Anti‐CagA and anti‐VacA antibodies in Helicobacter pylori‐infected patients with and without peptic ulcer disease in Serbia and Montenegro

Background: The expression of two Helicobacter pylori proteins, CagA and VacA, is associated with more severe pathogenesis and clinical outcomes of the infection. However, this association varies among geographical regions and ethnic groups. We therefore evaluated CagA and VacA seroprevalence in H. pylori‐positive dyspeptic patients in Serbia and Montenegro. Methods: In 173 consecutive dyspeptic patients referred to endoscopy (67M, mean age 49?±?15, 76 smokers), immunoblot assay was used to detect serum antibodies against CagA and VacA. Presence of H. pylori infection was assessed using a rapid urease test (RUT), routine histology and serology (anti‐IgG ELISA). Duodenal ulcer (DU) was diagnosed in 28, gastric ulcer (GU) in 3 and non‐ulcer dyspepsia (NUD) in the remaining 142 patients. Results: 129 (74.6%) patients were H. pylori‐positive, 27 (96.4%) with DU, 3 (100%) with GU and 99 (69.7%) with NUD (P?P?Conclusions: In Serbia and Montenegro there is high seroprevalence of CagA‐positive H. pylori strains in dyspeptic patients with and without peptic ulcer, while VacA‐positive strains are more closely related to peptic ulcer disease.     

Dextrocardia and two‐vessel percutaneous intervention

Dextrocardia is rare and percutaneous intervention in such patients presents additional challenges to the operator. This report describes successful two‐vessel angioplasty and stenting, including a chronic, sub‐totally occluded proximal left anterior descending artery.     

Effect of D,L‐threo‐1‐phenyl‐2‐decanoylamino‐3‐morpholino‐1‐propanol and tetrandrine on the reversion of multidrug resistance in K562/A02 cells

Abstract

We studied the clinical impact of CD38 expression in 226 chronic lymphocytic leukemia patients (CLL) at disease presentation and during follow up to determine its prognostic significance, progression free survival (PFS) and overall survival (OS), and to verify whether this parameter changed over time. Various patients' characteristics were studied including gender, Rai and Binet stages, immunoglobulin light chain expression, lymphocyte doubling time and CD38 expression. After a median follow up of 53 months (range 6–282), 62% CD38 positive(+) patients required therapy. PFS and OS at 84 months were significantly lower for CD38(+) patients: 20 and 71% respectively, compared to CD38 negative(?): 70 and 96%. At multivariate analysis CD38(+) showed to be the best factor for predicting progression: HR 3·3, 95%CI 2·10–5·14, p = 0·000. Its expression did not change in 98% re-evaluated patients. We confirm that CD38(+) is a stable parameter for the identification of CLL patients with a more aggressive disease course.     

Risk of extra‐oesophageal malignancies and colorectal cancer in Barrett's oesophagus and gastro‐oesophageal reflux

Background: The relationship between Barrett's oesophagus and colorectal cancer and other extra‐oesophageal malignancies (EOM) has been a matter of controversy. These relationships have therefore been examined in a prospective study design in the General Practice Research Database. Methods: Cohorts of patients having Barrett's oesophagus (n?=?1677), oesophagitis (n?=?6392), and simple reflux (n?=?6328), and a standard reference cohort representing the general population in the UK (n?=?13,416) were selected. The last three cohorts were matched to the Barrett's cohort by general practice, age and sex. Incident outcomes occurring beyond the first year of the follow‐up were used for analyses. Hazard ratios and 95% confidence intervals were calculated using Cox's proportional hazards regression. The associations with cataract and oesophageal cancer were explored for comparison. Results: Incident cases of 567 EOM (including 74 colorectal cancers), 448 cataract and 43 oesophageal cancers were used in the final analysis. The relative risks for colorectal cancer compared to the standard reference cohort were 1.16 (0.42–3.21) in the Barrett's cohort, 1.39 (0.76–2.54) in the oesophagitis cohort, and 0.93 (0.45–1.90) in the simple reflux cohort. The corresponding relative risks in the Barrett's cohort were 1.29 (0.90–1.85), 1.60 (1.10–2.32), and 10.56 (5.07–21.99) for EOM, cataract and oesophageal cancer, respectively. Conclusions: The risk of colorectal cancer was not higher in any of the Barrett's oesophagus, oesophagitis, or reflux cohorts compared to the general population. The explanations for the modest increase in the risk of EOM and cataract in the above cohorts are unclear but they may be mediated by ascertainment bias or shared risk factors.     

Intravenous n‐acetylcysteine,ascorbic acid and selenium‐based anti‐oxidant therapy in severe acute pancreatitis

Background: To observe outcome in a cohort of patients with severe acute pancreatitis receiving multiple anti‐oxidant therapy. Methods: An observational study was carried out in 46 consecutive patients with acute pancreatitis fulfilling current Atlanta consensus criteria for severe disease. All patients received multiple anti‐oxidant therapy based on intravenous selenium, N‐acetylcysteine and ascorbic acid plus β‐carotene and α‐tocopherol delivered via nasogastric tube. Principal outcomes were the effect of anti‐oxidant supplementation on anti‐oxidant levels, morbidity and mortality in patients on anti‐oxidant therapy, case‐control analysis of observed survival compared to predicted survival derived from logistic organ dysfunction score (LODS), logistic regression analysis of factors influencing outcome and side effect profile of anti‐oxidant therapy. Results: Paired baseline and post‐supplementation data were available for 25 patients and revealed that anti‐oxidant supplementation restored vitamin C (P?=?0.003) and selenium (P?=?0.028) toward normal. In univariate survival analysis, patient survival to discharge was best predicted by admission APACHE‐II score with relative risk of death increasing 12.6% for each unit increase (95% CI 6.0% to 19.6%). The mean LODS calculated on admission to hospital was 3.7 (standard error of the mean 4.1) giving a predicted mortality for the cohort of 21%. The observed in‐hospital mortality was 43%. Conclusions: Case‐control analyses do not appear to demonstrate any benefit from the multiple anti‐oxidant combination of selenium, N‐acetylcysteine and ascorbic acid in severe acute pancreatitis.     

What We Owe to α1‐Antitrypsin and to Carl‐Bertil Laurell

The archetypal status of α₁‐antitrypsin in biology and medicine grew from the finding, thirty years ago, by Carl‐Bertil Laurell, of the association of its deficiency with emphysema. In biology, α₁‐antitrypsin now provides the model for both the structure and the remarkable mechanism of the serpin protease inhibitors that control the key proteolytic pathways of the body. In medicine, the plasma deficiency of α₁‐antitrypsin has drawn attention to protease‐antiprotease imbalance as a contributory cause of chronic obstructive pulmonary disease. But even more significantly, the finding that the common genetic deficiency of α₁‐antitrypsin was also associated with the development of liver cirrhosis introduced the new entity of the conformational diseases. The proposal that the same general mechanism was responsible for the best known of the conformational diseases, the common late‐onset dementias, was controversial. It was vindicated however by the recent finding that a mutation, which results in the liver aggregation of α₁‐antitrypsin, also results in a typical late‐onset dementia when it occurs in a brain‐specific homologue of α₁‐antitrypsin. The extensive development of such diverse fields of studies, each based on α₁‐antitrypsin, is a measure of the encouragement Laurell gave to younger colleagues in the field. It also reflects the great advantage of linked contributions from clinical as well as basic sciences. Time after time, scientific controversies and deadlocks have been solved by landmark clinical cases, which have revealed unexpected findings and insights, within and beyond the fields of study.     

Incidence,etiology and bone marrow characteristics of non‐chemotherapy‐induced agranulocytosis

Abstract

Objective: Agranulocytosis is a rare but fatal condition. The majority of cases are associated with drugs. However, in‐patient incidences and the relationship between clinical outcomes and bone marrow characteristics have not been established.

Methods: We conducted a retrospective study in a university hospital. A total of 38 in‐patients diagnosed with agranulocytosis were analyzed.

Results: The average incidence of agranulocytosis in Songklanagarind Hospital between 1993 and 2007 was 0·98 cases per 10?000 admissions per year. Antimicrobial agents were the most common etiology (63% of patients) and antithyroid agents were the second most common (13·6%). Two patterns of bone marrow were noted: type I was characterized by a left‐shifted granulopoiesis and type II was recognized as having hypocellular bone marrow with markedly reduced granulocyte precursors. A significantly higher mortality was associated with type II.

Conclusion: Antimicrobial agents are the most common cause and the rare granulocyte precursors in bone marrow are associated with higher mortality rates.     

Inactivated influenza virus vaccine is efficient and reduces IL‐4 and IL‐6 in allergic asthma mice

Background

Allergic asthma is a globally respiratory inflammatory disease. Influenza virus is a respiratory pathogen that causes yearly epidemics and results in high rates of morbidity and mortality. Patients with allergic asthma had a more severe symptom and a higher mortality when they were infected with influenza virus. Hence, influenza vaccination is recommended for patients with asthma.

Objectives

We evaluated the efficacy and effects of influenza vaccination on allergic asthma in a mouse model.

Methods

Ovalbumin‐immunized mice were inoculated with inactivated influenza virus A/Puerto Rico/8/34 (PR8) as vaccines and morbidity or mortality and allergic asthma features of these mice were analyzed.

Results

Mice inoculated with inactivated PR8 induced high levels of anti‐PR8 IgG2a and upregulation of Toll‐like receptor (TLR) 7. Vaccinated allergic mice were healthy when they were challenged with live influenza virus while none of non‐vaccinated allergic mice survived. Furthermore, inactivated influenza virus vaccine induced neither extra airway inflammation nor asthma features such as IgE, airway hyper‐reactivity, and eosinophilia in allergic mice. Particularly, decreased frequency of immune cell infiltrated airways and Th2 cytokines IL‐4 and IL‐6 production in the bronchoalveolar lavage fluid were noted in vaccinated allergic mice. These results suggested that inactivated influenza virus vaccine is efficient to protect allergic mice from further influenza infection, and it does not exacerbate but reduces IL‐4 and IL‐6 of allergic asthma.

Conclusion

Influenza vaccination is essential and efficient for allergic subjects to protect influenza virus infection.     

A Cost‐Effectiveness Analysis of a Peak Flow‐Based Asthma Education and Self‐Management Plan in a High‐Cost Population

Background. Asthma education and action plans (AP) have been recognized as important components in the optimal management of asthma. Studies have differed on the importance of a peak flow‐based self‐management plans in reducing health care costs and use due to asthma exacerbation. Objective. To analyze the cost‐effectiveness of peak flow‐based action plans in reducing costs associated with ER visits and hospitalizations due to acute asthma exacerbation in a population of high‐risk and high‐cost patients, defined as patients with moderate to severe asthma with a history of recent urgent treatment in the ER or hospitalization due to asthma. Methods. A literature review of randomized clinical trials comparing peak flow‐based (PFB) action plans, symptom‐based (SB) action plans, and usual care/no action plan (NAP) was performed. Probability values regarding the effectiveness of each alternative (as measured by increase/decrease in ER visits and hospitalizations over a 6‐month period) were derived. Incremental cost‐effectiveness and cost‐benefit ratios were calculated for each alternative. Sensitivity analyses were performed. Results. For high‐risk and high‐cost asthma patients, our analysis revealed that the most cost‐effective alternative for reducing ER visits was a peak flow‐based self‐management plan. The peak flow‐based self‐management program had an incremental cost‐effectiveness (C/E) ratio of $ 60.57 per ER visit averted compared to usual care/NAP and a C/E ratio of $31.46 compared to the SB‐AP. The PFB‐AP was also the most cost‐effective in reducing asthma hospitalization costs with an incremental C/E ratio of $300 per hospitalization prevented, compared with usual care and a C/E ratio of $311, compared to a SB‐AP. Analysis yielded a cost‐benefit ratio of 13.79 for the PFB‐AP compared to NAP; the SB‐AP had a cost‐benefit ratio of 11.53 compared to NAP. Conclusion. Cost‐effectiveness and cost‐benefit analyses reveal that for high‐cost patients, a peak flow‐based asthma education and self‐management plan program is the most cost‐effective alternative in reducing costs associated with ER visits and hospitalizations due to asthma exacerbation. Further refinements to this cost‐effectiveness analysis including measuring changes in drug use and costs and patients' productivity losses need to be pursued and may demonstrate additional cost‐savings due to peak flow‐based asthma education plans.     

Colitis up‐regulates local glucocorticoid activation and down‐regulates inactivation in colonic tissue

Background: Pro‐inflammatory processes are counteracted by anti‐inflammatory factors such as glucocorticoids. The response of target cells to glucocorticoids depends on several factors including prereceptor modulation of glucocorticoid signals via local glucocorticoid metabolism. This is determined by two isoforms of 11β‐hydroxysteroid dehydrogenase (11βHSD); 11βHSD1 operates in vivo as a reductase converting inactive 11‐oxo glucocorticoids to active glucocorticoids cortisol or corticosterone, whereas 11βHSD2 catalyses oxidation of active glucocorticoids to their inactive 11‐oxo derivatives. The aim of this study was to investigate the changes in local metabolism of glucocorticoids and in the expression of 11βHSD1 and 11βHSD2 mRNA during colonic inflammation. Methods: Acute colitis was induced by intracolonic administration of 2,4,6‐trinitrobenzenesulphonic acid (TNBS) or by drinking a dextran sodium sulphate (DSS) solution. Metabolism of glucocorticoids was measured in tissue fragments in vitro and 11βHSD1 and 11βHSD2 mRNA abundance was quantified using real‐time RT‐PCR one week after administration of TNBS and 10 days after drinking the DSS solution. Results: In both models of inflammatory bowel disease we observed down‐regulation of corticosterone oxidation to 11‐dehydrocorticosterone by 64% (TNBS) and 53% (DSS) and reciprocal stimulation of reduction of 11‐dehydrocorticosterone to corticosterone by 83% and 54%, respectively. A similar pattern was observed at the level of mRNA; 11βHSD1 mRNA was significantly higher (TNBS: increase by 660%; DSS: increase by 760%) and 11βHSD2 mRNA lower (TNBS: decrease by 85%; DSS: decrease by 60%) during inflammation. Conclusions: Colitis induces local glucocorticoid activation from 11‐oxo steroids and decreases glucocorticoid inactivation; i.e. inflammation increases local tissue ratio of active and inactive glucocorticoids. The results indicate that the changes in local metabolism of glucocorticoids could contribute to the control of an overshoot of inflammation processes in the colon.     

The Short‐Term Effects and Unintended Long‐Term Consequences of Binge Drinking in College: A 10‐Year Follow‐Up Study

This study addresses binge drinking in college as a risk factor for heavy drinking and alcohol dependence after college. A national probability sample of 1972 college students from the National Longitudinal Surveys of Youth (NLSY79) was interviewed in 1984 and reinterviewed again as adults in 1994. The short‐term effects of binge drinking in college were assessed as well as the extent to which experiences of negative effects in college predicted patterns of alcohol use across the transition from college into postcollege years. As expected, college binge drinkers were comparatively more likely than nonbinge drinkers to experience one or more alcohol‐related problems while in college. In addition, weighted estimates of DSM‐IV‐defined diagnostic criteria in logistic regression models indicated that the binge drinking patterns exhibited during the college years, for some former college students of both genders, posed significant risk factors for alcohol dependence and abuse 10 years after the initial interview, in conjunction with evidence of academic attrition, early departure from college and less favorable labor market outcomes.     

Comparison of Oral and Depot Intra‐muscular Steroids in Assessing Steroid‐Responsiveness in COPD

Non‐compliance or euphoria may limit the usefulness of prednisolone tablets in assessing steroid‐responsiveness in chronic obstructive pulmonary disease (COPD). Depot intra‐muscular methyl‐prednisolone (imMP), producing a plateau steroid effect over two weeks, may be more reliable. Following two weeks of placebo, twenty‐seven COPD patients (mean FEV₁ 43% predicted) participated in a two‐week randomised, double‐blind, placebo‐controlled, parallel‐design trial taking either 120 mg imMP with placebo tablets or placebo injection with prednisolone 30 mg daily. After each period, post‐bronchodilator FEV₁, forced vital capacity (FVC), inspiratory capacity (IC) and six‐minute walking distance (6MWD) were assessed and patients completed both quality‐of‐life scores (St. George's 30 and Short Form 36) and mood scores (Hospital Anxiety and Depression scores and Altman's Self‐rating Mania Scale). There were no significant changes in 6MWD, quality of life or mood scores after either type of steroids and no change in lung function after imMP. By contrast, there were small mean improvements in lung function on oral prednisolone (mean FEV₁, FVC and IC increased by 100, 320 and 150 ml, respectively). Only the improvement in FVC was significantly greater after prednisolone compared with imMP. Single depot intra‐muscular injections of steroids have no advantage over oral daily prednisolone in testing steroid‐responsiveness in COPD patients.     

Different IL‐5 and IFN‐γ Production from Peripheral Blood T‐Cell Subsets in Atopic and Nonatopic Asthmatic Children

Defective Th1 and enhanced Th2‐type cytokine responses have been implicated in the development of atopic disease. However, the immunopathology of nonatopic asthma, especially in children, remains unclear, and there have been few studies to compare the cytokine profile in peripheral blood T‐cell subsets between atopic and nonatopic asthmatic children. To document whether atopic asthmatic children have a cytokine imbalance and to compare the cytokine profile between atopic and nonatopic asthmatic children, we investigated the interleukin (IL)‐5‐producing and interferon (IFN)‐γ‐producing T‐cell subsets from peripheral blood mononuclear cells (PBMC). The percentages of IFN‐γ‐producing CD4⁺ and CD8⁺ T cells from atopic asthmatic children were decreased, but those in nonatopic asthmatic children were not decreased. In both groups of asthmatic children, the percentages of IFN‐γ‐producing CD4⁺ T cells were inversely correlated with the peripheral blood eosinophils and had a significant correlation with airway responsiveness (PC₂₀). Thus, we found that the mechanism underlying allergic inflammation of nonatopic asthma is not simple a Th1/Th2 cytokine imbalance. Considering the inverse relationship between IFN‐γ‐producing CD4⁺ T cells and eosinophilia or airway hyperresponsiveness, IFN‐γ from CD4⁺ T cells may play an important role in allergic inflammation and airway hyperresponsiveness in asthmatic children.     

The Role of Budesonide in Adults and Children with Mild‐to‐Moderate Persistent Asthma

Asthma, a chronic and potentially life‐threatening disease of the airways, affects patients of all ages. Inhaled corticosteroids (ICS) are the recommended first‐line therapy for patients with persistent asthma. To review the clinical efficacy and tolerability data available on budesonide in the treatment of mild‐to‐moderate persistent asthma, a MEDLINE database search was performed for 1996–2003 using the following key words: budesonide, inhaled corticosteroid, efficacy, safety, systemic. When administered once or twice daily, budesonide effectively controls asthma in children, adolescents, and adults with mild‐to‐moderate asthma. Budesonide can be delivered effectively via a dry powder inhaler (Pulmicort Turbuhaler®) in patients aged ≥ 6 years or as an inhalation suspension (Pulmicort Respules®) in children as young as 12 months. With over 20 years' clinical exposure, budesonide has been demonstrated to be well tolerated in the treatment of chronic asthma in patients as young as 12 months. Specifically, at doses required to treat mild or moderate persistent asthma, budesonide does not affect hypothalamic‐pituitary‐adrenal axis function, bone mineral density, cataract formation, or final adult height. As Pulmicort Turbuhaler®, budesonide is the only ICS to achieve a Food and Drug Administration pregnancy category B rating. Early intervention with budesonide is recommended in asthma management: maximum benefit from therapy is reported in patients treated within 2 years of disease recognition. Budesonide is effective and well tolerated in the control of mild‐to‐moderate persistent asthma in patients aged 12 months and older. There is no evidence for variation in efficacy in population subgroups.     

Long‐term survival after resection for non‐pancreatic periampullary cancer followed by adjuvant intra‐arterial chemotherapy and concomitant radiotherapy

BackgroundThere is no consensus regarding the optimal adjuvant treatment after resection of non‐pancreatic periampullary adenocarcinoma (NPPC; distal common bile duct, ampulla, duodenum).ObjectivesThe present study was conducted to evaluate the impacts on longterm survival and recurrence of adjuvant intra‐arterial chemotherapy (IAC) and concomitant radiotherapy (RT) in patients submitted to resection for NPPC or pancreatic ductal adenocarcinoma (PDAC) in a randomized controlled trial.MethodsA total of 120 patients with PDAC (n = 62) or NPPC (n = 58) were prestratified at a ratio of 1:1 for tumour origin and randomized. Half of these patients were treated with adjuvant IAC/RT and the other half were treated with surgery alone. Follow‐up was completed for all patients up to 5 years after resection or until death.ResultsThere was no survival benefit in either the whole group (primary endpoint) or the PDAC group after IAC/RT. In the NPPC group, longterm survival was observed in 10 patients in the IAC/RT group and five patients in the control group: median survival was 37 months and 28 months, respectively. The occurrence of liver metastases was reduced by IAC/RT from 57% to 29% (P = 0.038). Cox regression analysis revealed a substantial effect of IAC/RT on survival (hazard ratio: 0.44, 95% confidence interval 0.23–0.83; P = 0.011).ConclusionsThis longterm analysis shows that median and longterm survival were improved after IAC/RT in patients with NPPC, probably because of the effective and sustained reduction of liver metastases. The present results illustrate that NPPC requires an adjuvant approach distinct from that in pancreatic cancer and indicate that further investigation of this issue is warranted.     

Endoscopic management of chronic and non‐biliary recurrent pancreatitis

Objective. Endoluminal gastroplication has been used with limited success for the treatment of gastro-oesophageal reflux disease (GORD). This method was used in 119 patients with GORD, and the results from short-term and long-term follow-up of symptoms and the use of acid suppression medication are reported. The purpose of this study was also to report on the effect of a second procedure on selected patients. Material and methods. The Bard EndoCinch® endosuturing system was used for all procedures. Data were recorded at 3 and 12 months, and symptoms and medication use were registered by means of a telephone survey after an average of 41 months (range 27–55 months). A second procedure was carried out in 20 of the initial patients, and mean follow-up time was 39 months (range 15–51 months). Results. There were very few complications of the procedure. Heartburn severity score was reduced from an initial 21.4 to 12.4 (p <0.01) and 13.4 (p<0.01) at 3 and 12 months, respectively, corresponding to a reduction in the use of acid suppression from 8.7 doses per week (DD/w) to 4.0 (p<0.01) and 5.6 DD/w (p<0.01). At long-term follow-up there was a return towards baseline values for acid suppression use (6.4 DD/w, p=0.06), whereas the heartburn severity score remained low (8.5, p<0.01). Loss of sutures was significant, from an average of 2.51 applied sutures to 1.87 (p<0.01) and 1.81 (p<0.01) remaining sutures at 3 and 12 months, respectively. After the second procedure, the heartburn severity score fell from an initial 22.5 to 12.7 (p<0.01) after 3 months and remained low at long-term follow-up (6.6, p<0.01). The corresponding data for acid suppression use were 11.7, 3.6 (p<0.01) and 5.2 (p<0.01) DD/w. Number of sutures increased from an average of 2.15 sutures placed initially, with 2.65 sutures added at the second procedure, to an average of 2.80 remaining sutures (p<0.01) at 3 months. Conclusions. Endoluminal gastroplication has a significant, yet transient effect on symptom score and the use of acid suppressants in GORD patients. A selection of patients for a subsequent procedure may be of value.     

IL‐1 RN 2/2 genotype and simultaneous carriage of genotypes IL‐1 RN 2/2 and IL‐1β‐511 T/T associated with oesophagitis in Helicobacter pylori‐negative patients

Background: Interleukin‐1 receptor antagonist genotype 2/2 is associated with a prolonged and enhanced inflammatory response. It is suspected of being a risk factor for atrophic gastritis and gastric cancer and for some autoimmune diseases. No specific genetic risk factors for oesophagitis have been identified so far and there are no reports of IL‐1 polymorphism in relation to oesophageal disease. Methods: We studied the IL‐1RN, IL‐1β‐511 and IL‐1β?+?3953 polymorphisms in an unselected series of 142 adult patients scheduled for gastrointestinal endoscopy because of dyspepsia. The control group consisted of university staff and students (n?=?179). Helicobacter pylori status was determined by antibody testing and bacterial detection. Results: Endoscopic oesophagitis was noted in 40 patients. The IL‐1RN 2/2 genotype was significantly more prevalent in the patients with H. pylori‐negative oesophagitis than in the control subjects (27% versus 9%; OR 3.574, CI 1.23–10.35, P?=?0.034) or in the dyspeptic patients (27% versus 7%; OR 5.089, CI 1.51–17.11, P?=?0.009). IL‐1β‐511 T/T genotype tended to be more frequent in the H. pylori‐negative patients with oesophagitis than in the control subjects (P?=?0.071). The strongest association was between the simultaneous carriage of genotypes IL‐1RN 2/2 and IL‐1β ‐511 T/T and H. pylori‐negative oesophagitis, where the combined genotype was more prevalent than in the control subjects (23% versus 6%; OR 4.492, CI 1.40–14.46, P?=?0.012) or the dyspeptic patients without oesophagitis (23% versus 3%; OR 9.706, CI 2.12–44.42, P?=?0.003). Conclusion: The results indicate that the IL‐1RN 2/2 genotype and the carriage of combined genotypes IL‐1RN 2/2?+?IL‐1β‐511 T/T are associated with H. pylori‐negative oesophagitis. This is the first report on the association between IL‐1 gene polymorphism and oesophagitis.