J Korean Med Sci.  2020 Aug;35(32):e259. 10.3346/jkms.2020.35.e259.

Changes in Seroprevalence of Helicobacter pylori Infection over 20 Years in Jinju, Korea, from Newborns to the Elderly

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

• KMID: 2505579
• DOI: http://doi.org/10.3346/jkms.2020.35.e259

Abstract

Background
The objective of this study was to examine changes in the prevalence of cytotoxic-associated gene A (CagA) positive Helicobacter pylori infection in Jinju, Korea, over the last 20 years.
Methods
Three cross-sectional analyses were conducted concurrently. A total of 1,305 serum samples were collected from 1994–1995, 2004–2005, and 2014–2015, respectively. The presence of immunoglobulin (Ig) G, IgA, and IgM antibodies against H. pylori CagA protein was examined by western blotting.
Results
Overall, seropositivity for anti-CagA IgG antibody was significantly decreased from 63.2% to 42.5% over the last 20 years (P < 0.001). Anti-CagA IgG seropositivities in children and young adults aged 10–29 years decreased from 1994 (60.0%–85.0%) to 2015 (12.5%– 28.9%). The age when plateau of increasing IgG seropositivity was reached in each study period shifted from the 15–19 year-old group in 1994–1995 (85.0%) to the 40–49 year-old group in 2014–2015 (82.5%). Overall seropositive rates of anti-CagA IgA and IgM antibodies did not change significantly either over the last 20 years.
Conclusion
H. pylori infection rate in children and young adults declined over 20 years in Jinju, probably due to improved sanitation, housing, or economy.

Keyword

Prevalence; Helicobacter pylori; CagA protein; Western Blotting

Figure

• 

  Fig. 1 Three different western blot patterns (A, B, and C) were identified. Only (A) showed reactivity with a 116–120 kDa band (red arrow).Thus it was considered positive for IgG, IgA, and IgM anti-CagA-H. pylori antibodies. (B) showed several other bands after reacting with whole cell lysate of H. pylori 51. No definitive band was observed in (C). (C) Phosphate buffered saline was used as a negative control.Ig = immunoglobulin, CagA = cytotoxic-associated gene A, H. pylori = Helicobacter pylori.

• 

  Fig. 2 Changes in anti-CagA IgG antibody seropositivity according to age during a 20-year study in Jinju. Each line connects values for each study period: 1994–1995 (line with circle), 2004–2005 (line with square), and 2014–2015 (line with triangle). There were significant differences in age specific seropositivity with time (from 1994 to 2015) between those aged 7–12 months and 10–29 years (P < 0.05). Anti-CagA IgG seropositivity in early childhood (age, 2–4 years) remained low and stable over 20 years.CagA = cytotoxic-associated gene A, Ig = immunoglobulin.

• 

  Fig. 3 Changes in anti-CagA IgA seropositivity according to age over the 20-year study period. Each line connects values for each study period: 1994–1995 (line with circle), 2004–2005 (line with square), and 2014–2015 (line with triangle). There was no significant reduction in seropositivity according to age over time.CagA = cytotoxic-associated gene A, Ig = immunoglobulin.

• 

  Fig. 4 Changes in anti-CagA IgM seropositivity according to age during the 20-year study period in Jinju. Each line connects values for each study period: 1994–1995 (line with circle), 2004–2005 (line with square), and 2014–2015 (line with triangle). There was no significant reduction in seropositivity according to age over time.CagA = cytotoxic-associated gene A, Ig = immunoglobulin.

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