Department of Medical, Surgical and Neurological Sciences, University of Siena and Policlinico S. Maria alle Scotte, , Siena, Italy.
J Clin Pathol. 2014 Mar;67(3):251-7. doi: 10.1136/jclinpath-2013-201743. Epub 2013 Dec 13.
B-type natriuretic peptide (BNP) determination is routinely used to evaluate the severity of congestive heart failure, a possible consequence of coronary artery disease (CAD). CAD originates from vascular atherosclerotic processes and is stimulated by inflammatory events, which may also be triggered by chronic bacterial infections.
To explore the effect of Helicobacter pylori infection upon systemic BNP, tumour necrosis factor-α (TNF-α) and interleukin-6 (IL-6) levels and linear homology between cardiac peptides and H pylori.
A group of 103 consecutive patients with a diagnosis of non-ST elevation acute CAD (ACAD) and no other concomitant pathology was examined. BNP was measured by a commercial solid-phase sandwich immunoradiometric assay. H pylori infection, CagA serological status and circulating levels of IL-6 and TNF-α, were determined by ELISA assays. Amino acid sequence homology between human cardiac and H pylori peptides was investigated by Basic Local Alignment Search Tool (BLAST) analysis.
Circulating levels of BNP and IL-6, in pg/mL (interquartile difference), among infected patients with anti-CagA serum antibodies, respectively 781 (1899) and 37.7 (137.6), were significantly increased in respect to those measured in uninfected patients, respectively 325 (655) and 7.7 (23.5), (p<0.01 and p=0.025), and, with regard to BNP alone, also in patients infected by CagA negative H pylori strains, 305 (593), (p<0.01). TNF-α levels were raised in CagA positive in respect to uninfected patients. Tropomyosin and Ca2+ transporting ATPases showed strong similarities to H pylori proteins, suggesting the existence of molecular mimicry phenomena.
Chronic infection by H pylori expressing CagA correlates with high circulating levels of BNP and IL-6 in patients with ACAD.
B 型利钠肽（BNP）的测定通常用于评估充血性心力衰竭的严重程度，充血性心力衰竭是冠状动脉疾病（CAD）的可能后果。CAD 源于血管动脉粥样硬化过程，受炎症事件刺激，也可能由慢性细菌感染引发。
探讨幽门螺杆菌感染对系统性 BNP、肿瘤坏死因子-α（TNF-α）和白细胞介素-6（IL-6）水平的影响，以及心脏肽与 H pylori 之间的线性同源性。
检查了一组 103 例非 ST 段抬高型急性 CAD（ACAD）诊断且无其他合并症的连续患者。BNP 通过商业固相夹心免疫放射测定法测定。通过酶联免疫吸附试验（ELISA）测定 H pylori 感染、CagA 血清状态以及循环 IL-6 和 TNF-α水平。使用 Basic Local Alignment Search Tool（BLAST）分析调查人心脏和 H pylori 肽之间的氨基酸序列同源性。
在有抗 CagA 血清抗体的感染患者中，pg/mL（四分位差）循环 BNP 和 IL-6 水平分别为 781（1899）和 37.7（137.6），明显高于未感染患者的 325（655）和 7.7（23.5），（p<0.01 和 p=0.025），并且仅针对 BNP，CagA 阴性 H pylori 株感染的患者中也分别为 305（593），（p<0.01）。CagA 阳性患者的 TNF-α水平升高。原肌球蛋白和 Ca2+转运 ATP 酶与 H pylori 蛋白表现出很强的相似性，表明存在分子模拟现象。
表达 CagA 的 H pylori 慢性感染与 ACAD 患者循环中 BNP 和 IL-6 水平升高相关。
