Yilmaz Ozlem, Sen Nazime, Küpelioğlu Ahmet Ali, Simşek Ilkay
Department of Micro-biology and Clinical Microbiology, Faculty of Medicine, Dokuz Eylul University, Inciralti 35340, Izmir, Turkey.
World J Gastroenterol. 2006 Sep 7;12(33):5375-8. doi: 10.3748/wjg.v12.i33.5375.
To detect H pylori infection and to evaluate the anti CagA seropositivity in adult Turkish dyspeptic patients.
We evaluated anti-H pylori IgA, IgG and anti-CagA antibodies using commercial enzyme-linked immunoassay (ELISA) and Western blot in dyspeptic Turkish patients. H pylori status was determined by histology and rapid urease testing.
Fifty-six patients were entered. Forty-eight (85.7%) out of the 56 patients were positive for H pylori. H pylori IgG seropositivity was 82.1%, IgA seropositivity 48.2%. CagA ELISA showed that IgG was positive in 50% and IgA in 30.4% of those with H pylori infections. Western blot showed that IgG seropositivity was 80.4% and IgA seropositivity 33.9%. Western blot detected IgG antibodies with reactivity to CagA in 50%, VacA in 62.5%, UreB in 87.5%, UreA in 80.4%, and OMP in 57.1%. None of the tests had a sensitivity and specificity above 80%.
None of these commercial tests seems clinically useful for H pylori detection in adult dyspeptic patients, while Western blot can give seropositivity and determine anti-CagA, VacA virulence factor status of Turkish dyspeptic patients in the Izmir region.
检测成年土耳其消化不良患者的幽门螺杆菌感染情况，并评估抗细胞毒素相关基因A（CagA）血清阳性率。
我们采用商业酶联免疫吸附测定（ELISA）和免疫印迹法，对土耳其消化不良患者的抗幽门螺杆菌IgA、IgG及抗CagA抗体进行了评估。通过组织学检查和快速尿素酶试验确定幽门螺杆菌感染状态。
纳入56例患者。56例患者中有48例（85.7%）幽门螺杆菌检测呈阳性。幽门螺杆菌IgG血清阳性率为82.1%，IgA血清阳性率为48.2%。CagA ELISA检测显示幽门螺杆菌感染患者中IgG阳性率为50%，IgA阳性率为30.4%。免疫印迹法显示IgG血清阳性率为80.4%，IgA血清阳性率为33.9%。免疫印迹法检测到对CagA有反应性的IgG抗体占50%，对空泡毒素A（VacA）有反应性的占62.5%，对尿素酶B（UreB）有反应性的占87.5%，对尿素酶A（UreA）有反应性的占80.4%，对外膜蛋白（OMP）有反应性的占57.1%。这些检测方法的敏感性和特异性均未超过80%。
这些商业检测方法对成年消化不良患者的幽门螺杆菌检测似乎均无临床实用性，而免疫印迹法可得出血清阳性结果，并确定伊兹密尔地区土耳其消化不良患者的抗CagA、VacA毒力因子状态。
