Anti-CagA Antibodies in Peptic Ulcer Patients Infected with <I>Helicobacter pylori</I>
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概要
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We investigated the clinical significance of serum anti-CagA antibody in peptic ulcer patients infected with <I>Helicobacter pylori</I> and assessed its association with histologic changes in gastric mucosa. The subjects were 62 Japanese patients with <I>H. pylori</I> infection and endoscopically diagnosed peptic ulcers (24 men and 19 women with gastric ulcers and 14 men and 5 women with duodenal ulcers) . Serum samples were assayed for the presence of antibodies to CagA with an enzyme-linked immunosorbent assay procedure. The <I>cagA</I> gene was assayed in the gastric juice of 42 of the 62 patients. Histologic examinations were performed according to the histologic classification of the Updated Sydney System. Serum anti-CagA antibody was detected in 76.7% of patients with gastric ulcer and in 73.7% of those with duodenal ulcer. Among the patients with duodenal ulcers, the scores of chronic inflammatory cell infiltration were significantly higher in seropositive patients than in seronegative patients (<I>P</I>=0.020) . Serum titers of anti-CagA antibody correlated with scores of chronic inflammatory cell infiltration (<I>r</I>=0.525, <I>P</I>=0.026) . The cagA gene of <I>H. pylori</I> was detected in the gastric juice of 28 of 29 patients with gastric ulcers and all in 13 patients with duodenal ulcers. The absence of anti-CagA antibody in the serum does not necessarily reflect the absence of the cagA gene of <I>H. pylori</I>. However, serum titers of anti-CagA antibodies correlated with chronic inflammatory cell infiltration into the gastric mucosa of the duodenal ulcer patients. This may indicate that infection with cagA-positive strains of <I>H. pylori</I> is associated with chronic inflammation in the gastric mucosa of Japanese patients with duodenal ulcers.
- 昭和大学・昭和医学会の論文
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