Evaluation of a new immunochromatographic test for Helicobacter pylori IgG antibodies in elderly symptomatic patients

Shirin, Haim; Bruck, Rafael; Kenet, G.; Krepel, Z.; Wardi, Y.; Reif, Simon; Zaidel, Liliana; Geva, Dikla; Avni, Yona; Halpern, Zamir

doi:10.1007/s005350050209

Cited by 16 publications

(16 citation statements)

References 19 publications

(17 reference statements)

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“…In general, one can expect an IgA ELISA to have lower sensitivity values than an IgG ELISA because most individuals exhibit a predominantly IgG immune response to infection with H. pylori (23). However, some investigators have found that about 2% of patients produce an IgA response in the absence of an IgG response (10,20). Furthermore, Jaskowski et al (24) showed a higher frequency of IgA-positive IgG-negative patients (38/824 cases; 7.2%) with gastrointestinal disorders suggestive of H. pylori infection.…”

Section: Discussionmentioning

confidence: 98%

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Comparison of Serum IgA and IgG Antibodies for Detecting Helicobacter pylori Infection

et al. 2004

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Objective Although the diagnostic utility of serum IgG antibodies to Helicobacter pylori (H. pylori) is well established, the usefulness of IgA-based tests is less well documented. The aim of this study was to evaluate two commercially available ELISAs, both for IgG and IgA.Patients and Methods Rapid urease test and histology analysis were performed in 183 patients. A patient was considered to be H. pylori-positive when either biopsy test was positive, and considered to be noninfected when both tests were negative. Intestinal metaplasia was determined by dye endoscopy with methylene blue. ELISA testing was performed using the EPI HM-CAP IgG and PP-CAP IgA assays and EIAgen IgG and IgA assays.Results

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Section: Discussionmentioning

confidence: 98%

“…Two studies have noted few patients with confirmed H. pylori infection and with only IgA antibodies (20,21). Aromaa A et al (22) reported that IgA antibodies and low levels of pepsinogen I increase the risk of gastric carcinoma.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Serum IgA and IgG Antibodies for Detecting Helicobacter pylori Infection

et al. 2004

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“…In Japan, several studies 22,37 have shown that the prevalence of infection is strongly associated with age and this age‐related increase in infection falls in the elderly. Thus, the absence of serum antibodies in patients with active or previous infection seems to increase in the elderly 41,42 . It is possible that patients who had a previous infection and do not have serum antibodies are not detected as a high risk group for gastric cancer, despite the presence of severe atrophic gastritis.…”

Section: Atrophic Gastritis and Intestinal Metaplasiamentioning

confidence: 99%

“…Thus, the absence of serum antibodies in patients with active or previous infection seems to increase in the elderly. 41,42 It is possible that patients who had a previous infection and do not have serum antibodies are not detected as a high risk group for gastric cancer, despite the presence of severe atrophic gastritis. Measuring serum PG can detect patients with extensive atrophic gastritis, regardless of their H. pylori status.…”

Section: Atrophic Gastritis and Intestinal Metaplasiamentioning

confidence: 99%

Using serum pepsinogens wisely in a clinical practice

Miki

Urita

2007

J of Digest Diseases

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Serum pepsinogen (PG) has been used as biomarkers of gastric inflammation and mucosal status, including atrophic change, before the discovery of Helicobacter pylori (H. pylori). Serum pepsinogen I (PG I) and pepsinogen II (PG II) levels are known to increase in the presence of H. pylori-related nonatrophic chronic gastritis. The measurement of serum PG provides much information on the presence of intestinal metaplasia as well as atrophic gastritis. The eradication of H. pylori provokes a significant change in serum PG values: it reduces both PG I and PG II and elevates the PG I to PG II ratio. Recently, the serum PG test method has been the first screening step in Japan, as well as photofluorography. Serum PG tests are used to screen for high risk subjects with atrophic gastritis, rather than as a test for cancer itself. Unlike photofluorography or endoscopy, serum PG screening can identify nonulcerated differentiated asymptomatic cancer, irrespective of the size and location of the lesion. Most cases detected by the PG method are asymptomatic early gastric cancers and are limited to the mucosa, which are particularly well suited for endoscopic treatment. The PG method can contribute greatly to the patients' quality of life.KEY WORDS: atrophic gastritis, gastric cancer screening, non-atrophic gastritis, serum pepsinogens I and II.

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“…Although anti-H. pylori IgA has been reported to be of diagnostic value in complementing IgG analysis, as some patients can be IgA positive and IgG negative (Kosunen et al, 1992;Granberg et al, 1993;Jaskowski et al, 1997;Martin-de-Argila et al, 1997;Shirin et al, 1999;Urita et al, 2004), neither the ELISA-nor the LB-based detection of IgA led to an increase in sensitivity. Although anti-H. pylori IgA has been reported to be of diagnostic value in complementing IgG analysis, as some patients can be IgA positive and IgG negative (Kosunen et al, 1992;Granberg et al, 1993;Jaskowski et al, 1997;Martin-de-Argila et al, 1997;Shirin et al, 1999;Urita et al, 2004), neither the ELISA-nor the LB-based detection of IgA led to an increase in sensitivity.…”

Section: Discussionmentioning

confidence: 99%

Performance of individualHelicobacter pyloriantigens in the immunoblot-based detection ofH.pyloriinfection

Deyi

Dahma²,

Scheper

et al. 2012

FEMS Immunol Med Microbiol

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To develop a specific line blot (LB) for supporting ELISA-based serodiagnosis of Helicobacter pylori infection, individual native/recombinant H. pylori antigens were evaluated with respect to their reactivity with both serum IgG and IgA from 156 dyspeptic screening patients (67% H. pylori positive). Of 13 antigens, HP0175, p17, and p19 revealed highest positive likelihood ratios for H. pylori-specific IgG (> 5.0) and were selected as LB substrates, in addition to the established virulence markers VacA and CagA. For validation, the LB was compared to a commercial whole-cell-lysate-based ELISA by parallel (re-)analysis of 156 screening sera, 22 sera from diabetes mellitus patients and 15 sera from follow-up patients after H. pylori eradication. In screening patients, the combined use of IgG ELISA and LB revealed a sensitivity, specificity, and accuracy of 94%, 81%, and 90%, respectively, whereas IgG ELISA alone exhibited a low specificity of 75%. In diabetic and follow-up patients, IgA ELISA exhibited high accuracy of 89% and 93%, respectively, whereas IgG detection was unreliable (accuracy < 80%). In conclusion, using HP0175, p17, p19, CagA, and VacA as LB substrates significantly improves the specificity of anti-H. pylori IgG analysis, providing a reliable tool for (1) confirmation/refutation of ELISA-based screening results and (2) assessment of the CagA/VacA status.

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Evaluation of a new immunochromatographic test for Helicobacter pylori IgG antibodies in elderly symptomatic patients

Cited by 16 publications

References 19 publications

Comparison of Serum IgA and IgG Antibodies for Detecting Helicobacter pylori Infection

Comparison of Serum IgA and IgG Antibodies for Detecting Helicobacter pylori Infection

Using serum pepsinogens wisely in a clinical practice

Performance of individualHelicobacter pyloriantigens in the immunoblot-based detection ofH.pyloriinfection

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