The humoral immuneresponse toHelicobacter pyloriinfection in children with gastrointestinal symptoms

Abstract

The prevalence of Helicobacter pylori is high in Eastern Europe. The purpose of this study was to estimate the prevalence of H. pylori in symptomatic Lithuanian children and to identify the infection by clinicopathological and serological analyses. One hundred sixteen symptomatic children (age 8-16) with gastritis and duodenal ulcer were included. Biopsies were histologically assessed according to the Sydney-System. Serum IgG antibodies against H. pylori were detected by an enzyme-linked immunosorbent assay (ELISA), using low molecular mass antigen. The western blot technique was used to detect serum antibodies against the cytotoxin-associated protein (CagA) using whole cell antigen. Histologically the prevalence of H. pylori infection was 79% and not influenced by demographic factors. Mucosal inflammation and atrophy were associated with a H. pylori infection. Intestinal metaplasia was found in eight children, suggesting early H. pylori acquisition in life. Increased levels of IgG antibodies were detected in 57% of children. The prevalence of IgG antibodies was significantly higher in patients with duodenal ulcer compared to children with gastritis. Forty-four (67%) H. pylori-seropositive children had antibodies against CagA. Low molecular weight-ELISA and whole cell-western blot results were significantly associated with histopathology, the presence of duodenal ulcer and the CagA status. A high number of false seronegative cases were due to poor immunological responses in children and poor locally validated tests. The prevalence of H. pylori infection in Lithuanian children is higher compared to Western Europe. The infection is acquired in early life. Diagnosing H. pylori infection, serology is helpful, but endoscopy/histology remains as gold standard.

Potential Complications of Helicobacter pylori Infection in Children of a Non-Urban Community

“…It has been previously reported that there was a positive correlation between H. pylori antibodies and food allergy manifested by gastrointestinal symptoms (24). In the current study, the results revealed a statistically significant (P < 0.01) positive correlation between H. pylori infection and gastrointestinal symptoms (recurrent abdominal pain, vomiting and chronic anorexia) and such results are consistent with that described previously by some investigators in Eastern Europe (11). On the other hand, it was reported that H. pylori infection in India was not associated with recurrent abdominal pain (25).…”

“…Moreover, there is a good correlation between ELISA antibody test and rapid urease test, which afford confirmatory diagnosis of H. pylori infection (10,11). In this study, serum samples were assessed through ELISA for the presence of anti-H. pylori IgG antibodies against high molecular weight cell-associated protein (HM-CAP) of H. pylori using the HM-CAP ELISA kit (EZ-EM Inc., Westbury, NY, USA) as described previously (12).…”

Participation of Capsaicin-Sensitive Afferent Nerves in the Gastric Mucosa of Patients with Helicobacter pylori-Positive or-Negative Chronic Gastritis

“…Nowdays, the importance of Helicobacter pylori infection is increasing as the main causative factor in gastric diseases in humans. This bacterium is highly prevalent in many countries [3] and it increases the risk for development of gastric and duodenal ulcer disease, gastric cancer, and gastric mucosa-associated lymphoid tissue lymphoma [4][5][6][7][8][9].…”

Management of <b><i>Helicobacter pylori</i></b>-Related Diseases in the Baltic States

“…The same study revealed gender-related differences in H. pylori prevalence among gastric cancer patients, suggesting that in Lithuania H. pylori could be more important for development of gastric cancer in females, whereas smoking and alcohol consumption as risk factors have a stronger impact in males [32]. However, differences in smoking and alcohol consumption could not fully explain the gender-related difference in the prevalence of H. pylori in the study, and other, yet unknown, host and environmental factors might also be important in the development of gastric cancer.…”