Host gastric Lewis expression determines the bacterial density of Helicobacter pylori in babA2 genopositive infection

Sheu, B.-S.; Sheu, S.-M.; Yang, H.-B.; Huang, A.-H.; Wu, J.-J.
July 2003
Gut;Jul2003, Vol. 52 Issue 7, p927
Academic Journal
Background and aims: We tested if host gastric Lewis antigens and the babA2 genotype of Helicobacter pylori correlated with clinico-histological outcome. Methods: We enrolled 188 dyspeptic patients (45 with duodenal ulcer, 45 with gastric ulcer, and 98 with chronic gastritis) with H pylori infection, proved by culture and gastric histology, reviewed by the updated Sydney system. Gastric expression of Lewis (Le) antigens Le[sup a], Le[sup b], Le[sup x], and Le[sup y] was determined immunochemically to determine intensity (range 0-3). The corresponding 188 H pylori isolates were screened for babA2 genotype by polymerase chain reaction. Results: All H pylori isolates had a positive babA2 genotype. We identified Le[sup a] in 33.5%, Le[sup b] in 72.9%, Le[sup x] in 86.2%, and Le[sup y] in 97.4% of biopsies from these 188 patients. Patients who expressed Le[sup b] had a higher H pylori density than those who did not express Le[sup b] (p < 0.001). Among 139 patients who expressed Le[sup b], H pylori density increased with a higher Le[sup b] intensity (p < 0.05). Gastric atrophy decreased with Le[sup b] intensity and thus resulted in lower H pylori density in the antrum (p < 0.05). For the 49 patients without gastric Le[sup b] expression, H pylori density was positively related with Le[sup x] and Le[sup a] expression (p < 0.05). Conclusions: Taiwanese H pylori isolates are 100% babA2 genopositive. Gastric Le[sup b] as well as Le[sup x] intensity may be major determinants of H pylori density. While lacking gastric Le[sup b] expression, Le[sup x] and Le[sup a] were closely related to H pylori colonisation.


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