Rebamipide-Promoted Restoration of Gastric Mucosal Sonic Hedgehog Expression after Early Helicobacter Pylori Eradication

trolled trial, rebamipide significantly promoted gastric ulcer healing following eradication. Here, the effect of rebamipide on the restoration of Shh expression after H. pylori eradication was assessed. The data of gerbils with chow diet used in this study were previously examined and partially reported, in terms of eradication and Shh regeneration [3] . The experimental design is shown in figure 1 . In experiment I, 32 male Mongolian gerbils (MGS/Sea) were divided into 2 groups. Gerbils assigned to the H. pyloriinfected group (I group, n = 16) and the H. pylori infected group administered eradication therapy (I+E group, n = 16) were administered H. pylori suspensions at the age of 5 weeks. For H. pylori eradication, lansoprazole (10 mg/kg), amoxicillin (3 mg/kg) and clarithromycin (30 mg/kg; in 0.5% wt/wt carboxymethyl cellulose sodium salt) were administered intragastrically twice daily on 2 successive days 12 weeks after bacterial inoculation [3] . After eradication, the animals in both the I group and the I+E group were further subdivided into the chow diet and rebamipide-containing diet groups (0.25%) [6] . Ten weeks after eradication, the gerbils were examined under ether anesthesia. In experiment II, eradication was carried out 24 weeks after inoculation, and in experiment III, 48 weeks after inoculation. Myeloperoxidase (MPO) Dear Sir, Sonic hedgehog (Shh) is a soluble signal that is secreted in concentration gradients through a tissue and regulates epithelial cell differentiation. Disturbances of epithelial cell differentiation induced by Helicobacter pylori -associated gastritis in Mongolian gerbils are correlated closely with changes in Shh expression [1] . We previously reported that suppressed Shh expression in the gastric mucosa by H. pylori infection was significantly restored following eradication of the bacterium, in both humans [2] and Mongolian gerbils [3] . H. pyloriassociated deregulation of Shh expression was reversible after H. pylori eradication. The restoration of Shh expression was confirmed by immunohistochemistry, mRNA expression and in situ hybridization in Mongolian gerbils [3] . Earlier eradication promoted better restoration of the Shh expression in the gastric mucosa of the Mongolian gerbil [3] . Rebamipide, 2-(4-chlorobenzoylamino)-3-[2-(1H)-quinolinon-4-yl]propionic acid, has been reported to exert a preventive effect on drug-induced gastric ulcer formation by inhibiting neutrophil activation [4] . The drug has oxygen radical scavenging effects and stimulates prostaglandin generation in the gastric mucosa. Terano et al. [5] recently reported that in a randomized, double-blind, placebo-conPublished online: May 7, 2009