Sheu B-S, Sheu S-M, Yang H-B, Huang A-H, Wu J-J
Institute of Clinical Medicine, Department of Internal Medicine, National Cheng Kung University, Medical College, No. 1 University Road, Tainan, Taiwan 701.
Gut. 2003 Jul;52(7):927-32. doi: 10.1136/gut.52.7.927.
We tested if host gastric Lewis antigens and the babA2 genotype of Helicobacter pylori correlated with clinicohistological outcome.
We enrolled 188 dyspeptic patients (45 with duodenal ulcer, 45 with gastric ulcer, and 98 with chronic gastritis) with H pylori infection, proved by culture and gastric histology, reviewed by the updated Sydney system. Gastric expression of Lewis (Le) antigens Le(a), Le(b), Le(x), and Le(y) was determined immunochemically to determine intensity (range 0-3). The corresponding 188 H pylori isolates were screened for babA2 genotype by polymerase chain reaction.
All H pylori isolates had a positive babA2 genotype. We identified Le(a) in 33.5%, Le(b) in 72.9%, Le(x) in 86.2%, and Le(y) in 97.4% of biopsies from these 188 patients. Patients who expressed Le(b) had a higher H pylori density than those who did not express Le(b) (p<0.001). Among 139 patients who expressed Le(b), H pylori density increased with a higher Le(b) intensity (p<0.05). Gastric atrophy decreased with Le(b) intensity and thus resulted in lower H pylori density in the antrum (p<0.05). For the 49 patients without gastric Le(b) expression, H pylori density was positively related with Le(x) and Le(a) expression (p<0.05).
Taiwanese H pylori isolates are 100% babA2 genopositive. Gastric Le(b) as well as Le(x) intensity may be major determinants of H pylori density. While lacking gastric Le(b) expression, Le(x) and Le(a) were closely related to H pylori colonisation.
我们检测了宿主胃Lewis抗原及幽门螺杆菌的babA2基因型是否与临床组织学结果相关。
我们纳入了188例经培养和胃组织学证实感染幽门螺杆菌的消化不良患者（45例十二指肠溃疡患者、45例胃溃疡患者和98例慢性胃炎患者），并根据更新的悉尼系统进行评估。通过免疫化学方法测定胃中Lewis（Le）抗原Le(a)、Le(b)、Le(x)和Le(y)的表达，以确定其强度（范围为0至3）。通过聚合酶链反应对相应的188株幽门螺杆菌分离株进行babA2基因型筛查。
所有幽门螺杆菌分离株的babA2基因型均为阳性。在这188例患者的活检样本中，我们发现33.5%的样本表达Le(a)，72.9%的样本表达Le(b)，86.2%的样本表达Le(x)，97.4%的样本表达Le(y)。表达Le(b)的患者幽门螺杆菌密度高于未表达Le(b)的患者（p<0.001）。在139例表达Le(b)的患者中，幽门螺杆菌密度随Le(b)强度的增加而升高（p<0.05）。胃萎缩程度随Le(b)强度降低，从而导致胃窦部幽门螺杆菌密度降低（p<0.05）。对于49例未表达胃Le(b)的患者，幽门螺杆菌密度与Le(x)和Le(a)的表达呈正相关（p<0.05）。
台湾地区的幽门螺杆菌分离株100%为babA2基因阳性。胃Le(b)以及Le(x)强度可能是幽门螺杆菌密度的主要决定因素。在缺乏胃Le(b)表达的情况下，Le(x)和Le(a)与幽门螺杆菌定植密切相关。
