Immune responses to Helicobacter pylori infection in children with intellectual disabilities
Masoumeh Douraghi1, Hossein Goudarzi, Mahmoud Nateghi Rostami
1Department of Microbiology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran 19395-4719, Iran.
Insights
Helicobacter pylori infection is common in children with intellectual disabilities, increasing with age and institutionalization. CagA-positive cases warrant monitoring due to risks of severe H. pylori-associated diseases.
Area of Science:
- Medical Microbiology
- Pediatric Infectious Diseases
- Public Health
Background:
- Intellectual disability (ID) can impact health outcomes.
- Helicobacter pylori (H. pylori) infection is a global health concern.
- The prevalence and risk factors of H. pylori in institutionalized children with ID are not well-established.
Purpose of the Study:
- To determine the seroprevalence of H. pylori IgG antibodies in children with ID.
- To investigate the association between H. pylori infection and age, and duration of institutionalization.
- To assess the serostatus of cytotoxin-associated gene A (CagA) and its correlation with H. pylori infection severity in this population.
Main Methods:
- Serum samples from 210 children with ID residing in three institutes in Tehran were analyzed.
- Enzyme-linked immunosorbent assay (ELISA) was used to detect H. pylori IgG and anti-CagA antibodies.
- Medical history and demographic data were collected from medical records.
Main Results:
- H. pylori IgG antibodies were detected in 74.8% of the children.
- Infection rates significantly correlated with increased age (P=0.001) and longer institutionalization (P=0.018).
- Anti-CagA antibodies were found in 58.6% of participants, with higher H. pylori IgG titers in CagA-positive children (P=0.017).
Conclusions:
- The seropositivity rate of H. pylori in institutionalized children with ID is high and increases with age and duration of stay.
- The presence of CagA antibodies indicates a higher risk for severe H. pylori-associated sequelae.
- Regular monitoring of CagA-positive children with ID is recommended to prevent severe outcomes like gastric cancer and duodenal ulcers.
Abstract:
Infection with Helicobacter pylori was assessed through serum H. pylori IgG antibody in children with intellectual disabilities (ID). The sero-status of cytotoxin-associated gene A (CagA) was determined as a risk determinant for severe H. pylori-associated diseases. In total, 210 children with ID were included who were permanent resident of three institutes in Tehran. Medical history and demographic data were collected by reviewing the medical file records. The anti H. pylori IgG antibody was detected in serum of 74.8% of children using ELISA. Significant correlations were found between the rate of infection and age (P = 0.001) and duration of institutionalization (P = 0.018). The likelihood of H. pylori IgG positive response increased with age with the highest response in 15-18 years age group (OR = 6.66, 95% CI: 2.14-20.17; P = 0.001). Similarly, the average titers of H. pylori IgG antibody were increased with age. The institutionalization duration of more than 49 months affected the likelihood of H. pylori IgG positive response (OR = 2.437, 95% CI: 1.12-5.26; P = 0.023). Anti-CagA titers were higher than 5arbU/ml in 92 (58.6%) children, indicating a positive response against CagA protein. The titer of H. pylori IgG was significantly higher in CagA-positive (mean ± SE = 51.04 ± 3.41) than in CagA-negative children (38.07 ± 4.18; P = 0.017). In contrast to total H. pylori IgG titers, anti-CagA antibody had non-regular trend of alterations with age. The seropositivity rate of H. pylori infection in ID children was higher than other reports in healthy children from various regions of the country. The risk of H. pylori infection is increased with age and duration of institutionalization. The serostatus of CagA in children with IDs has not been reported so far. The regular monitoring of the CagA-positive carriers is recommended; since CagA positive cases carry the risk of progression of infection toward severe H. pylori associated sequels such as gastric cancer and duodenal ulcers.
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