Corcoran, P.A.; Kerrigan, S.W.; Cox, D.; Atherton, J.C.; Fitzgerald, D.J.; Murray, F.E.; Byrne, M.F.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA53
Academic Journal
Background: Clinical studies have suggested an association between cardiovascular disease and infection with H pylori. We have described strain specific H pylori-induced platelet aggregation that involves platelet glycoprotein lb and van Willebrand factor (vWf). We exam ned the role of H pylori antibodies in this aggregation. Methods and Results: Addition of pooled immunoglobin (Ig) and fibrinogen along with H pylori strain 60190 (coated in vWf) to washed platelets led to platelet aggregation (60±4% n=3). Antibodes involved were specific to H pylori as bacteria incubated in pooled g and subsequently washed could support platelet aggregation (49±7%, n=3). To confirm this, pooled Ig was incubated with H pylori or Streptococcus sanguis. Bacteria were removed by centrifugation and the depleted g used in aggregation assays. H pylori-depleted Ig showed greatly reduced platelet aggregation to H pylori (13±9%, n=3, p<0.01) while the S sanguis-depleted Ig was not affected (54±3%, n=3, p=NS). All 20 plasma donors were tested for H pylori seropositivity using a H pylori ELISA. All 4/4 of the positive volunteers consistent y aggregated in response to H pylori while only 2/15 of the H pylori negative donors aggregated consistently (p=0.039, Fisher's Exact Test). The relative risk of H pylori positivity for aggregation was 7.5 (CI 2.0-27.3). Conclusions: H pylori-induced platelet aggregation requires binding of H pylori-specific IgG. This pro-aggregatory phenotype is not unique to H pylori and has been described with S sanguis and P gingivalis. Exposure to oral bacteria such as S sanguis can lead to infective endocarditis and in the case of P gingivalis, to enhancement of atherosclerosis in animal models. Repeated exposure to proaggregatory bacteria such as certain strains of H pylori may not cause coronary artery disease but could accelerate the progression of the disease. Local platelet effects may also contribute to the pathogenesis of H...


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