Epithelium-protective therapy for patients with autoimmune gastritis with different status of Helicobacter pylori

Introduction. Helicobacter pylori (H. pylori) and autoimmune inflammation are leading etiologic factors of chronic gastritis. Given the lack of etiological treatment for autoimmune gastritis (AIG), there is a need to consider the use of epithelial-protective therapy for this group of patients and analyze of its effectiveness.Aim. To assess the effectiveness of therapy with the cytoprotector rebamipide in patients with AIG with different status of infection with H. pylori.Materials and methods. An open, cohort randomized study was conducted involving 60 patients with chronic atrophic gastritis (CAG). Three groups were formed considering the etiologic factor of CAG: the main group of patients with AIG, comparison group 1 – with AIG in combination with H. pylori, comparison group 2 – with H. pylori-associated gastritis. Patients with AIG, some with AIG in combination with H. pylori and those with H. pylori-associated gastritis received rebamipide for 12 weeks. A statistical analysis of the control results of the dynamics of dyspepsia symptoms and a morphological study of gastrobiopsy samples, was performed.Results. In groups of patients receiving rebamipide therapy, a statistically significant decrease in the severity and incidence of dyspepsia symptoms was observed by the 4th and 12th weeks of observation. When assessing the results of a control morphological study in the groups of patients with AIG and AIG in combination with H. pylori, a statistically significant trend towards a decrease in the degree of inflammation was observed. In the group of patients with H. pylori-associated gastritis, a statistically significant decrease in the degree of inflammation was also noted.Conclusion. The use of epithelium-protective therapy in patients with AIG has a beneficial effect on the manifestations of dyspepsia syndrome. A statistically significant trend towards a decrease in the severity of inflammatory changes in the gastric mucosa in patients with AIG was observed while taking rebamipide. Further studies are required regarding the effectiveness of rebamipide in patients with AIG with a long follow-up period.