Clinical and pathological implications of IgG antibody responses toHelicobacter pyloriand its virulence factors in non‐ulcer dyspepsia

Abstract

SUMMARYAim: To determine whether pre-treatment antibody response to Helicobacter pylori virulence factors predicts eradication success and symptom relief 12 months after triple therapy in non-ulcer dyspepsia. Methods: H. pylori-positive patients with non-ulcer dyspepsia received 1-week omeprazole-based triple therapy, or omeprazole plus placebos. Symptoms were assessed using a validated Likert scale. Gastric biopsies taken before and 12 months after treatment were used for histological examination. Pre-treatment blood samples were used for the detection of anti-H. pylori immunoglobulin G (IgG) antibodies, and specific IgG antibodies to and 116-kDa (CagA) antigens of H. pylori.Results: IgG antibodies to the six antigens were detected in 62%, 96%, 88%, 47%, 54% and 78% of patients, respectively. The presence of antibody to 19.5-, 26.5-or 30-kDa antigen was associated with an increased anti-H. pylori IgG absorbance index. IgG absorbance indices were greater in those with H. pylori eradication (vs. persistent infection). The prevalence of antibodies to the six antigens was not significantly different between those with symptom relief vs. those without. The 19.5-kDa antigen (P ¼ 0.018) and VacA (P ¼ 0.001) were independent risk factors for body gastritis. Conclusions: An increased pre-treatment anti-H. pylori IgG absorbance index may be a useful predictor of the success of eradication therapy. Although the 19.5-kDa antigen and VacA were associated with body gastritis, none of the six antigens tested predicted symptom relief after triple therapy.

Role of Helicobacter pylori virulence factor and genotypes in non‐ulcer dyspepsia¶

“…This is consistent with a subanalysis in one of the studies where cagA status was checked using IgG antibodies and it was found that cagA status was not predictive of a response to treatment 18 . The results of the present study are also similar to those of another study, 32 where virulence factors were assessed to determine whether they would predict eradication success and symptom relief 12 months after triple therapy and a negative result was obtained. However, in that particular study, the virulence factors and genotypes were assessed using antibodies and it was concluded that the prevalence of antibodies was not significantly different between patients with and without symptom relief.…”

Systematic review and meta‐analysis: importance of CagA status for successful eradication of Helicobacter pylori infection

“…Furthermore, we identified two articles 31, 32 in reference lists of the candidate articles through the search process, which met the inclusion criteria. Finally, 14 studies 17, 19–23, 25, 26, 31–36 were selected for the meta‐analysis (Table 1).…”

Seroreactivity to specific antigens of Helicobacter pylori infection is associated with an increased risk of the dyspeptic gastrointestinal diseases

“…1,28,29 Both VacA and CagA antigens have been shown to be significantly related to gastroduodenal disease in Western countries, 5,29,30 however no significant association has been found in Asian countries. 12,13,23,31,32 Previous studies have reported that anti-VacA antigen is associated with the presence of inflammation in the gastric body, 33 and that the anti-CagA antigen is highly associated with gastric cancer and peptic ulcer. 34,35 Our findings agree with several Asian studies and a study in a United States population, in which no significant association was found between those antigens and the development of gastroduodenal diseases.…”