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Relation of CagA seropositivity to cagPAI phenotype and histological grade of gastritis in patients with Helicobacter pylori infection

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World Journal of Gastroenterology 2005年第24期11卷 3751-3755页

作者： Tadashi Shimoyama Shinsaku Fukuda Fumika Nakasato tetsuro yoshimura Tatsuya Mikami Akihiro Munakata First Department of Internal Medicine

AIM: Infection with Helicobacter pylori(H pylon) possessing the cag pathogenicity island (PAI) has been associated with severe clinical outcome and CagA-antibody has been used to indicate cagPAI-positive infection. The aim of this study was to examine the accuracy of CagA seropositivity to indicate the virulence of the cagPAI in Japan. METHODS: Sixty isolates of H pylori cultured from gastricbiopsies were examined by polymerase chain reaction assays for the presence of cagA, cagE and VirD4. AntiCagA IgG antibody in matching sera was tested by both ELISA and immunoblot assay. Histological grade of gastritis was graded according to the updated Sydney System.RESULTS: Amongst 53 patients infected with cagA+/cagE+/ViD4+ strain, 38 were CagA seropositive. There were fourpatients infected with strains possessing incomplete cagPAI.Two out of three patients with cagA+/cagE-/VirD4- infection were CagA seropositive, while a patient with cagA-/cagE+/VirD4+ infection was CagA seronegative. Accuracy of ELISA to predict bacterial possession of cagA was 61.7% whereas 58.3% for cagEand VirD4. The immunoblot assay showed relatively higher sensitivity and showed better accuracy. The lower grade of gastric mucosal inflammatory infiltration was seen in false CagA-seronegative patients.CONCLUSION: Some serodiagnosis does not seem tohave enough accuracy to indicate virulence of cagPAI,particularly in infection of strains with incomplete cagPAI.The degree of gastric mucosal inflammation may affect the results of CagA serodiagnosis.

关键词： CagA cagPAI 组织级别胃炎幽门螺杆菌细菌感染

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