Detection of Antibody against Helicobacter pylori in the Saliva of Patients with Dyspepsia

Abstract

There is a need to develop noninvasive assays to detectHelicobacter pyloriinfection in the gastric mucosa, Current dogma predicts that the presence of antibody within saliva should accurately reflect contemporary colonization of the gut mucosa. This study examined the clinical value of a saliva enzyme-linked immunoadsorbent assay (ELISA) for anti-H pyloriantibody, compared with the serum ELISA assay, and found the sensitivity of the saliva assay was 89%, specificity 94%, accuracy 93%, positive predictive value 89% and negative predictive value 94%. Assessment following eradication therapy demonstrated that salivary antibody was a more sensitive indicator of colonization than was serum antibody. The immunoglobulin G antibody in saliva correlated best with colonization, and regression analysis was most consistent with a local production of antibody. These results indicate that detection of antibody in saliva contributes to diagnosis and management ofH pyloriinfection.

Evaluation of anti‐Helicobacter pylori IgG2 antibody for the diagnosis of Helicobacter pylori infection in western and Chinese populations

“…Non-invasive salivary H. pylori IgG has been reported as a useful tool in monitoring the efficacy of H. pylori eradication therapy. 5 Our studies have shown that gastric cancer is associated with a major cytokine shift within the gastric mucosa and that this shift correlated with a selective reduction in secretion of IgG2 anti-H. pylori antibody. 6,7 The question can be asked, therefore, as to whether an IgG2 antibody assay would add value to existing serology assays by identifying those at higher risk of gastric cancer, especially in regions with high prevalence of H. pylori infection.…”

“…19 Detection of antibodies in saliva has been used for the diagnosis of infectious disease, including monitoring response to eradication therapy in H. pylori infection. 5 Tests performed with saliva have shown an overall sensitivity ranging from 81 to 94% and specificity from 70 to 90%. 20,21 Similar sensitivity and specificity parameters were found for saliva testing as were observed with the serum test.…”

“…This could be because of a local source of IgG antibody in saliva more reflective of mucosal antigen or to different kinetics of a downregulated mucosal environment. 5 In animal models, it has been shown that secretory IgG antibody correlates with the kinetics of local IgA secretion rather than with those of serum IgG antibody. 23 Saliva IgG antibody does increase following mucosal stimulation with microbial antigens, with a poor correlation noted between IgG antibody levels in serum and saliva, 5 while others have noted that the distribution of saliva IgG subclass antibody differs from that of serum IgG.…”

“…A simple non‐invasive test to follow‐up H. pylori infection status is needed. Non‐invasive salivary H. pylori IgG has been reported as a useful tool in monitoring the efficacy of H. pylori eradication therapy 5 …”

Validation of a New Saliva Test for Helicobacter pylori Infection

“…Recently, a saliva test measuring immunoglobulin (Ig) G antibodies to H pylori has been developed. This has been compared with serological tests (4)(5)(6) and with antral biopsies (5)(6)(7)(8) tions. In the present study, we validated the saliva test, using antral biopsies as the gold standard of diagnosis.…”