Serum Antibodies Positivity to 12 Helicobacter pylori Virulence Antigens in Patients with Benign or Malignant Gastroduodenal Diseases – Cross-sectional Study

摘要

Aim To investigate the association of gastric histological andendoscopic findings in patients with Helicobacter pylori (H. pylori),according to presence of seropositivity to 12 bacterial virulenceantigens.Methods This is a cross-sectional single-center study of 360consecutive outpatients referred in the period of one year toupper gastrointestinal endoscopy because of dyspeptic complaints.Patients sera were tested by Western blot method todetermine the presence of serum antibodies to bacterial virulenceantigens – p120 (CagA – cytotoxin-associated antigen),p95 (VacA – vacuolating cytotoxin), p67 (FSH – flagellar sheathprotein), p66 (UreB – urease enzyme heavy subunit), p57 (HSPhomologue – heath shock protein homologue), p54 (flagellin),p33, p30 (OMP – outer membrane protein), p29 (UreA – ureaseenzyme light subunit), p26, p19, and p17. Upper gastrointestinalendoscopy was performed, endoscopic diagnosis recorded,and 4 mucosal biopsy samples were obtained and assessed accordingto Updated Sydney protocol.Results The sera of 207 patients were analyzed. Thirty patientshad gastric adenocarcinoma, 126 peptic ulcers, and 51 normalfinding. p120 (CagA) seropositivity was significantly moreoften present in patients with higher activity grade in the antrum(P = 0.025), p30 in patients with greater inflammation inthe antrum (P = 0.025) and the corpus (P = 0.010), p33 in patientswith greater inflammation in the corpus (P = 0.050), andp19 (OMP) in patients with lower intestinal metaplasia gradesin the corpus (P = 0.025). Seroreactivity to all other bacterial proteinsshowed no association with the histological status of thestomach mucosa. Except for the seropositivity to protein p95(VacA), which was more often present in patients with duodenalulcer (P = 0.006), there was no difference in seroreactivity toother bacterial proteins and upper gastrointestinal endoscopicfindings.Conclusions p120 (CagA), p33, p 30 (OMP), and p19 (OMP)seropositivity was more often present in patients with highergrades of the histological parameters of gastritis and seropositivityto protein p95 (VacA) with endoscopic presence of duodenalulcer. Histological parameters of gastritis are more associatedwith bacterial virulence than endoscopic findings