J Korean Med Sci.  2016 Mar;31(3):417-422. 10.3346/jkms.2016.31.3.417.

Correlations between the CagA Antigen and Serum Levels of Anti-Helicobacter pylori IgG and IgA in Children

• Seo JH
• Lim CW
• Park JS
• Yeom JS
• Lim JY
• Jun JS
• Woo HO
• Youn HS
• Baik SC
• Lee WK
• Cho MJ
• Rhee KH

• KMID: 2363503
• DOI: http://doi.org/10.3346/jkms.2016.31.3.417

Abstract

We tested correlations between anti-Helicobacter pylori IgG and IgA levels and the urease test, anti-CagA protein antibody, degree of gastritis, and age. In total, 509 children (0-15 years) were enrolled. Subjects were stratified as 0-4 years (n = 132), 5-9 years (n = 274), and 10-15 years (n = 103) and subjected to the urease test, histopathology, ELISA, and western blot using whole-cell lysates of H. pylori strain 51. The positivity rate in the urease test (P = 0.003), the degree of chronic gastritis (P = 0.021), and H. pylori infiltration (P < 0.001) increased with age. The median titer for anti-H. pylori IgG was 732.5 IU/mL at 0-4 years, 689.0 IU/mL at 5-9 years, and 966.0 IU/mL at 10-15 years (P < 0.001); the median titer for anti-H. pylori IgA was 61.0 IU/mL at 0-4 years, 63.5 IU/mL at 5-9 years, and 75.0 IU/mL at 10-15 years (P < 0.001). The CagA-positivity rate was 26.5% at 0-4 years, 36.5% at 5-9 years, and 46.6% at 10-15 years for IgG (P = 0.036), and 11.3% at 0-4 years, 18.6% at 5-9 years, and 23.3% at 10-15 years for IgA (P < 0.001). Anti-H. pylori IgG and IgA titers increased with the urease test grade, chronic gastritis degree, active gastritis, and H. pylori infiltration. Presence of CagA-positivity is well correlated with a high urease test grade and high anti-H. pylori IgG/IgA levels.

Keyword

Antibodies IgG/IgA; Helicobacter pylori; CagA Protein; Urease; Children

MeSH Terms

Adolescent
Antibodies, Bacterial/*blood
Antigens, Bacterial/*analysis/immunology
Bacterial Proteins/*analysis/immunology/metabolism
Blotting, Western
Child
Child, Preschool
Chronic Disease
Enzyme-Linked Immunosorbent Assay
Female
Gastritis/pathology
Helicobacter Infections/blood/microbiology/*pathology
Helicobacter pylori/isolation & purification/*metabolism
Humans
Immunoglobulin A/*blood
Immunoglobulin G/*blood
Infant
Infant, Newborn
Male
Severity of Illness Index
Urease/metabolism
Antibodies, Bacterial
Antigens, Bacterial
Bacterial Proteins
Immunoglobulin A
Immunoglobulin G
Urease

Figure

• 

  Fig. 1 The immunoblot assay results were classified into four patterns on the basis of immunoreactive bands. Only pattern I, with reactivity against 120-kDa antigens and other H. pylori antigens, was considered to be a specific marker of H. pylori infection in this study. Panel A shows the Ponceau S‐stained nitrocellulose membrane onto which the marker proteins and separated H. pylori antigen were transferred.

• 

  Fig. 2 Proportions with the four western blot patterns according to age groups. The CagA-positivity rate was 26.5% at 0–4 years, 36.5% at 5–9 years, and 46.6% at 10–15 years for IgG (P = 0.036). Post-hoc analysis using Scheffé’s method detected no differences in the proportions with the four western blot pattern among the three age groups for IgG (P = 0.094).

• 

  Fig. 3 Anti-H. pylori IgG antibody titers according to age groups and the urease test grade. The anti-H. pylori IgG antibody titers were higher with grade I (positive within 6 hours) than the other grades (P < 0.001) in all age groups.

• 

  Fig. 4 Anti-H. pylori IgA antibody titers according to age groups and the urease test grade. The anti-H. pylori IgA antibody titers were higher with grade I (positive within 6 hours) than the other grades (P < 0.001) in all age groups.

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  Fig. 5 Anti-H. pylori IgG antibody titers according to the western blot patterns and age. The anti-H. pylori IgG antibody titers were higher with the CagA-positive pattern (P < 0.001) regardless of age.

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  Fig. 6 Anti-H. pylori IgA antibody titers according to the western blot patterns and age. The anti-H. pylori IgA antibody titers were higher with the CagA-positive pattern (P < 0.001) regardless of age.

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