Wirth H P, Yang M, Peek R M, Tham K T, Blaser M J
Division of Infectious Diseases, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Gastroenterology. 1997 Oct;113(4):1091-8. doi: 10.1053/gast.1997.v113.pm9322503.
BACKGROUND & AIMS: Lewis antigens occur in human gastric epithelium and in Helicobacter pylori lipopolysaccharide; their expression is polymorphic in both. Autoimmune mechanisms induced by bacterial Lewis expression have been proposed to cause gastritis. The aim of this study was to examine the relationship between bacterial and host gastric Lewis expression, as determined by the erythrocyte Lewis(a/b) phenotype, and between gastric histopathology and bacterial Lewis expression.
H. pylori Lewis expression was determined by enzyme immunoassays, erythrocyte Lewis phenotype was assessed by agglutination tests, and gastric histopathology was scored blindly.
The host Lewis phenotype was (a+b-) in 15, (a-b+) in 34, and (a-b-) in 17 patients, therefore expressing Lewis x, y, or neither as their major gastric epithelial Lewis type 2 antigen. H. pylori from patients with Lewis(a+b-) expressed Lewis x more than y (1147 +/- 143 vs. 467 +/- 128 optical density units [ODU]; P = 0.006), isolates from patients with Lewis(a-b+) expressed Lewis x less than y (359 +/- 81 vs. 838 +/- 96 ODU; P = 0.0001), and isolates from Lewis(a-b-) patients expressed Lewis x and y approximately equally. Gastritis was unrelated to H. pylori Lewis expression.
In mimicking host gastric epithelium, H. pylori cells not only express Lewis x and y, but the relative proportion of expression corresponds to the host Lewis phenotype, suggesting selection for host-adapted organisms.
Lewis抗原存在于人类胃上皮细胞以及幽门螺杆菌的脂多糖中；二者的表达均具有多态性。有研究提出，由细菌Lewis抗原表达所诱导的自身免疫机制可引发胃炎。本研究旨在探讨通过红细胞Lewis(a/b)表型所确定的细菌与宿主胃Lewis抗原表达之间的关系，以及胃组织病理学与细菌Lewis抗原表达之间的关系。
通过酶免疫测定法确定幽门螺杆菌的Lewis抗原表达，通过凝集试验评估红细胞Lewis表型，并对胃组织病理学进行盲法评分。
15例患者的宿主Lewis表型为(a+b-)，34例为(a-b+)，17例为(a-b-)，因此分别以Lewis x、Lewis y或二者均无作为其主要的胃上皮Lewis 2型抗原。来自Lewis(a+b-)患者的幽门螺杆菌表达Lewis x多于Lewis y（光密度单位[ODU]：1147±143 vs. 467±128；P = 0.006），来自Lewis(a-b+)患者的菌株表达Lewis x少于Lewis y（359±81 vs. 838±96 ODU；P = 0.0001），而来自Lewis(a-b-)患者的菌株表达Lewis x和Lewis y的量大致相等。胃炎与幽门螺杆菌的Lewis抗原表达无关。
幽门螺杆菌在模拟宿主胃上皮细胞时，不仅表达Lewis x和Lewis y，而且其表达的相对比例与宿主Lewis表型相对应，提示存在对宿主适应性微生物的选择。
