Changes in Prooxidant and Antioxidant-Related Trace Element Levels During Helicobacter pylori Eradication Therapy

Abstract

Helicobacter pylori (H. pylori) is a spiral-shaped Gram-negative bacterium strongly linked to chronic gastritis, peptic ulcer disease, and gastric cancer. The Maastricht V/Florence Consensus Report recommends eradication therapy to prevent related complications. Trace elements are essential for maintaining oxidative balance, and their alterations during therapy may provide insights into the metabolic mechanisms of H. pylori and the cellular metabolic response to PPI and antibiotic therapy. This study investigated alternations in seven key trace elements and the oxidative stress marker malondialdehyde (MDA) in patients undergoing H. pylori eradication therapy. Blood and urine samples were collected from 40 patients at baseline and 1 month after standard triple eradication therapy. Trace element concentrations were assessed using inductively coupled plasma-mass spectrometer (ICP-MS) or atomic absorption spectrophotometer (AAS), while MDA levels were determined via high-performance liquid chromatography with fluorescence detector (HPLC-FLD). H. pylori eradication was confirmed 1 month post-treatment using the urea breath test. Clinical hematology and chemistry parameters were largely unchanged, except for an increase in blood urea nitrogen (p = 0.007). Post-treatment, the average plasma levels of iron, copper, chromium, and MDA increased significantly, whereas zinc and selenium decreased (p < 0.05). In urine, the average concentrations of iron, copper, zinc, and selenium decreased significantly, whereas chromium increased (p < 0.05). These findings indicate that eradication therapy altered the average levels of both prooxidant-related elements and MDA, alongside reductions in antioxidant-related elements, suggesting enhanced oxidative stress. These findings highlight the need for further studies to clarify the clinical implications of these average changes following eradication.

Keywords: Helicobacter pylori eradication; Antioxidant; Malondialdehyde (MDA); Prooxidant; Trace element.