title: Serological response to specific Helicobacter pylori antigens: antibody against CagA antigen is not predictive of gastric cancer in a developing country.
abstract: OBJECTIVE
  In symptomatic patients resident in developed countries, a high prevalence of antibody to the cytotoxin-associated antigen (CagA) of Helicobacter pylori has been linked to the development of peptic ulcer disease and gastric cancer. This association has not been examined in developing countries, nor in asymptomatic subjects resident in either developed or developing countries. The aim of this study was to examine the seroprevalence of antibody to the CagA antigen; as well as other specific H. pylori antigens in symptomatic and asymptomatic individuals resident in Australia and China.
  
  
  METHODS
  The Helico-blot 2.0 Western blot system was used for the detection of antibodies to specific antigens of H. pylori in sera obtained from the following H. pylori-positive groups: 19 Australian blood donors, 96 Australian nonulcer dyspepsia patients, 29 Australian duodenal ulcer patients, 35 asymptomatic Chinese subjects, and 48 Chinese gastric cancer patients.
  
  
  RESULTS
  Nine antigens were commonly recognized by sera from Australian and Chinese subjects. These antigens were of molecular mass 19.5 kDa, 26.5 kDa, 35 kDa, 45 kDa, 60 kDa, 89 kDa (VacA), 116 kDa (CagA), and 180 kDA. A significant association between the prevalence of antibody to the CagA antigen and duodenal ulcer disease was observed in Australian subjects; however, no association between the prevalence of antibody to the CagA antigen and gastric cancer was found in Chinese subjects. In subjects from both countries, a significant association was found between antibody to the 30-kDa and 45-kDa antigens and more serious gastroduodenal disease.
  
  
  CONCLUSIONS
  The results of this study suggest that the cagA gene is not associated with the development of more serious gastroduodenal disease; however, it cannot be ruled out that this gene may be an important but insufficient factor in some disease processes.
authors.affiliation: School of Microbiology and Immunology, University of New South Wales, Sydney, Australia.
authors.forename: H M
authors.initials: HM
authors.lastname: Mitchell
authors.forename: S L
authors.initials: SL
authors.lastname: Hazell
authors.forename: Y Y
authors.initials: YY
authors.lastname: Li
authors.forename: P J
authors.initials: PJ
authors.lastname: Hu
mesh_terms: D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood*; D000942:Antigens, Bacterial / Q000276:immunology*; D001315:Australia / Q000453:epidemiology; D001426:Bacterial Proteins / Q000276:immunology*; D015153:Blotting, Western; D002681:China / Q000453:epidemiology; D003906:Developing Countries; D004381:Duodenal Ulcer / Q000453:epidemiology / Q000382:microbiology; D004415:Dyspepsia / Q000453:epidemiology / Q000382:microbiology; D016481:Helicobacter Infections / Q000453:epidemiology*; D016480:Helicobacter pylori / Q000276:immunology*; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D016036:Seroepidemiologic Studies; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000382:microbiology; D013276:Stomach Ulcer / Q000453:epidemiology / Q000382:microbiology
chemical_list: D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D001426:Bacterial Proteins; C080866:cagA protein, Helicobacter pylori