Pepsinogen Concentrations Research Articles

Reduced Ostertagia circumcincta burdens in milk-fed lambs

Aims: To compare the susceptibility to parasitism by Ostertagia circumcincta of lambs fed entirely with bovine milk or weaned on to solid feed at 3 weeks of age. In addition, the effect of a single daily feed of milk on worm burdens was assessed. Methods: Eight lambs were assigned to each of the 3 diets: milk (M), milk plus solid feed (cereal-based pellets and lucerne chaff) (MS), or solid feed only (S). Those to be fed solid feed were converted from complete milk feeding to the designated diet during their third week of life. From 3 weeks of age, all lambs were infected with 1000 O. circumcincta larvae twice weekly for 6 weeks; 4 lambs from each diet group were given normal sheathed L3 and another 4 were infected with exsheathed larvae. Faecal egg counts (FEC) and serum gastrin and pepsinogen concentrations were monitored from Day 17 after first infection, and worm burdens and abomasal pH and morphology were determined at necropsy. Results: Total worm burdens and FEC were significantly lower in the M than MS and S groups, whereas there was no significant difference between those receiving sheathed and exsheathed larvae. The milk-fed lambs had a smaller reticulo-rumen and omasum and a more acidic abomasal pH. Serum gastrin and pepsinogen were increased in all groups, irrespective of diet or type of larvae used for infection. Conclusions: The cause of the lower worm establishment in lambs fed only milk was probably not failure to exsheath in the immature gastro-intestinal tract, as there were similar worm burdens in lambs whether sheathed or exsheathed larvae were administered. The lower pH of the abomasal contents of the preruminant lambs may have been a factor, as the parasites have previously been shown to die more rapidly in vitro at low pH. Alternatively, the milk itself had adverse effects on the parasites, but was ineffective when combined with solid feed. There was no benefit from feeding a milk plus solid diet over a solid diet.

Duodenogastric reflux is associated with antral metaplastic gastritis

Background: It has long been suspected that duodenogastric reflux plays a role in the pathogenesis of intestinal metaplasia (IM), although recent studies have demonstrated a close association between Helicobacter pylori infection and gastroduodenal diseases, including IM. The objective of this study was to investigate the relation among IM and duodenogastric reflux, H pylori infection, and smoking. Methods: Subjects with “marked” characteristics of IM, all with extensive prepyloric distribution at endoscopy that was confirmed histologically, were studied as an IM group (27 men, 26 women; mean age, 64 years). A control group was comprised by subjects without characteristics of IM (29 men, 28 women; mean age, 63 years). Fasting pH, total bile acid concentration, and ammonia concentration were measured in the gastric juice of all participants. Histologic examination endoscopic biopsy specimens were evaluated histologically. H pylori infection was determined by serum antibody and urease testing, and by histology. Serum gastrin and pepsinogen concentrations, and gastric emptying time were measured. Dietary, drinking, and smoking habits were recorded. Comparisons were made between groups and analyzed statistically. Results: The pH and total bile acid concentrations were significantly higher in the IM group than the control group (p < 0.01). No significant difference in H pylori infection was found between the IM and control group. Smoking was associated with IM (odds ratio [OR], 15.74; 95% CI, 3.96 to 62.50). Conclusions: A high pH and total bile acid concentration and smoking were associated with “marked” IM, suggesting that these factors may play a role in the development of IM. (Gastrointest Endosc 2001;53:53-9.)

Basal concentrations of gastrin and pepsinogen I and II in gastric ulcer: influence of Helicobacter pylori infection and usefulness in the control of the eradication

To study the influence of Helicobacter pylori eradication on basal gastrin and pepsinogen I and II levels in patients with gastric ulcer over a 1-year follow-up period, and to assess the usefulness of these values in confirming H. pylori eradication after treatment. Fifty-six patients with gastric ulcer and H. pylori infection were prospectively studied. At the beginning of the study, endoscopy with biopsies for histologic examination and urease testing was carried out, as were 13C-urea breath test and blood samples for determination of gastrin and pepsinogen I and II values by radioimmunoassay and serology. Histologic study, 13C-urea breath test and laboratory determinations were repeated at months 1, 6 and 12 after completion of eradication treatment. H. pylori infection was eradicated in 82.1% of patients. In patients with successful H. pylori eradication, the initial mean gastrin value was 75.5 +/- 39.1 pg/ml, while at 1 month after treatment this value decreased to 49.2 +/- 21 pg/ml (p < 0.0001). No further reductions were noted. Initial pepsinogen I and II values were 104 +/- 58 and 15.8 +/- 10 ng/ml, respectively, whereas at month 1 after treatment these values were 77 +/- 42 and 7.3 +/- 4 ng/ml, respectively (p < 0.0001) and were 72 +/- 41 and 6.7 +/- 3 ng/ml respectively at month 6 (p < 0.01); no further variations were observed thereafter. The area under the ROC curve which reveals eradication through reductions in hormonal values was 0.70 for gastrin, 0.78 for pepsinogen I, 0.93 for pepsinogen II and 0.92 for the pepsinogen I/II ratio. At months 6 and 12 after treatment completion, differences in mean gastrin and pepsinogen I and II values between the patients with normal histologic findings and those with chronic gastritis were significant (p < 0.05). a) H. pylori eradication is associated with an early fall in basal gastrin values and a progressive decrease in basal pepsinogen I and II values. b) In patients with gastric ulcer, determination of the decrease in basal pepsinogen II levels is a useful and early non-invasive method for confirming eradication. c) Determination of gastrin and pepsinogen I and II values may be useful for assessing improvement in gastritis 6 months after treatment completion.

Can an increased intake of metabolizable protein affect the periparturient relaxation in immunity against Teladorsagia circumcincta in sheep?

Within the overall hypothesis that the periparturient relaxation of immunity (PPRI) to gastrointestinal parasites has a nutritional basis, we studied whether an increased intake of metabolizable protein (MP) could affect the expression of immunity to Teladorsagia ( Ostertagia) circumcincta of twin-bearing and -rearing Greyface ewes. Two sets of iso-energetic diets were formulated to provide either 85% (L-) or 130% (H-) of the MP requirements during the last 6 weeks of pregnancy (-P) and the first 6 weeks of lactation (-L). Thirty ewes were allocated to LP or HP. Six ewes of each group were slaughtered after lambing (S 0); the remaining 24 ewes of each group were allocated to either LL or HL, thus creating four treatment combinations during lactation (LP/LL, LP/HL, HP/LL and HP/HL; n=12). Six ewes of each treatment combination were slaughtered at Week 3 (S 3) or at Week 6 (S 6) in lactation. The HP ewes were heavier at lambing, produced heavier lambs, had lower faecal egg counts (FECs), a lower concentration of plasma pepsinogen, a higher concentration of plasma albumin during late pregnancy and more abomasal globule leukocytes (GLs) but similar worm burdens at S 0 compared to the LP ewes. The LP/HL and HP/HL ewes had a higher calculated milk production than the LP/LL and HP/LL ewes. FECs increased for each treatment combination during the first 3 weeks of lactation. This increase concurred with fewer abomasal GLs at S 3 compared to S 0. The LP/HL and HP/HL ewes had a higher proportion of immature worms and more abomasal GLs than the LP/LL and HP/LL ewes at S 6. The FECs continued to increase during the second 3 weeks of lactation for the LP/LL ewes only, which concurred with an elevated plasma pepsinogen concentration and an absence of abomasal GLs at S 6. The plasma pepsinogen concentration decreased rapidly for the LP/HL ewes during lactation. We conclude that an increased intake of MP could enhance the expression of immunity to T. circumcincta of twin-bearing and -rearing Greyface ewes.

Nematode parasitism in adult dairy cows in Belgium

Over a period of 1 year, from November 1997 to October 1998, the abomasa, blood and faecal samples of 121 dairy cows in Belgium were collected and examined for nematode infections. Nematodes were present in the abomasa of 110 animals. Ostertagia was found in all 110, Trichostrongylus was seen in 65 and Haemonchus in 14 abomasa. Overall, 91% of all trichostrongyles recovered were Ostertagia. The geometric mean total number of Ostertagia was 2750, with an average of 74% inhibited early fourth stage larvae (EL4). Between November and February >90% of the Ostertagia worm burden were EL4 stages. The majority of the animals (56%) harboured a low Ostertagia burden (100–5000) and 15% had a high burden (>10,000). Sixty-four percent of the coprocultures were positive and the genera recovered were Ostertagia sp. (100%), Trichostrongylus sp. (42%), Oesophagostomum (32%), Haemonchus sp. (29%) and Cooperia sp. (16%). A seasonal pattern was evident for serum Ostertagia-specific antibodies and for serum pepsinogen concentration, with the highest levels during the summer, and low values during the winter. Dictyocaulus viviparus specific antibodies were detected in the serum of eight (7%) animals.

Increased serum pepsinogen-I level predicts development of new duodenal erosion following eradication teraphy of H.pylori

Aims: Eradication of Helicobacter pylori (Hp) decreases the concentrations of serum gastrin (G) and pepsinogen (PG). However, the changes in serum level of such peptides during or just after eradication therapy have not been well investigated. In this study, we evaluated the changes in serum G and PG levels at the end of eradication therapy, and then investigated the relation to the duodenal erosion following eradication. Methods: We randomly treated 318 patients (104 female and 318 men, mean age 51 years) with abdominal symptom (109 gastric ulcer (GU), 113 duodenal ulcer (DU), 32 gastro-duodenal ulcer (GDU), and 64 atrophic gastritis (AG». Before eradication, endoscopy was performed and patients with duodenal erosion were excluded. One month after eradication, endoscopy was performed to check duodenal erosion, and Hip culture, histology, and urea breath test performed to assess Hip treatment. We determined G and PG level in sera at three time points: before eradication, at the end of eradication, and one month after eradication. Results: In 272 (85.5%) cured patients, 39 (14.3%) patients had new duodenal erosions. In 46 (14.5%) patients with unsuccessful treatment, no duodenal erosion appeared. Duodenal erosion developed in 27.3%, 10.7%, 9.1%, and 0% in the patients with DU, GDU, GU, and AG. The prevalence of duodenal erosion after Hip eradication was significantly higher (p < 0.005) in DU patients than in GU, and AG patients. In cured patients, G, PG-I, II, and IIII level one month after eradication were significantly decreased compared to those measured before eradication (p < 0.005). At the end of eradication, G and PG-I level were significantly higher than before eradication (p < 0.0001). In uncured patients, no changes were seen. In the patients with new duodenal erosions, G, PG-I, II, and IIII levels were similar to non-duodenal erosion patients before eradication and one month after eradication. However, at the end of eradication, only PG-I levels were significantly higher (p < 0.0001) than in the patients with non-duodenal erosion. Conclusions: 1. Successful Hip treatment causes a temporary high G and PG-I response at the end of eradication therapy. 2. Increased PG-I might be a kind of gastric mucosal response to H.p eradication since this temporary high level of serum PG-I is strongly associated with development of new erosions in duodenum. 3. These phenomenon strongly bring about duodenal mucosal damage by excess acid secretion and PG-I following eradication therapy.

A sequential study of the pathology associated with the infection of sheep with adult and larval Ostertagia circumcincta

Disturbances in the physiology of the abomasa of sheep infected with either adult Ostertagia circumcincta given via abomasal cannulae, or larvae (L3) given intraruminally were matched by pathological changes in tissues collected by repeated mucosal biopsy. Within 2–3 days of the transplant of adult worms, abomasal pH had increased markedly in five out of six animals, and there also had been rapid increases in serum gastrin and pepsinogen concentrations in all animals. Reductions in parietal cell number were recorded as early as 1 day after the transplant of adults and were associated with the rapid accumulation of many neutrophils and eosinophils. Mucosal hyperplasia, with increased numbers of cells closer in appearance to mucous/mucous neck cells, was a relatively late development, being most pronounced in the latter part of the infection. In sheep given larvae, changes in secretory physiology were again matched by a concurrent fall in parietal cell number and by the accumulation of inflammatory cells. Changes became maximal when most worms could be expected to be present as adults, confirming the role of adults in the natural disease. Some abnormalities were detected in biopsies collected from animals maintained free of parasites and, although milder in degree, there were similarities to those observed in parasitised tissues, there being fewer parietal cells, a modest degree of mucous cell hyperplasia and inflammatory infiltrates of predominantly neutrophils. These changes were the likely result of trauma to the tissues in the immediate vicinity of the cannula, due either to the presence of the cannula itself or to the frequent collection of biopsy material from areas close to it.

A model for study of lungworm ( Dictyocaulus sp.) and gastrointestinal nematode infection in young red deer ( Cervus elaphus)

A model of sub-clinical parasitism in young red deer, using concurrent trickle infections of lungworm ( Dictyocaulus sp.) and mixed gastro-intestinal (GI) nematodes of deer-origin was evaluated. 20 parasite-free deer calves were artificially reared indoors from 4 days of age. A further five calves were naturally reared on pasture with their dams, treated with anthelmintic and brought indoors at 3–4 months. At 4–4.5 months of age they were individually housed and allocated to five groups ( n=5). Groups were dosed 3× per week, for 9 weeks with 0, 100 and 500, 200 and 1000 (2 groups), 400 and 2000 infective larvae of lungworm and mixed GI nematodes, respectively, cultured from deer faeces. Liveweight and voluntary feed intake measurements and faecal and blood samples were taken weekly. In the fourth week following cessation of trickle infection, deer were euthanased and lung and GI nematodes recovered. Both lungworm and GI nematode infections became patent at Week 4 of infection. Maximum group arithmetic mean faecal egg counts were 100–190 epg. Maximum group arithmetic mean faecal lungworm larval counts were 58–123 lpg. Group arithmetic mean nematode counts at slaughter ranged from 439–806 for GI nematodes and 31–73 for lungworm, respectively. Despite low nematode counts, reduced liveweight gain, voluntary feed intake and serum albumin concentration, elevated serum pepsinogen, gastrin and globulin concentrations and elevated peripheral eosinophil counts and slight haemoconcentration, but no clinical signs, were observed. The reduction in liveweight gain was related to the reduction in voluntary feed intake ( r 2=0.83; p<0.088). Naturally-reared deer had similar liveweight gains, voluntary feed intake and nematode counts to artificially-reared deer. Thus, methods of infection to produce concurrent sub-clinical lungworm and GI nematode burdens for study of sub-clinical parasitism in young deer have been defined.

The relationship between the number and size of nematodes in the abomasum and the concentration of pepsinogen in ovine plasma

Six-month-old lambs that had been naturally infected with predominantlyTeladorsagia (Ostertagia) circumcinctawere tested for plasma pepsinogen concentrations because pepsinogen concentrations may reflect the extent of damage to the abomasum. The distribution of pepsinogen concentrations among these lambs was positively skewed with most individuals having relatively low concentrations. Pepsinogen concentrations were more strongly associated with variation in the mean length of the adult female worms than with variation in the number of nematodes present. Previous trials have suggested that genetic variation in the growth of lambs is strongly influenced by genetic variation in worm length. Together these results imply that variation among lambs in the pathogenic effects ofT. circumcinctadepends upon the mean size of the worms as well as the number of worms present.

Hypergastrinaemia, abomasal bacterial population densities and pH in sheep infected with Ostertagia circumcincta

Serum gastrin and pepsinogen concentrations, food intake, abomasal pH and abomasal aerotolerant and anaerobic bacterial populations were measured in sheep infected with Ostertagia circumcincta to search for links between hypergastrinaemia, food intake and changes in the abomasal environment. Abomasal pH and serum gastrin and pepsinogen concentrations were elevated in each of five sheep infected via abomasal cannulae with 150 000 exsheathed larval stage three, followed 11 days later by 100 000 sheathed larvae given intraruminally. Unparasitised abomasa contained aerotolerant bacterial population densities of between 10 3 and 10 6 cells ml −1 and these did not change significantly following parasitism. In contrast, anaerobic bacterial population densities increased markedly by about 10 4-fold following parasitism. Anaerobic numbers changed rapidly when abomasal pH increased from 2.5 to 3.5. At pH 4 and above, anaerobic bacterial numbers approached levels expected in rumen contents but parameters other than pH did not relate to bacterial numbers. Brief periods when serum gastrin was lower than expected, coinciding with raised abomasal pH, were not explicable by increased bacterial numbers. Food intake, which decreased for a variable period from around Day 5 p.i., correlated poorly with serum gastrin concentration, suggesting hypergastrinaemia is not the sole cause of anorexia in parasitised animals. The survival of substantial numbers of rumen bacteria in the abomasum at only slightly raised pH may significantly lower the bacterial protein available to the sheep.

Accuracy of screening for gastric cancer using serum pepsinogen concentrations

BACKGROUND/AIMSThe characteristics of pepsinogen screening for gastric cancer were investigated to establish a suitable cut off point for identifying gastric cancer, using endoscopic diagnosis as the yardstick.SUBJECTS/METHODSSerum pepsinogen concentrations were...

Predicting Effects of Naturally Acquired Abomasal Nematode Infections on Growth Rate and Food Intake in Reindeer Using Serum Pepsinogen Levels

An experiment was performed on semiwild reindeer with naturally acquired parasite infections to assess whether measures of serum pepsinogen concentration and fecal egg counts can be used to predict effects of abomasal nematodes on reindeer weight gain and food intake. Food intake and weight gains were lower in infected calves compared with calves where parasites had been removed by anthelmintic treatment. Among the infected animals, concentration of pepsinogen in serum was correlated with food intake and weight gains. Concentration of abomasal nematode eggs in feces was not. Our results suggest that measures of pepsinogen levels in serum, but not fecal egg counts, may be used to predict the effects of abomasal nematodes on food intake and weight gain of reindeer.

Abomasal secretion in sheep receiving adult Ostertagia circumcincta that are prevented from contact with the mucosa

Aims. Both adult and larval Ostertagia circumcincta infections raise abomasal pH and serum gastrin and pepsinogen concentrations, either because of physical effects of the worms or from their chemical secretions. The study was designed to examine whether adult worms require contact with the gastric mucosa to effect changes in gastric secretion. Methods. Abomasal pH and serum gastrin and pepsinogen concentrations were measured in four groups of sheep: Group A (n = 4): abomasal contents containing about 18 000 adult O. circumcincta were obtained from donor sheep, concentrated and infused into 5 µm mesh porous bags attached to surgically implanted abomasal cannulae. A second worm transplantation was carried out 1 week later to assess worm survival after 16 hours. Group B (n = 4): about 9000 adult worms, recovered after migration out of abomasal contents set in agar, were placed in small 5 µm mesh bags which were inserted through indwelling abomasal cannulae and left for 3 days. Group C (n = 2): about 9000 adult worms from the population recovered from agar were infused through abomasal cannulae which allowed. free movement in the abomasum. Group D (n = 3) was left uninfected. Results. Worms transplanted directly into the abomasum (Group C) caused rapid and marked effects on abomasal secretion. Adult O. circumcincta died within 16 hours of transfer into the abomasum when they were restrained within porous bags. Nevertheless, in sheep receiving 18 000 worms, abomasal pH increased soon after new feed was presented on Days 1, 2 and 4 after worm transfer; serum gastrin was elevated in three sheep from 113 hours and serum pepsinogen increased in one animal. Sheep receiving 9000 worms showed similar trends but the results were equivocal. Conclusions. Adult O. circumcincta prevented from physical contact with the gastric mucosa by restraint in porous bags are able to raise abomasal pH. This study implicates parasite excretory-secretory products in mediating changes in gastric secretion caused by adult abomasal worms.

Basal and stimulated gastrin and pepsinogen levels after eradication of Helicobacter pylori: a 1-year follow-up study.

A decrease in gastrin and pepsinogen (PG) levels 1 month after Helicobacter pylori eradication has been described repeatedly, but the long-term progression of such a decrease has been scarcely studied. We therefore studied the effect of H. pylori eradication on basal and stimulated gastrin and PG levels for 1 year. Initially, the usefulness of measuring these parameters for the noninvasive diagnosis of H. pylori eradication was validated. Furthermore, an assessment was made of the association between H. pylori reinfection and a re-increase in gastrin and PG values. Finally, an evaluation was made of the variables influencing gastrin and PG concentration, with particular attention to H. pylori infection and histological lesions of gastric mucosa. Two-hundred and twenty-two patients with duodenal ulcer were studied prospectively. Exclusion criteria were the administration of antibiotics, H2 antagonists, omeprazole or bismuth prior to endoscopy. In all patients serum basal levels of gastrin, PGI, and PGII were measured before and 1 month after completing eradication therapy. In the successfully eradicated patients, gastrin, PGI, and PGII were also measured at 6 and 12 months. In 80 patients stimulated measurements of gastrin (after ingestion of two beef cubes) and PGI (after injection of pentagastrin) were also performed. H. pylori-negative patients after therapy underwent a urea breath test at 6 and 12 months, and patients who had stimulated gastrin and PG concentration measured had also an endoscopy performed at 6 months. H. pylori was eradicated in 73% of patients. A histological improvement was observed 1 month after completing H. pylori eradication therapy, both at gastric antrum and body (P < 0.001), while a further improvement at antrum was demonstrated at 6 months (P < 0.01). With regard to the different cut-off points for decreased basal and stimulated measurements for diagnosing H. pylori eradication, the best results were obtained, respectively, with PGII (sensitivity of 90% and specificity of 76%) and PGI 30 min after stimulation (sensitivity and specificity of 82%), with an area under the ROC curve of 0.87 in both cases. In the multiple regressions analysis H. pylori status correlated with gastrin, PGI and PGII after therapy (P < 0.001), while histological lesions correlated only with gastrin levels (P < 0.05). A decrease in basal and stimulated serum parameters was demonstrated immediately after eradication (Wilcoxon test, P < 0.001), and an additional decrease (at 6 months) was observed just in PGI (Friedman test, P < 0.01). However, gastrin and PGII values remained unchanged after the first month post-eradication. Seven patients were reinfected with H. pylori during follow-up. Quantitation of basal and stimulated gastrin and PGI levels was not reliable as a reinfection marker. Regarding basal PGII, the parallelism was strong at 6 months (re-increase in all four reinfected patients), although only in one out of three with reinfection at 1 year did PGII rise at that stage. (1) Measurement of gastrin and PG levels (especially basal PGII values) is a useful non-invasive method to confirm H. pylori eradication after therapy. (2) H. pylori eradication is associated with a significant decrease in basal and stimulated gastrin levels and in basal PGII levels that is detected immediately (1 month) after finishing treatment, and remains unchanged for 1 year. However, the decrease in basal and stimulated PGI levels occurs progressively for 6 months, although such levels remain also unchanged afterwards. (3) Measurement of gastrin and PGI concentrations has a limited usefulness in the diagnosis of H. pylori reinfections after successful eradication, although PGII determination could be more useful in this situation.

Variation in resistance to haemonchosis: selection of female sheep resistant to Haemonchus contortus

Seventy female lambs (6-7 months old) which were exposed to natural infections of Haemonchus contortus were designated as responders or non-responders on the basis of 10 weekly cumulative faecal egg counts. Selected responder and non-responder lambs were treated with ivermectin, housed separately and 6 weeks post-housing, seven lambs from each group were given a trickle infection of Haemonchus contortus at 1000 L3 daily for 5 days per week up to 2 weeks and examined weekly for 10 weeks after first infection. Analysis of data revealed significantly lower mean faecal egg counts and non-significantly less weight loss in responder than non-responder lambs. Mean values of haemoglobin, packed cell volume, total serum protein and peripheral eosinophil counts were significantly higher in responders than non-responders. In contrast, serum pepsinogen concentration was significantly less in responders than in non-responders. At 10 weeks post-infection, there were fewer pathological lesions and significantly lower worm burdens in responders than in non-responders. These results demonstrate a distinct resistance in responders to Haemonchus contortus infection.

Variation in resistance to haemonchosis: selection of female sheep resistant to Haemonchus contortus

Seventy female lambs (6–7 months old) which were exposed to natural infections of Haemonchus contortus were designated as responders or non-responders on the basis of 10 weekly cumulative faecal egg counts. Selected responder and non-responder lambs were treated with ivermectin, housed separately and 6 weeks post-housing, seven lambs from each group were given a trickle infection of Haemonchus contortus at 1000 L3 daily for 5 days per week up to 2 weeks and examined weekly for 10 weeks after first infection. Analysis of data revealed significantly lower mean faecal egg counts and non-significantly less weight loss in responder than non-responder lambs. Mean values of haemoglobin, packed cell volume, total serum protein and peripheral eosinophil counts were significantly higher in responders than non-responders. In contrast, serum pepsinogen concentration was significantly less in responders than in non-responders. At 10 weeks post-infection, there were fewer pathological lesions and significantly lower worm burdens in responders than in non-responders. These results demonstrate a distinct resistance in responders to Haemonchus contortus infection.

Influences of Helicobacter pylori on serum pepsinogen concentrations in dialysis patients.

Patients with impaired renal function have been known to have elevated concentrations of serum pepsinogens, which are raised by Helicobacter pylori infection of the stomach. The present study was performed to examine the effect of H. pylori infection on serum pepsinogen concentrations in dialysis patients. Forty nine patients on dialysis and 48 subjects with no known kidney disease were examined for upper gastroduodenal endoscopy, H. pylori infection and serum concentrations of pepsinogen I and II. The status of H. pylori infection was evaluated from results of a urease test, histology and culture of biopsy specimens of the gastric mucosa. Serum pepsinogen levels were measured by radioimmunoassay. Serum concentrations of pepsinogen I and II were elevated in the dialysis patients in comparison with those in the controls (277.4+/-24.2 vs 52.6+/-4.0 pg/ml, P<0.01 for pepsinogen I, and 30.2+/-2.9 vs 14.9+/-1.3 pg/ml, P<0.01 for pepsinogen II). In both the dialysis patients and controls, those with H. pylori infection had significantly higher concentrations of serum pepsinogen I and II and a lower ratio of pepsinogen I to pepsinogen II than those without infection. Among the controls, 15 of 25 subjects with atrophic gastritis had a pepsinogen I/pepsinogen II ratio < or = 3.0, while only two out of 17 patients on dialysis fell into this range. We conclude that H. pylori status should be taken into account when serum pepsinogen concentrations are evaluated in dialysis patients.

Influence of impaired renal function and Helicobacter pylori infection on serum pepsinogen concentrations

It has been known that patients with chronic renal failure have elevated concentrations of serum pepsinogens, which are raised by Helicobacter pylori (H. pylori) infection of the stomach. This study was conducted to examine how renal dysfunction and H. pylori infection affect serum pepsinogen (PG) concentrations. The subjects consisted of 93 patients with renal disease (60 males and 33 females with a mean age of 55 +/- 1.3 years). Dialysis patients were not included. Twenty-four-hour urinary collection was performed, and creatinine clearance (Ccr) was calculated for all the subjects. Status of H. pylori infection was assessed by serum IgG antibody against H. pylori. Fasting serum PG I and PG II were measured by RIA. The subjects were divided into 4 groups based on Ccr: group A: Ccr > or = 71 ml/min; group B: 30-70 ml/min; group C: 11-30 ml/min; group D: Ccr < or = 10 ml/min. Regardless of the H. pylori status, serum PG I concentrations were elevated as the renal function declined; serum PG I levels of groups C and D (177.5 +/- 15.2 ng/ml and 234.0 +/- 32.2 ng/ml, respectively) were significantly higher than those of group A (66.1 +/- 9.6 ng/ml, p < 0.01); Group D also had a significantly higher concentration of PG I than group B (106.0 +/- 17.2 ng/ml, p < 0.01). The same tendency was found in serum PG II concentrations. However, the differences among the 4 groups were not statistically significant (16.2 +/- 2.3, 24.2 +/- 4.0, 28.3 +/- 3.5, 34.3 +/- 5.6 ng/ml for group A, B, C, and D, respectively). There was a negative correlation between Ccr and serum PG I concentrations (r = -0.45, p < 0.01). In comparison between H. pylori-infected patients and uninfected patients, serum levels of PG II were higher in the former patients than in the latter. This difference was significant in groups A and C. Serum PG I concentrations were the same between H. pylori-infected patients and their uninfected counterparts for the 4 groups. The present study has shown that serum PG I concentrations are raised by a loss of renal function, while PG II levels are elevated mainly by H. pylori infection of the stomach. It is concluded that renal function and H. pylori infection should be taken into account when serum PG concentrations are evaluated in patients with renal diseases.

A survey of internal parasites and parasite control on North Island deer farms

Aim. To evaluate internal parasite control practices and their effectiveness, and to investigate relationships between indices of parasitism and production outcomes by analysis of data collected during a deer herd health and production profiling project. Methods. A longitudinal study of 15 red deer farms in the North Island of New Zealand was carried out from March 1992 to April 1994. Anthelmintic usage was recorded. Sentinel weaner, yearling and adult hinds and stags were blood and faecal sampled in early autumn, winter, spring and summer for serum pepsinogen and faecal egg and larval counts. A descriptive analysis of control programmes and egg and larval counts was produced. In addition, further measurements of parasitism and parasite control, including faecal egg count and faecal larval count data, individual pepsinogen concentrations, timing and numbers of anthelmintic treatments, and a farm calf faecal lungworm larvae count index were firstly subjected to univariate statistical association with production outcomes, followed by stepwise multivariable logistic regression analysis. Timing and numbers of anthelmintic treatments, along with other farm, herd or animal management risk factors, were included into path models. Results. A wide range of anthelmintic programmes in all age groups, within farms between years and between farms was recorded. Weaner deer received three to nine treatments in their first year. Many farmers treated older deer in only one of the years of study. Older stags were treated more often than younger stags. Oxfendazole, ivermectin and moxidectin were the most commonly used anthelmintics. Egg and larval counts varied between properties and between years in some seasons but a higher proportion of deer shed larvae than eggs. In winter the number of weaners shedding eggs was the same as in autumn, but fewer shed lungworm larvae. Counts were lower at 12 months of age. Counts in older stags and hinds were highest in early spring, and counts were higher in yearling stags than in adult stags. Geometric mean pepsinogen concentration was lowest in weaners and rose to adult levels by early spring. Statistical analyses showed a lower weaning weight associated with higher faecal larval count index, and a reduced number of anthelmintic treatments prior to weaning. Weaners grew faster in spring after late winter anthelmintic treatment than those without treatment or with later treatments. There were inverse relationships between both farm mean weaner and adult serum pepsinogen and summer growth of weaners, and weaning percentage of adult hinds, respectively. Conclusion. This study has highlighted current parasite control practices, relationships between indices of parasitism and production outcomes, and has identified areas for further research into parasitism in farmed deer.

Evaluation of a micro method for the routine determination of serum pepsinogen in cattle

Estimation of serum pepsinogen concentration in cattle is used to aid the detection of clinical or subclinical infections with the abomasal nematode Ostertagia ostertagi. An inexpensive, simple micro method for the routine determination of pepsinogen concentration in bovine serum samples is described which is based on the hydrolysing effect of serum on buffered bovine albumin substrate. Comparison of this assay with a macro method, based on the same principle, gave almost identical results in the range of 0 to 10 Units tyrosine. The reproducibility of the assay was shown to be very satisfactory, intra-assay and day-to-day coefficients of variations were less than 4·7 and 8 per cent, respectively.