胃十二指肠疾病对HpcagA,vagA基因产物的体液免疫应答

Humoral immunologic response to cagA and vagA gene products in patients with gastroduodenal disease

目的研究幽门螺杆菌(Hp)感染患者中Hp CagA,VacA抗体在消化性溃疡和功能性消化不良的发生率,评估Hp感染的CagA,VacA状态对胃窦粘膜炎症活动、萎缩、肠化生等病变的作用。方法对106例消化不良合并Hp感染患者应用免疫印迹法测定血清中CagA,VacA抗体,同时评估胃窦粘膜的炎症程度、活动性、萎缩、肠化病变。结果 74％的Hp感染者中出现CagA抗体,53％Hp感染者中出现VacA抗体,但CagA或VacA抗体在不同病种中的分布无显著差异(P>0.05)。患者胃窦粘膜炎症活动程度,萎缩、肠化生和Hp CagA,VacA状态相关联,血清CagA和VagA抗体同时阳性的患者和CagA和VagA抗体同时阴性相比,胃窦粘膜萎缩的发生率分别为20/27(74％)和4/13(30％),高于CagA和VagA抗体同时阴性组明显增高(P<0.05)。结论 Hp CagA和VacA状态在消化性溃疡和功能性消化不良患者之间无显著差异,不能作为判断胃十二指肠疾病的单一指标。针对Hp CagA和WgA的抗体和胃窦粘膜的萎缩病变相关,在诱导胃粘膜组织学改变并发展为胃腺癌过程中可能起重要作用。

AIM To assess the soroprevalence CagA and VacA in patients with peptic ulcer and functional dispepsia. The role of CagA and VscA status in development of inflammation, atrophy and intestinal metaplasia in the antrum were also evaluated. METHODS The immunoblot assay was used to detect serum antibodies to CagA and VecA obtained from the patients Infected by H.pylori.The severity and activity of inflammation and the presence of atrophy and intestinal metaplass in the antrum mere evaluated and compaired with Hp status. RESULTS Serum antibodies to CagA were detected in 78% and VscA in 53% of the patients infected by H. pylori.The prevalence of serum antibodies to CagA or VacA was not statistietically different between peptic ulcer and functional dispepsia. CagA and VagA positive patients had significantly higher scores for atrophy in gastric antrum than both CagA and VacA negative patients (P<0.05). CONCLUSION CagA and VacA status of H. pylori infection could be important factors in inducing chronological changes of the gastric mucosa leading to the development of gastric adenocarcinoma.