Increased mucosal apoptosis is seen in H. pylori-infected gastric tissue; however, the precise mechanism by which this organism triggers programmed cell death is poorly understood and is investigated in this study. One pathway for induction of apoptosis is the Fas Ag pathway. Normal gastric and small bowel tissue express low levels of Fas antigen and nondetectable levels of Fas ligand. Consequent to H. pylori infection, there is elevated expression of Fas antigen in mucosal cells concurrent with Fas ligand expressing lymphocytes. This prompted us to investigate the potential role of Fas in mediating H. pylori-related apoptosis. It has been shown that inflammatory cytokines are abundant in H. pylori-infected tissue and that cytokines regulate the expression of Fas Ag in various tissue types. Using cell culture, we examine the role of specific inflammatory cytokines in activating this pathway. This communication presents the first evidence to implicate the Fas pathway in mediating apoptosis in H. pylori-associated gastric and duodenal ulcer disease.