscopy before and after the eradication were studied. Biopsy specimens were taken from the greater curvature of the middle third of the stomach body. The specimens were evaluated for the severity of acute and chronic inflammation and for that of mucosal atrophy, based on the updated Sydney system. Immunohistochemistry for Shh and H⁺-, K⁺-ATPase was also performed; the percentages of positively stained epithelial cells for the two molecules were expressed as the Shh index and H⁺-, K ⁺-ATPase index, respectively. Results: There was a significant decrease in the acute and chronic inflammation scores and also in the mucosal atrophy score following the eradication. The Shh and H⁺-, K ⁺-ATPase index were significantly increased following the eradication. Conclusions: Suppressed Shh expression in the gastric mucosa by H. pylori infection was significantly restored following eradication of the infection.