title: Serum tumour necrosis factor-alpha is increased in patients with Helicobacter pylori infection and CagA antibodies.
abstract: BACKGROUND
  Helicobacter pylori causes gastric inflammation secondary to the mucosal release of cytokines and tumour necrosis factor-alpha.
  
  
  OBJECTIVE
  To investigate whether serum levels of tumor necrosis factor-alpha correlate with Helicobacter pylori infection, CagA antibodies, 13C-urea breath test results, endoscopic, and histological findings.
  
  
  METHODS
  Endoscopy (with gastric biopsies), 13C-urea breath test, and serological assay of CagA antibodies and tumour necrosis factor-alpha were performed in 172 dyspeptic patients.
  
  
  RESULTS
  A total of 126 patients (73.2%) were infected; of the 126 patients, 84 with CagA antibodies (66.7%) showed a higher prevalence rate of duodenal ulcer (p = 0.03), more severe neutrophil infiltration (p = 0.03) and higher bacterial colonization (p = 0.03) than those without antibodies. CagA+ and CagA- groups differed also in 13C-urea breath test results (p = 0.03). A significant difference in serum tumour necrosis factor-alpha levels was observed between infected and uninfected individuals (p = 0.03) as well as between CagA+ and CagA- patients (p = 0.002).
  
  
  CONCLUSIONS
  Helicobacter pylori infection is associated with increased serum levels of tumour necrosis factor-alpha. Subjects who harbour CagA positive strains have more severe mucosal damage, higher bacterial colonization, higher probability of developing duodenal ulcer and higher serum levels of tumour necrosis factor-alpha than those infected with CagA- strains.
authors.affiliation: Division of Gastroenterology, Casa Sollievo della Sofferenza Hospital, I.R.C.C.S., San Giovanni Rotondo, Italy. perrisgr@tin.it
authors.forename: F
authors.initials: F
authors.lastname: Perri
authors.forename: R
authors.initials: R
authors.lastname: Clemente
authors.forename: V
authors.initials: V
authors.lastname: Festa
authors.forename: C C
authors.initials: CC
authors.lastname: De Ambrosio
authors.forename: M
authors.initials: M
authors.lastname: Quitadamo
authors.forename: M
authors.initials: M
authors.lastname: Fusillo
authors.forename: E
authors.initials: E
authors.lastname: Grossi
authors.forename: A
authors.initials: A
authors.lastname: Andriulli
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000276:immunology*; D000942:Antigens, Bacterial; D001426:Bacterial Proteins / Q000276:immunology*; D001706:Biopsy; D001944:Breath Tests; D004415:Dyspepsia / Q000382:microbiology; D016099:Endoscopy, Gastrointestinal; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology; D016481:Helicobacter Infections / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D016480:Helicobacter pylori / Q000254:growth & development / Q000276:immunology*; D006801:Humans; D009504:Neutrophils / Q000473:pathology; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*
chemical_list: D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D014409:Tumor Necrosis Factor-alpha; C080866:cagA protein, Helicobacter pylori