Havlasová J, Bures J, Rejchrt S, Voxová B, Krejsek J
Oddĕlení klinické imunologie a alergologie FN, Hradec Králové.
Cas Lek Cesk. 1998 Jun 29;137(13):404-9.
CagA antigen of Helicobacter pylori is highly immunogenic in humans. There is an increasing evidence that infection with CagA-positive strains is related to the development of peptic ulcer disease, atrophic gastritis, or gastric cancer. The aim of our study was to assess seropositivity to CagA in a group of 95 clinically symptomatic adults who underwent gastroduodenoscopy and to correlate results to their disease characteristics.
Serum immunoglobulin G antibodies to CagA detected by ELISA kit (Helicobacter p120, Viva Diagnostika, Germany) were compared to standard IgG specific antibodies against a pool of H. pylori antigens Synelisa Pin plate, ELIAS, Germany). Immunoglobulin G antibodies to CagA were present in 5/31 (16%) serum samples from H. pylori negative persons and 10/28 (36%) serum samples from H. pylori positive patients without peptic ulcer disease compared with 8/11 (73%) H. pylori positive patients with peptic ulcer disease in the past, 11/13 (85%) H. pylori positive patients with duodenal ulcers or duodenitis and 4/5 (80%) H. pylori positive (1/7, 14% H. pylori negative) serum samples from patients with gastric resection for peptic ulcers in the past. Serum levels of antibodies to CagA in the groups of patients with peptic ulcer disease in the past, with present duodenal ulcers of duodenitis and in H. pylori infected patients with gastric resection were significantly higher then those of H. pylori infected patients without peptic ulcer disease (P < 0.05). On the other hand, there was no significant difference in the presence of the specific antibodies against at pool of H. pylori antigens between these four groups.
These data suggest that serologic response to the CagA antigen is more prevalent in H. pylori positive persons with present or past peptic ulceration than among infected persons without peptic ulcer disease. The presence of antibodies to CagA in H. pylori positive persons may be useful for the identification of patients with higher risk or more severe disease.
幽门螺杆菌的CagA抗原在人体内具有高度免疫原性。越来越多的证据表明，感染CagA阳性菌株与消化性溃疡疾病、萎缩性胃炎或胃癌的发生有关。我们研究的目的是评估一组95例有临床症状并接受了胃十二指肠镜检查的成年人中CagA的血清阳性率，并将结果与其疾病特征相关联。
使用ELISA试剂盒（德国Viva Diagnostika公司的Helicobacter p120）检测血清中针对CagA的免疫球蛋白G抗体，并与德国ELIAS公司的Synelisa Pin板上针对幽门螺杆菌抗原池的标准IgG特异性抗体进行比较。在幽门螺杆菌阴性者的5/31（16%）份血清样本以及无消化性溃疡疾病的幽门螺杆菌阳性患者的10/28（36%）份血清样本中检测到了针对CagA的免疫球蛋白G抗体，相比之下，过去有消化性溃疡疾病的幽门螺杆菌阳性患者中8/11（73%）份血清样本、有十二指肠溃疡或十二指肠炎的幽门螺杆菌阳性患者中11/13（85%）份血清样本以及过去因消化性溃疡接受胃切除术患者的4/5（80%）份幽门螺杆菌阳性（1/7，14%幽门螺杆菌阴性）血清样本中检测到了该抗体。过去有消化性溃疡疾病的患者组、目前有十二指肠溃疡或十二指肠炎的患者组以及幽门螺杆菌感染且接受胃切除术的患者组中，针对CagA的抗体血清水平显著高于无消化性溃疡疾病的幽门螺杆菌感染患者（P<0.05）。另一方面，这四组之间针对幽门螺杆菌抗原池的特异性抗体存在情况没有显著差异。
这些数据表明，与无消化性溃疡疾病的感染者相比，目前或过去有消化性溃疡的幽门螺杆菌阳性者对CagA抗原的血清学反应更为普遍。幽门螺杆菌阳性者中存在针对CagA的抗体可能有助于识别风险较高或病情更严重的患者。
