[Application of serology to confirm the eradication of Helicobacter pylori in peptic ulcer patients].
BACKGROUND
Measurement of changes in serum antibodies is an excellent predictor of Helicobacter pylori eradication after antibiotic treatment.


OBJECTIVE
To measure the changes in serum antibody titers to Helicobacter pylori, before and after treatment.


METHODS
IgG antibodies to H. pylori were prospectively evaluated in 107 duodenal ulcer patients treated either with antibiotics (amoxicillin, metronidazole and bismuth subsalicylate) plus omeprazole or omeprazole alone. IgG antibody levels were determined using an "in house" ELISA in sera from 49 eradicated patients that received quadruple therapy and 58 non-eradicated patients (12 in whom antibiotic therapy failed and 46 that received omeprazole alone). Endoscopy, urease test, microscopy, and culture of gastric biopsies confirmed H. pylori eradication.


RESULTS
Patients in whom H. pylori was eradicated, showed a maintained drop in serum antibody titers that ranged from 15%, 62%, 74% to 76% at 28 days, 4, 8 and 12 months respectively. Such reduction was not observed in patients treated with omeprazole. Patients, in whom quadruple therapy failed to eradicate H. pylori, showed a discrete and transient decrease in antibody titers. By the fourth month, patients in whom eradication with quadruple therapy was not achieved, irrespective of whether they received quadruple therapy or omeprazole alone.


CONCLUSIONS
A 45% decrease in IgG titer after 4 months is indicative of therapeutic success in H. pylori eradication. Therefore, serology may be useful to monitor the outcome of antibiotic therapy (Rev Méd Chile 2000; 128: 1119-26).
Figueroa
G
G
Unidad de Microbiología INTA, Universidad de Chile y Departamento de Gastroenterología, Hospital del Salvador. gfiguero@uchile.cl
Troncoso
M
M
Toledo
M S
MS
Acuña
R
R
D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D015153:Blotting, Western; D004797:Enzyme-Linked Immunosorbent Assay; D005500:Follow-Up Studies; D016481:Helicobacter Infections / Q000188:drug therapy / Q000382:microbiology*; D016480:Helicobacter pylori / Q000276:immunology* / Q000302:isolation & purification; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008875:Middle Aged; D010437:Peptic Ulcer / Q000188:drug therapy / Q000382:microbiology*; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D000907:Antibodies, Bacterial; D015415:Biomarkers; D007074:Immunoglobulin G