[CagA and VacA cytotoxin antibodies and risk for peptic ulcer disease in patients with Helicobacter pylori infection].
BACKGROUND
The presence of cagA antibodies constitutes a serum marker of infection caused by virulent strains of Helicobacter pylori. The objective of this study was to determine the risk of peptic ulcer in patients with H. pylori infection, in relation to the detection of CagA and VacA antibodies.


METHODS
Prospective case-control study including 104 peptic ulcer patients with active H. pylori infection (positive urease test and/or histology, or positive urea breath test) and 104 age- and sex-matched controls, without peptic ulcer history, with active H. pylori infection (positive urea breath test). Serum CagA and VacA antibodies were determined by Western blot. Non-steroidal antiinflamatory drugs (NSAID) use was determined by structured data collection. A multivariate analysis (logistic regression) was carried out to determine the odds ratio (OR).


RESULTS
Presence of serum antibodies against CagA was higher in peptic ulcer patients (74%) than in controls (46.2%) (OR = 5.7; 95% CI = 2.1-15.6). However, presence of serum antibodies against VacA in patients (46.2%) was similar to that in controls (36.5%). NSAID use was also more frequent in patients (51.9%) than in controls (21,2%) (OR = 6.5; 95% CI = 2.2-19,5).


CONCLUSIONS
Serum antibodies against CagA and use of NSAID are the most important risk factors for peptic ulcer disease.
Santolaria
S
S
Aparato Digestivo. Hospital Universitario Lozano Blesa. Zaragoza.
Lanas A
Benito
R
R
Piazuelo
E
E
Sáinz
R
R
D000368:Aged; D000942:Antigens, Bacterial / Q000097:blood*; D001426:Bacterial Proteins / Q000276:immunology*; D003603:Cytotoxins / Q000097:blood*; D005260:Female; D016481:Helicobacter Infections / Q000097:blood* / Q000150:complications*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000097:blood* / Q000453:epidemiology / Q000382:microbiology*; D011446:Prospective Studies; D012307:Risk Factors
D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D003603:Cytotoxins; C074689:VacA protein, Helicobacter pylori; C080866:cagA protein, Helicobacter pylori