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慢性肝病患者及幽门螺杆菌感染高流行率人群中针对肝肠螺杆菌属的血清抗体。

Serum antibodies to enterohepatic Helicobacter spp. in patients with chronic liver diseases and in a population with high prevalence of H. pylori infection.

作者信息

Vorobjova T, Nilsson I, Terjajev S, Granholm M, Lyyra M, Porkka T, Prükk T, Salupere R, Maaroos H-I, Wadström T, Uibo R

机构信息

Department of Immunology, Centre of Molecular and Clinical Medicine, Institute of General and Molecular Pathology, University of Tartu, Ravila 19, 51014 Tartu, Estonia.

出版信息

Dig Liver Dis. 2006 Mar;38(3):171-6. doi: 10.1016/j.dld.2005.12.008. Epub 2006 Feb 7.

Abstract

BACKGROUND

Enteric Helicobacter species might be a risk factor for chronic liver and biliary tract diseases.

AIMS

To analyse serum antibody levels to three enteric Helicobacter species in patients with various biliary tract and chronic liver diseases and compare results with corresponding parameters for an adult population group, known to have a high prevalence of Helicobacter pylori infection, and with healthy blood donors, to explore a possible association of enteric Helicobacter with chronic liver diseases.

SUBJECTS

Sera of 90 patients with various chronic liver diseases, 121 Estonian adult persons and 68 blood donors were analysed.

METHODS

Sera, previously tested for H. pylori were analysed for IgG to Helicobacter hepaticus, Helicobacter bilis and Helicobacter pullorum. ELISA was initially used for screening and exclusion of negative cases. Sera with positive ELISA results were further analysed by immunoblot. To remove cross-reactive antibodies between H. pylori and the enteric species, sera were pre-absorbed with lysed H. pylori cells.

RESULTS

Liver patients showed a significantly higher seroprevalence to H. hepaticus and H. bilis, compared with the adult population group (p=0.0001 and 0.04, respectively), and to H. hepaticus, compared with blood donors (p=0.01). Patients with autoimmune hepatitis showed no significant antibody reactivity to the enteric Helicobacter spp. in contrast to patients with other chronic liver diseases.

CONCLUSION

Patients with chronic liver diseases, except autoimmune hepatitis patients, showed increased antibody levels to H. bilis/H. hepaticus compared with the population and blood donors indicating a possible role of enteric Helicobacter in the natural course of chronic liver diseases. Immunoblot seems to be a promising method for serodiagnosis of infections with these fastidious pathogens.

摘要

背景

肠道幽门螺杆菌属可能是慢性肝脏和胆道疾病的一个危险因素。

目的

分析各种胆道和慢性肝病患者针对三种肠道幽门螺杆菌属的血清抗体水平,并将结果与已知幽门螺杆菌感染率高的成年人群组以及健康献血者的相应参数进行比较,以探讨肠道幽门螺杆菌与慢性肝病之间可能存在的关联。

研究对象

分析了90例各种慢性肝病患者、121名爱沙尼亚成年人和68名献血者的血清。

方法

对先前检测过幽门螺杆菌的血清进行分析,检测针对肝螺杆菌、胆螺杆菌和拉氏螺杆菌的IgG。最初使用酶联免疫吸附测定(ELISA)进行筛查并排除阴性病例。ELISA结果呈阳性的血清通过免疫印迹进一步分析。为去除幽门螺杆菌与肠道菌种之间的交叉反应性抗体,血清用裂解的幽门螺杆菌细胞进行预吸附。

结果

与成年人群组相比,肝病患者对肝螺杆菌和胆螺杆菌的血清阳性率显著更高(分别为p = 0.0001和0.04),与献血者相比,对肝螺杆菌的血清阳性率更高(p = 0.01)。与其他慢性肝病患者相比,自身免疫性肝炎患者对肠道幽门螺杆菌属没有明显的抗体反应性。

结论

与普通人群和献血者相比,除自身免疫性肝炎患者外的慢性肝病患者对胆螺杆菌/肝螺杆菌的抗体水平升高,表明肠道幽门螺杆菌在慢性肝病的自然病程中可能发挥作用。免疫印迹似乎是诊断这些苛求病原体感染的一种有前景的方法。

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