The effect of eradication treatment on serum thiol / disulphide levels in patients with helicobacter pylori positive non-ulser dyspepsy

Purpose: Functional or non-ulcer dyspepsia (NUD) is a condition of recurrent or continuous abdominal pain and discomfort localized to the epigastric region, which no definite structural or biochemical cause to explain the symptoms. Dyspepsia etiology includes multifactorial conditions such as abnormalities in visceral perception, motor dysfunction, acid secretion, psychological stress, personality structure, environmental factors (diet, smoking, socio-economic status) and Helicobacter pylori (HP) infection. There is no definitive decision about the place and effect of Hp which is accepted as one of the etiological reasons in dyspepsia. However, eradication treatment is recommended in patients with dyspepsia with Hp. Helicobacter pylori settles on the gastric mucosa leading to a chronic inflammatory response. As a result of this inflammation the balance of oxydoreduction in the gastric mucosa is affected. The aim of our study is to investigate thiol-disulfide levels in HP positive NUD patients and its relation to eradication treatment success. Method: Between March 2019 and December 2019 , total of 144 patients (mean age 36.3±12.8) including 73 men with NUD and 71 women with NUD who with ambulatory follow up and endoscopy at Dicle University Medical Faculty Gastroenterology Outpatient Clinic were included prospectıve in this study. These patients were divided into two groups as Hp positive NUD and Hp negative NUD According to the results of Hp in the histopathological examination of the endoscopic biopsy . Serum natural thiol (sNT), serum total thiol (sTT) and serum disulfide (sD) levels that initial and post-treatment of the patients included in the study were evaluated using the method developed by Erel and Neselioglu. Results:There was no significant difference in age and gender compared with the 92 Hp positive patients and 52 Hp negative patients. Histopathologically, the degree of inflammation (p <0.001), neutrophil activity (p <0.001) and presence of atrophy (p = 0.041) were significantly higher in the Hp positive group. Helicobacter pylori eradication treatment success was 93% (52/56 patients). There was no difference between the initial thiol-disulfide levels of patients with Helicobacter pylori positive and negative dyspepsia. Histopathologically, there was a negative correlation between the presence of atrophy and sNT (R = -0.214, p = 0.010) and sTT (R = -0.189, p = 0.024). in the group where the treatment was successful the changes in SNT, sTT and sD levels after eradication were statistically significant (p=0.003, p=0.018, p=0.04). Conclusion:In our study, it was observed that Hp eradication reduced oxidative stress by reversing the deterioration in cell redox balance in the form of thiol reduction and disulfide increase, as well as thiol increase and disulfide decrease. Thiol and disulfide levels can be a cheap, simple, useful biochemical marker in predicting the presence of atrophy in the stomach. In addition to eradication therapy in H.pylori positive NUD patients, the use of antioxidant agents may provide additional benefits in oxidative stress and clinical response.