Erzin Yusuf, Altun Sibel, Dobrucali Ahmet, Aslan Mustafa, Erdamar Sibel, Dirican Ahmet, Tuncer Murat, Kocazeybek Bekir
Department of Gastroenterlogy, Istanbul University, Cerrahpasa Medical Faculty, 34303 Kocamustafapasa-Istanbul, Turkey.
World J Gastroenterol. 2006 Nov 14;12(42):6869-73. doi: 10.3748/wjg.v12.i42.6869.
To investigate the frequency of seropositivity against CagA, VacA proteins and to determine their independent effects on the development of duodenal ulcer (DU) in Turkish patients.
The study was designed as a prospective one from a tertiary referral hospital. Dyspeptic patients who were referred to our endoscopy unit for upper gastrointestinal endoscopy between June 2003 and March 2004 and diagnosed to have DU or nonulcer dyspepsia (NUD) were included. Biopsies from the antrum and body of the stomach were taken in order to assess the current H pylori status by histology, rapid urease test and culture. Fasting sera were obtained from all patients and H pylori status of all sera was determined by IgG antibodies using an enzyme-linked immunosorbent assay (ELISA) kit. All seropositive patients were further analysed using Western blot assays detecting IgG antibodies against CagA and VacA proteins. The c2 test was used for statistical comparison of the values and age-sex adjusted multiple regression analysis was used to determine the independent effects of CagA and VacA seropositivities on the development of DU.
Sixty-three patients with DU and 62 patients with NUD were eligible for the final analysis. Seropositivity for anti-CagA was detected in 51 of 62 (82%), and in 55 of 63 (87%) patients with NUD and DU, respectively (P = no significance), and seropositivity for anti-VacA was found in 25 of 62 (40% ) and in 16 of 63 (25%) patients, with NUD and DU, respectively.
These findings suggest that none of these virulence factors is associated with the development of DU in the studied Turkish patients with dyspepsia.
调查土耳其患者中抗细胞毒素相关基因A(CagA)、空泡毒素A(VacA)蛋白血清阳性率,并确定它们对十二指肠溃疡(DU)发生发展的独立影响。
本研究为来自一家三级转诊医院的前瞻性研究。纳入2003年6月至2004年3月间因上消化道内镜检查转诊至我院内镜科且诊断为DU或非溃疡性消化不良(NUD)的消化不良患者。取胃窦和胃体组织活检,通过组织学、快速尿素酶试验和培养评估当前幽门螺杆菌感染状况。采集所有患者的空腹血清,使用酶联免疫吸附测定(ELISA)试剂盒通过IgG抗体检测所有血清的幽门螺杆菌感染状况。所有血清阳性患者进一步采用蛋白质印迹法检测抗CagA和VacA蛋白的IgG抗体。采用卡方检验进行数值的统计学比较,采用年龄-性别校正的多元回归分析确定CagA和VacA血清阳性对DU发生发展的独立影响。
63例DU患者和62例NUD患者纳入最终分析。抗CagA血清阳性率在62例NUD患者中有51例(82%),在63例DU患者中有55例(87%)(P =无显著性差异);抗VacA血清阳性率在62例NUD患者中有25例(40%),在63例DU患者中有16例(25%)。
这些发现表明,在本研究的土耳其消化不良患者中,这些毒力因子均与DU的发生发展无关。