Wagtmans M J, Witte A M, Taylor D R, Biemond I, Veenendaal R A, Verspaget H W, Lamers C B, van Hogezand R A
Dept. of Gastroenterology and Hepatology, University Hospital Leiden, The Netherlands.
Scand J Gastroenterol. 1997 Jul;32(7):712-8. doi: 10.3109/00365529708996523.
Our aim was to determine the seroprevalence of Helicobacter pylori antibodies in historical sera from a large group of patients with Crohn's disease and to compare the findings with those of a control group of healthy blood transfusion donors.
The historical sera from 386 patients with Crohn's disease were studied (serum age, 9.9 years; range, 0.4-21.6 years). Serum IgG and IgA H. pylori antibodies were measured with enzyme-linked immunosorbent assay. Western blots (detecting IgG only) were also used to study a subpopulation of the patients' sera and to assess the presence of cagA bands, indicating a cytotoxic variety of H. pylori. The serology of the Crohn's disease patients was compared with that of 277 age-matched controls. A longitudinal follow-up study of 14 IgG and IgA anti-H. pylori-positive and 14 IgG- and IgA-negative Crohn's disease patients was also performed (mean follow-up, 7.6 years; range, 1.7-20.5 years).
Of the total Crohn's disease patients, 47 (12.2%) had IgG antibodies against H. pylori, 67 (17.4%) had IgA antibodies, and 31 (8.0%) had both IgG and IgA antibodies. The corresponding antibody positivities for the controls were 98 (35.4%) for IgG, 77 (27.8%) for IgA, and 64 (23.1%) for both IgG and IgA. When compared, with the control group, the seroprevalence of H. pylori in the Crohn's disease patients was significantly lower (P < or = 0.002). In addition the relative IgG response of the patients was lower than the IgA response. The opposite was true for the controls. There was no difference in the absolute levels of H. pylori antibodies between patients and controls. In the follow-up study two patients initially IgG-positive for H. pylori became negative over time; these patients had been treated for their infection. the rest, who continued to be positive, were not treated. One patient who was initially IgA-positive also became IgA-negative over time. The follow-up group, who were initially IgG- and IgA-negative, remained IgG-negative with time, and two patients became IgA-positive. Findings of anti-H. pylori IgG were confirmed with Western blots. Furthermore, these showed that of the H. pylori-positive patients (indicated by their IgG positivity), 66% were infected with a cytotoxic (cagA-positive) variety, compared to 69.4% of the controls.
Patients with Crohn's disease have a lower prevalence of H. pylori antibodies than an age-matched control group. There is a reversal of the relative IgG and IgA responses in Crohn's disease patients compared with the controls. Of the Crohn's disease patients with H. pylori most are infected with cytotoxic varieties, similar to controls.
我们的目的是确定一大群克罗恩病患者历史血清中幽门螺杆菌抗体的血清流行率，并将结果与健康输血献血者对照组进行比较。
研究了386例克罗恩病患者的历史血清（血清保存时间9.9年；范围0.4 - 21.6年）。采用酶联免疫吸附测定法检测血清中幽门螺杆菌IgG和IgA抗体。还使用免疫印迹法（仅检测IgG）研究患者血清亚群，并评估细胞毒素相关基因A（cagA）条带的存在情况，以表明幽门螺杆菌的细胞毒性类型。将克罗恩病患者的血清学结果与277名年龄匹配的对照组进行比较。还对14例IgG和IgA抗幽门螺杆菌阳性以及14例IgG和IgA阴性的克罗恩病患者进行了纵向随访研究（平均随访7.6年；范围1.7 - 20.5年）。
在所有克罗恩病患者中，47例（12.2%）有抗幽门螺杆菌IgG抗体，67例（17.4%）有IgA抗体，31例（8.0%）同时有IgG和IgA抗体。对照组相应的抗体阳性率分别为IgG 98例（35.4%）、IgA 77例（27.8%）、IgG和IgA均阳性64例（23.1%）。与对照组相比，克罗恩病患者中幽门螺杆菌的血清流行率显著较低（P≤0.002）。此外，患者的相对IgG反应低于IgA反应。对照组情况相反。患者和对照组之间幽门螺杆菌抗体的绝对水平没有差异。在随访研究中，2例最初幽门螺杆菌IgG阳性的患者随时间变为阴性；这些患者曾接受过感染治疗。其余持续阳性的患者未接受治疗。1例最初IgA阳性的患者也随时间变为IgA阴性。最初IgG和IgA阴性的随访组随时间IgG仍为阴性，2例患者变为IgA阳性。抗幽门螺杆菌IgG的结果通过免疫印迹法得到证实。此外，这些结果表明，在幽门螺杆菌阳性患者中（以IgG阳性表示），66%感染了细胞毒性（cagA阳性）类型，而对照组为69.4%。
克罗恩病患者幽门螺杆菌抗体的流行率低于年龄匹配的对照组。与对照组相比，克罗恩病患者中相对的IgG和IgA反应发生了逆转。在患有幽门螺杆菌的克罗恩病患者中，大多数感染的是细胞毒性类型，与对照组相似。
