Department of Biochemistry, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran.
Helicobacter. 2012 Apr;17(2):116-20. doi: 10.1111/j.1523-5378.2011.00923.x.
Cardiac syndrome X (CSX) is a condition in which patients have the pain of angina despite normal coronary angiogram. Helicobacter pylori (H. pylori) infection causes chronic inflammation which may play a pathogenic role in CSX. We surveyed the association of inflammation with H. pylori and its virulent strain (cytotoxin-associated gene A positive; CagA+) infections with CSX.
Sixty patients with CSX (38 women/22 men; mean age: 51.8 ± 12.3) and 60 age- and gender-matched healthy controls (39 women/21 men; mean age: 48.9 ± 6.3) were enrolled. Plasma samples were tested for the presence of IgG antibody to H. pylori using enzyme linked immunosorbent assay (ELISA) method. IgG- positive patients were determined by the presence of IgG antibody to CagA, also by ELISA method. Also, plasma levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were measured by ELISA method.
Patients with CSX were detected to have significantly higher plasma IL-6 and TNF-α level in comparison with normal controls (33.6 ± 3.5 vs 3.2 ± 0.4 and 24.2 ± 2.3 vs 3.1 ± 0.4, respectively; p < 0.01). The plasma levels of these inflammatory factors in CgA+ were significantly higher than those in CagA- (CSX: IL-6: 43.05 ± 5.04 vs 23.97 ± 4.58 and TNF-α: 31.43 ± 3.13 vs 16.47 ± 2.93, CONTROLS: IL-6: 3.52 ± 1.39 vs 2.90 ± 0.67 and TNF-α: 5.39 ± 1.17 vs 2.22 ± 0.43, respectively; p < 0.05).
The CagA+ strain of H. pylori, can not only be a trigger, and may also have a role via chronic inflammation in the pathogenesis of CSX.
心脏综合征 X（CSX）是一种患者尽管冠状动脉造影正常但仍有胸痛的病症。幽门螺杆菌（H. pylori）感染会引起慢性炎症，这种炎症可能在 CSX 中起致病作用。我们调查了炎症与 H. pylori 及其毒力株（细胞毒素相关基因 A 阳性；CagA+）感染与 CSX 之间的关联。
共纳入 60 例 CSX 患者（38 名女性/22 名男性；平均年龄：51.8 ± 12.3）和 60 名年龄和性别匹配的健康对照者（39 名女性/21 名男性；平均年龄：48.9 ± 6.3）。使用酶联免疫吸附试验（ELISA）法检测血浆样本中 H. pylori 的 IgG 抗体。通过 ELISA 法检测 IgG 阳性患者是否存在 CagA 的 IgG 抗体。同时，通过 ELISA 法测量血浆中白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）的水平。
与正常对照组相比，CSX 患者的血浆 IL-6 和 TNF-α 水平明显升高（分别为 33.6 ± 3.5 比 3.2 ± 0.4 和 24.2 ± 2.3 比 3.1 ± 0.4；p < 0.01）。CagA+患者的这些炎症因子的血浆水平明显高于 CagA-患者（CSX：IL-6：43.05 ± 5.04 比 23.97 ± 4.58 和 TNF-α：31.43 ± 3.13 比 16.47 ± 2.93；CONTROLS：IL-6：3.52 ± 1.39 比 2.90 ± 0.67 和 TNF-α：5.39 ± 1.17 比 2.22 ± 0.43；均 p < 0.05）。
H. pylori 的 CagA+菌株不仅可以作为触发因素，而且可能通过慢性炎症在 CSX 的发病机制中发挥作用。
