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Serum immune response to Helicobacter pylori in children: epidemiologic and clinical applications
C De Giacomo1, L Lisato, R Negrini
1Clinica Pediatrica dell'Universitã di Pavia, IRCCS Policlinico S. Matteo, Italy.
Insights
This study shows that measuring IgG and IgA antibodies is a useful way to diagnose Helicobacter pylori infection in children. Antibody levels decrease after successful treatment, aiding in infection management.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Immunology
Background:
- Helicobacter pylori infection is a common cause of chronic gastritis in children.
- Accurate diagnosis and monitoring of H. pylori infection are crucial for effective management.
Purpose of the Study:
- To evaluate the utility of measuring IgG and IgA antibodies against H. pylori.
- To assess the diagnostic accuracy and epidemiological insights provided by antibody testing.
- To determine the impact of antimicrobial treatment on antibody titers.
Main Methods:
- Solid-phase whole-cell enzyme-linked immunosorbent assay (ELISA) was used to detect H. pylori-specific IgG and IgA antibodies.
- Study included 150 children and adolescents, 47 undergoing endoscopy (17 with H. pylori infection), and 46 family members.
- Antibody levels were assessed before and after antimicrobial treatment in infected children.
Main Results:
- H. pylori seropositivity increased with age in children.
- High seropositivity rates (94% parents, 71% siblings) suggest intrafamilial spread.
- Antibody testing demonstrated 95% sensitivity and 84% specificity for identifying infected children.
- Successful eradication led to a significant decrease in IgG and IgA titers, normalizing within 12 months in 10 patients.
Conclusions:
- ELISA for H. pylori-specific IgG and IgA antibodies is a valuable tool for epidemiological studies.
- This antibody detection method serves as a useful adjunct for diagnosing and managing chronic gastritis in children.
- Monitoring antibody titers can help confirm successful H. pylori eradication.
Abstract:
Antibody responses to Helicobacter pylori were measured by a solid-phase whole-cell enzyme-linked immunosorbent assay in 150 children and adolescents; in 47 consecutive children undergoing upper gastrointestinal endoscopy, including 17 with H. pylori infection before and after antimicrobial treatment; and in 46 family members of the infected children. Abnormal levels of either IgG or IgA were found in 6% of the 150 children. In the latter group the prevalence of H. pylori seropositivity increased with age. Parents and siblings of the infected children had 94% and 71% seropositivity, respectively, suggesting intrafamilial spread. Abnormal levels of IgG or IgA against H. pylori identified infected children with 95% sensitivity and 84% specificity. Eradication of the infection was accompanied by a significant decrease in IgG and IgA titers, with normalization in 10 cured patients in 12 months or less. We conclude that the method described for evaluation of H. pylori-specific IgG and IgA antibodies gives helpful information on the epidemiology of the infection and represents a useful adjunct to diagnosis and management of chronic gastritis in children.