Alpha-glutamyl-tryptophan in the treatment for post-eradication gastritis: a novel therapeutic approach

Alpha-glutamyl-tryptophan in the treatment for post-eradication gastritis: a novel therapeutic approach

Yu.P. Uspenskiy^1,2, N.V. Baryshnikova^1–3, Yu.A. Fominykh^1,2, A.A. Krasnov⁴, S.V. Petlenko⁵, V.A. Apryatina⁶ 

¹St. Petersburg State Pediatric Medical University, St. Petersburg

²I.P. Pavlov First Saint-Petersburg State Medical University, St. Petersburg

³Institute of Experimental Medicine, St. Petersburg

⁴Herzen University, St. Petersburg

⁵S.N. Golikov Scientific Clinical Center of Toxicology of the Federal Medical Biological Agency, St. Petersburg

⁶St. Petersburg State University, St. Petersburg 

This paper reviews published data on the role of chronic inflammation and gastric mucosal atrophy in the pathogenesis of post-eradication gastritis (post-eradication syndrome, or ex-Helicobacter gastritis). The development of this condition is associated with several factors, i.e., persistence of inflammatory infiltration of the gastric mucosa by neutrophilic granulocytes, oxidative stress, direct and indirect cytokine damage to the gastric mucosa, changes in the gastric microbiota, and contamination of the gastric mucosa by other microorganisms. Inflammatory infiltration is considered a risk factor for coolant atrophy. Atrophy subsequently transforms into intestinal metaplasia, dysplasia, and neoplasia of the gastric mucosa. Therefore, treatment for Helicobacter pylori infection implies not only eliminating the pathogen but also starting therapy as early as possible to prevent inflammation and gastric mucosa atrophy.

The efficacy of cytoprotective drugs to prevent and treat post-eradication gastritis after successful eradication of Helicobacter pylori is discussed. The study results demonstrate that alpha-glutamyl-tryptophan is characterized by potent anti-inflammatory and regenerative effects, which contribute to a significant reduction in the severity of inflammation of the gastric mucosa in chronic atrophic gastritis. Adding alpha-glutamyl-tryptophan to the treatment regimen for H. pylori-associated gastritis (both atrophic and non-atrophic) allows consolidation of the anti-inflammatory effect of anti-Helicobacter therapy as quickly and fully as possible. In the context of these findings, this drug is considered to be a treatment and prevention of post-eradication gastritis.

Keywords: chronic atrophic gastritis, Helicobacter pylori, alpha-glutamyl-tryptophan, histology, morphology, inflammation, atrophy, stomach, gastritis.

For citation: Uspenskiy Yu.P., Baryshnikova N.V., Fominykh Yu.A., Krasnov A.A., Petlenko S.V., Apryatina V.A. Alpha-glutamyl-tryptophan in the treatment for post-eradication gastritis: a novel therapeutic approach. RMJ. 2023;10:52–55.