Over the past few years, it has been suggested that increased gastric production of some cytokines, including tumor factor-alpha (TNF-alpha), play a crucial role in the pathogenesis of H. pylori associated gastroduodenal diseases. On the other hand, it has been postulated that the presence of autoantibodies directed against several cytokines could represent or a down-regulatory response of the host to limit the damage associated with chronic bacterial infection or a specific cytokine inhibitor. The aim of this study was to evaluate whether serum anti-TNF-alpha antibodies are produced in response to H. pylori infection. The anti-TNF-alpha antibody titer among H. pylori positive and H. pylori negative patients showed no statistically significant difference. Interestingly, after eradication of H. pylori, no significant modification in anti-TNF-alpha antibody levels was found. In H. pylori positive patients, no correlations (either positive or negative) was demonstrated between anti-TNF-alpha antibody and activity of gastritis, nor between these antibodies levels and presence of duodenal ulcer. The lack of correlation between anti-TNF-alpha antibody levels and activity of gastritis indicates that these autoantibodies do not affect the clinical course of the H. pylori associated gastroduodenal diseases. Therefore, the biological and clinical relevance (if any) of anti-TNF-alpha antibodies in H. pylori associated gastritis remains to be better elucidated.