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Anti-CagA antibodies are associated with atrophic gastritis in a population at high gastric cancer risk: a
F Bonvicini1, L Baldini, S Pretolani
1Department of Internal Medicine, University of Bologna, Italy.
Background:
CagA-positive Helicobacter pylori strains appear to increase the risk for atrophic gastritis.
Aim:
To verify the association between CagA status and atrophic gastritis in the general population by means of computerized image analysis.
Subjects:
Forty-five subjects were chosen out of a representative sample of a population at high gastric cancer risk.
Methods:
Helicobacter pylori status was assessed by IgG ELISA, rapid urease test and histology. Serum anti-CagA antibodies were detected by western blotting. Subjects were subdivided into 3 groups: 15 subjects Helicobacter pylori positive CagA-positive, 15 Helicobacter pylori positive CagA-negative and 15 controls Helicobacter pylori negative. Biopsies were studied using the Sydney System score. A computerized image analysis was used to count inflammatory cells in the lamina propria and to measure the area of the gastric glands.
Results:
Anti-CagA antibodies were associated with reduction of gland area (126,671 +/- 81,032 mu 2/mm2 vs 231,384 +/- 54,159; p = 0.0001), with increasing both of polymorphonuclear cells (426 +/- 238 cell/mm2 vs 136 +/- 69; p = 0.0001) and mononuclear cells (8675 +/- 1304 cell/mm2 vs 7141 +/- 1230; p = 0.003).
Conclusions:
The association of anti-CagA antibodies with a high grade of gastric atrophy further supports the hypothesis that Helicobacter pylori CagA-positive strains can promote the multifactorial process of gastric carcinogenesis.