The relationship between Helicobacter pylori CagA IgG positivity and gastrointestinal complaints and histopathological findings

Yıl 2018, Cilt: 17 Sayı: 3, 98 - 103, 29.12.2018

Sibel Bakırcı Üreyen , Cumali Efe Narin Nasıroğlu İmga Tankut Köseoğlu Ersan Özaslan Hasan Tunca Engin Sennaroğlu

https://doi.org/10.17941/agd.469636

Öz

Background and Aims: In recent years, there has been a
widespread use of serologic tests based on detection of IgG-type antibodies
against Helicobacter pylori CagA outer membrane protein, which is a strong
immunogen and cytotoxin, for the identification of pathologies caused by these
microorganisms. The aim of this study was to evaluate the relationship between
CagA IgG antibodies against Helicobacter pylori and gastrointestinal complaints
and histopathological and demographic data. Material and Methods: This study included 74 adult patients
who were admitted to the internal medicine outpatient clinic with different
gastrointestinal complaints, showed Helicobacter pylori positivity in the urea
breath test, and underwent esophagogastroduodenoscopic biopsy because of the
diagnosis.  The presence of IgG antibodies against CagA protein was
detected by Enzyme Linked Immunosorbent Assay. Results: The 74 patients included 20 (27%) females and 54
(73%) males. CagA IgG positivity was detected in 62% of the Helicobacter
pylori-positive patients. The most common gastrointestinal complaint was
abdominal pain, and the most common histopathological finding was chronic
active gastritis in the CagA IgG-positive patient group. Conclusion: Further long-term studies with a large sample
size are needed to standardize the use of these serologic tests, which are
inexpensive, practical, and noninvasive, in the early diagnosis of pathologies
associated with Helicobacter pylori infection.

Anahtar Kelimeler

Helicobacter pylori, CagA IgG, gastrointestinal complaints, histopathology, urea breath test

Helicobacter pylori CagA IgG pozitifliğinin gastrointestinal yakınmalar ve histopatolojik bulgular ile ilişkisi

Öz

Giriş ve Amaç: Güçlü immünojen ve sitotoksin olan Helicobacter
pylori CagA
dış membran proteinine karşı
oluşan IgG tipi antikorların tespitine dayanarak yapılan serolojik testlerin,
bu mikroorganizmaların neden olduğu patolojilerin tespitinde kullanımı son
yıllarda yaygınlaşmaktadır. Bu çalışmada, Helicobacter
pylori’ye karşı oluşmuş
CagA IgG antikorlarının gastrointestinal yakınmalar, histopatolojik ve demografik
veriler ile ilişkisinin
değerlendirilmesi amaçlandı. Gereç ve Yöntem: Farklı gastrointestinal yakınmalar ile
dahiliye polikliniğine başvurduktan sonra rutin değerlendirmelerinde üre nefes
testi ile Helicobacter pylori açısından pozitif olarak tespit edildikten sonra tanı amaçlı özofagogastroduodenoskopik biyopsi yapılan18
yaş üzeri toplam 74 hasta çalışmamıza dahil edildi. Bu hastalarda CagA proteinine ait özgül IgG antikor varlığını saptamak için Enzyme Linked Immunosorbent Assay yöntemi
kullanıldı. Bulgular: Yetmişdört hastanın 20’si kadın (%27) ve 54’ü erkekti (%73). Helicobacter pylori pozitif saptanan
hastaların %62’sinde CagA IgG pozitifliği saptandı. CagA
IgG pozitif hasta
grubunda en sık saptanan gastrointestinal şikayet karın ağrısı ve en sık
histopatolojik bulgu kronik aktif gastrit olarak tespit edildi. Sonuç: Helicobacter pylori enfeksiyonu
ile ilişkili patolojilerin erken tanısında daha
ucuz, pratik ve invaziv olmayan bu serolojik
testlerin kullanımının standardize edilmesi için uzun dönemli ve büyük örneklem
büyüklüğüne sahip çalışmaların yapılmasına ihtiyaç vardır.

Anahtar Kelimeler

Helicobacter pylori, CagA IgG, gastrointestinal şikayetler, histopatoloji, üre-nefes testi

Kaynakça

• 1. Eusebi LH, Zagari RM, Bazzoli F. Epidemiology of Helicobacter pylori infection. Helicobacter 2014;19:1-5.
• 2. Ozaydin N, Turkyilmaz SA, Cali S. Prevalence and risk factors of Helicobacter pylori in Turkey: a nationally-representative, cross-sectional, screening with the 13C-Urea breath test. BMC Public Health 2013;13:1215.
• 3. McColl KE. Helicobacter pylori infection. N Engl J Med 2010; 362:1597-604.
• 4. Tonkic A, Tonkic M, Lehours P, Mégraud F. Epidemiology and diagnosis of Helicobacter pylori infection. Helicobacter 2012;(17 Suppl 1):1-8.
• 5. Braden B. Diagnosis of Helicobacter pylori infection. BMJ 2012;344:e828
• 6. Yilmaz O, Sen N, Küpelioğlu AA, Simşek I. Detection of H. pylori infection by ELISA and Western blot techniques and evaluation of anti CagA seropositivity in adult Turkish dyspeptic patients. World J Gastroenterol 2006;12:5375-8.
• 7. Wu H, Nakano T, Daikoku E, et al. Intrabacterial proton-dependent CagA transport system in Helicobacter pylori. J Med Microbiol 2005;54:1117-25.
• 8. Franco AT, Israel DA, Washington MK, et al. Activation of beta-catenin by carcinogenic Helicobacter pylori. Proc Natl Acad Sci U S A 2005;102:10646-51.
• 9. Krueger S, Hundertmark T, Kalinski T, et al. Helicobacter pylori encoding the pathogenicity island activates matrix metalloproteinase 1 in gastric epithelial cells via JNK and ERK. J Biol Chem 2006;281:2868-75.
• 10. Zhou Q, Li L, Ai Y, et al. Diagnostic accuracy of the 14C-urea breath test in Helicobacter pylori infections: a meta-analysis. Wien Klin Wochenschr 2017;129:38-45.
• 11. Dixon MF, Genta RM, Yardley JH, Correa P. Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994. Am J Surg Pathol 1996;20:1161-81.
• 12. Fakhre-Yaseri H, Baradaran-Moghaddam A, Shekaraby M, et al. Evaluating the relationship between serum immunoglobulin G (IgG) and A (IgA) anti-CagA antibody and the <i>cagA</i> gene in patients with dyspepsia. Iran J Microbiol 2017;9:97-102.
• 13. Amieva MR, El-Omar EM. Host-bacterial interactions in Helicobacter pylori infection. Gastroenterology 2008;134:306-23.
• 14. Suerbaum S, Michetti P. Helicobacter pylori infection. N Engl J Med 2002; 347:1175-86.
• 15. Syam AF, Miftahussurur M, Makmun D, et al. Risk factors and prevalence of Helicobacter pylori in five largest islands of Indonesia: a preliminary study. PLoS One 2015;10:e0140186
• 16. Santibáñez M, Aguirre E, Belda S, et al. Relationship between tobacco, cagA and vacA i1 virulence factors and bacterial load in patients infected by Helicobacter pylori. PLoS One. 2015; 10: e0120444.
• 17. Ghosh P, Bodhankar SL. Association of smoking, alcohol and NSAIDs use with expression of cagA and cag T genes of Helicobacter pylori in salivary samples of asymptomatic subjects. Asian Pac J Trop Biomed. 2012;2:479-84.
• 18. Said Essa A, Alaa Eldeen Nouh M, Mohammed Ghaniam N, et al. Prevalence of cagA in relation to clinical presentation of Helicobacter pylori infection in Egypt. Scand J Infect Dis 2008;40:730-3.
• 19. Kantarceken B, Aladag M, Atik E, et al. Association of CagA and VacA presence with ulcer and non-ulcer dyspepsia in a Turkish population. World J Gastroenterol 2003;9:1580-3.
• 20. Erzin Y, Koksal V, Altun S, et al. Prevalence of Helicobacter pylori vacA, cagA, cagE, iceA, babA2 genotypes and correlation with clinical outcome in Turkish patients with dyspepsia. Helicobacter 2006;11:574-80.
• 21. Parsonnet J, Friedman GD, Orentreich N, Vogelman H. Risk for gastric cancer in people with CagA positive or CagA negative Helicobacter pylori infection. Gut 1997;40:297-301.
• 22. Suriani R, Colozza M, Cardesi E, et al. CagA and VacA Helicobacter pylori antibodies in gastric cancer. Can J Gastroenterol 2008;22:255-8.
• 23. Sozzi M, Valentini M, Figura N, et al. Atrophic gastritis and intestinal metaplasia in Helicobacter pylori infection: the role of CagA status. Am J Gastroenterol 1998;93:375-9.