Abstract
We evaluated a commercially available second-generation anti-H. pylori immunoglobulin G enzyme immunoassay (EIA) (Cobas Core Anti-Helicobacter pylori EIA; Roche S. A., Basel, Switzerland) for serodiagnosis of H. pylori infection. The results of the assay were assessed in relation to the results of bacterial culture, urease testing, and histological Giemsa stain of gastric biopsy specimens from 1,134 patients with a variety of symptoms relating to the upper gastrointestinal tract. H. pylori was detected in biopsy specimens from 660 (58.2%) patients: 6 had a normal mucosa, 123 had chronic gastritis only, and 531 were found to have chronic active gastritis by histology; endoscopy showed duodenal and gastric ulcers in 137 and 64 patients of the last two groups, respectively. The test was evaluated with different age and ethnic groups. The prevalence, sensitivity, specificity, and positive and negative predictive values were, respectively, (i) for Belgian patients between 18 and 40 years old, 34, 93, 95, 91, and 96%; (ii) for Belgian patients more than 40 years old, 53, 96, 91, 93, and 95%; and (iii) the Mediterranean patients more than 17 years old, 87, 94, 70, 95, and 64%. All sera showing discordant immunoassay results compared with the results of histology and culture of biopsy specimens, as well as those with borderline immunoassay results, were tested further by immunoblotting. Among the EIA results considered false negative, we demonstrated an absence of seroconversion in 14 of 19 patients tested by immunoblotting. Among the EIA results considered false positive, immunoblotting showed the presence of specific antibodies in 28 of 37 patients tested. Among the borderline results obtained in the first assay with 22 patients' sera, a second assay showed positive results in 10 patients (8 were positive by immunoblotting) and negative reactions in 10 patients (9 were negative by immunoblotting), whereas 2 remained borderline. These data indicate that sera showing borderline immunoassay results must be tested again. In conclusion, this commercially available second-generation EIA, which is easy and quick to perform, was found highly reliable for the serodiagnosis of H. pylori infection.
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Selected References
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- Bolton F. J., Hutchinson D. N. Evaluation of three Campylobacter pylori antigen preparations for screening sera from patients undergoing endoscopy. J Clin Pathol. 1989 Jul;42(7):723–726. doi: 10.1136/jcp.42.7.723. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Evans D. J., Jr, Evans D. G., Graham D. Y., Klein P. D. A sensitive and specific serologic test for detection of Campylobacter pylori infection. Gastroenterology. 1989 Apr;96(4):1004–1008. doi: 10.1016/0016-5085(89)91616-8. [DOI] [PubMed] [Google Scholar]
- Glupczynski Y., Burette A., Nyst J. F., De Prez C., De Koster E., Deltenre M. Campylobacter pylori-associated gastritis: attempts to eradicate the bacteria by various antibiotics and anti-ulcer regimens. Acta Gastroenterol Belg. 1988 Jul-Oct;51(4-5):329–337. [PubMed] [Google Scholar]
- Jones D. M., Eldridge J., Fox A. J., Sethi P., Whorwell P. J. Antibody to the gastric campylobacter-like organism ("Campylobacter pyloridis")--clinical correlations and distribution in the normal population. J Med Microbiol. 1986 Aug;22(1):57–62. doi: 10.1099/00222615-22-1-57. [DOI] [PubMed] [Google Scholar]
- Jones D. M., Lessells A. M., Eldridge J. Campylobacter like organisms on the gastric mucosa: culture, histological, and serological studies. J Clin Pathol. 1984 Sep;37(9):1002–1006. doi: 10.1136/jcp.37.9.1002. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Loffeld R. J., Stobberingh E., Flendrig J. A., van Spreeuwel J. P., Arends J. W. Diagnostic value of an immunoassay to detect anti Campylobacter pylori antibodies in non-ulcer dyspepsia. Lancet. 1989 May 27;1(8648):1182–1185. doi: 10.1016/s0140-6736(89)92761-x. [DOI] [PubMed] [Google Scholar]
- Musgrove C., Bolton F. J., Krypczyk A. M., Temperley J. M., Cairns S. A., Owen W. G., Hutchinson D. N. Campylobacter pylori: clinical, histological, and serological studies. J Clin Pathol. 1988 Dec;41(12):1316–1321. doi: 10.1136/jcp.41.12.1316. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Newell D. G., Stacey A. Antigens for the serodiagnosis of Campylobacter pylori infections. Gastroenterol Clin Biol. 1989;13(1 Pt 1):37B–41B. [PubMed] [Google Scholar]
- Perez-Perez G. I., Dworkin B. M., Chodos J. E., Blaser M. J. Campylobacter pylori antibodies in humans. Ann Intern Med. 1988 Jul 1;109(1):11–17. doi: 10.7326/0003-4819-109-1-11. [DOI] [PubMed] [Google Scholar]
- Price A. B. The Sydney System: histological division. J Gastroenterol Hepatol. 1991 May-Jun;6(3):209–222. doi: 10.1111/j.1440-1746.1991.tb01468.x. [DOI] [PubMed] [Google Scholar]
- Rathbone B. J., Wyatt J. I., Worsley B. W., Shires S. E., Trejdosiewicz L. K., Heatley R. V., Losowsky M. S. Systemic and local antibody responses to gastric Campylobacter pyloridis in non-ulcer dyspepsia. Gut. 1986 Jun;27(6):642–647. doi: 10.1136/gut.27.6.642. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sobala G. M., Crabtree J. E., Pentith J. A., Rathbone B. J., Shallcross T. M., Wyatt J. I., Dixon M. F., Heatley R. V., Axon A. T. Screening dyspepsia by serology to Helicobacter pylori. Lancet. 1991 Jul 13;338(8759):94–96. doi: 10.1016/0140-6736(91)90085-4. [DOI] [PubMed] [Google Scholar]
- Towbin H., Staehelin T., Gordon J. Electrophoretic transfer of proteins from polyacrylamide gels to nitrocellulose sheets: procedure and some applications. Proc Natl Acad Sci U S A. 1979 Sep;76(9):4350–4354. doi: 10.1073/pnas.76.9.4350. [DOI] [PMC free article] [PubMed] [Google Scholar]
- von Wulffen H., Heesemann J., Bützow G. H., Löning T., Laufs R. Detection of Campylobacter pyloridis in patients with antrum gastritis and peptic ulcers by culture, complement fixation test, and immunoblot. J Clin Microbiol. 1986 Nov;24(5):716–720. doi: 10.1128/jcm.24.5.716-720.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]