Serum Pepsinogen, Gastrin-17, and Interleukin-17 as Biomarkers of Helicobacter pylori-Associated Gastric Mucosal Injury
Author(s):
Rehab Gheni Jolan
Date: 09/10/2026
doi: https://doi.org/10.5281/zenodo.8425890
Abstract
Background: Helicobacter pylori causes progressive gastric mucosal injury, highlighting the need for
accurate noninvasive biomarkers reflecting glandular dysfunction and inflammation. Aims of the study:
This study aimed to evaluate serum pepsinogen, gastrin-17, and interleukin-17 as biomarkers of H. pylori
associated gastric mucosal injury and severity. Methodology: This case–control study included 135
participants (90 patients with H. pylori-associated gastric mucosal injury and 45 matched controls)
recruited at Al-Habbobi Teaching Hospital during January 2025–April 2026. Patients underwent
endoscopy, Sydney-protocol biopsies, histopathology, and rapid urease testing. Fasting serum was stored
at −80°C and analyzed in duplicate for PGI, PGII, G-17, and IL-17 using ELISA; the PGI/PGII ratio was
calculated. Major gastrointestinal, systemic, pregnancy-related, medication-related, and surgical
confounders were excluded. Routine hematological and biochemical tests supported characterization and
quality control. Result: Groups were demographically comparable (all P > 0.05). Among patients,
moderate gastritis predominated (41.1%), while active inflammation, atrophy, and intestinal metaplasia
occurred in 61.1%, 20.0%, and 15.6%, respectively. Compared with controls, patients had lower PGI and
PGI/PGII ratios but higher PGII, G-17, and IL-17 (all P < 0.001). Biomarker alterations progressed with
histological severity. IL-17 correlated most strongly with severity (r = 0.711) and achieved the best
individual discrimination (AUC = 0.931). The combined model provided 95.6% sensitivity and 93.3%
specificity (AUC = 0.972), supporting complementary diagnostic value for injury. Conclusions: Serum
PGI, PGII, the PGI/PGII ratio, G-17, and IL-17 effectively reflected H. pylori-associated gastric mucosal
injury. IL-17 and the PGI/PGII ratio showed the strongest severity associations, while their combined
assessment provided excellent diagnostic accuracy and may support noninvasive patient stratification.
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