Culture of gastric biopsies in celiac disease and its relationship with gastritis and Helicobacter pylori infection

BACKGROUND: Celiac disease (CD) is a gluten-related multisystemic disorder. Duodenal biopsy organ culture is a reliable supporting tool for CD diagnosis and can reveal specific immunological activation in many intestinal tracts. AIM: we investigated the gastric gluten-dependent immunological activation in CD, compared to duodenum. Gastric cultural results were also compared with histology and HP findings. METHODS: 18 patients with suspected CD and HP infection underwent EGD. Biopsies from duodenum (bulb and second portion) and gastric antrum were collected for histology and organ culture system. RESULTS: all patients were diagnosed with CD and gastritis. Nine out of 18 (50%) patients were HP-positive. EMA and anti-tTG were positive in 18/18 (100%) cultures from duodenum, as well as in 17/18 (94.4%) gastric cultures. Anti-tTG were higher in duodenal cultures than in gastric ones (p <0.05). Anti-tTG in gastric cultures were similar in HP-positive and HP-negative patients. Nine out of 17 (53%) patients with positive EMA in gastric culture were HP-positive and 8/17 (47%) were HP-negative. No significant difference in EMA gastric culture results was observed between HP-positive and HP-negative patients. CONCLUSIONS: Our data reveal an involvement also of stomach in CD. HP seems to not affect anti-tTG and EMA results in gastric cultures.