title: Colonisation density and topographic localisation of Helicobacter pylori do not depend on the cagA status.
abstract: OBJECTIVE
  To explore the correlation between the cagA status of Helicobacter pylori and the density and topographic localisation of H pylori.
  
  
  METHODS
  Gastric antral biopsy specimens were taken from 716 consecutive patients, including 293 H pylori positive patients (124 men, 169 women; mean age, 52.6 years; range, 12-87). A serum sample was taken for determination of IgG anti-CagA antibodies (sensitivity of 94.4% and specificity of 92.5%). The density of H pylori was assessed semiquantitatively (grades I-IV) in biopsy specimens stained with the modified Giemsa stain. Topographic localisation was classified as follows: score A, H pylori closely attached to the mucosa; score B, H pylori attached to the mucosa and in the mucus; and score C, H pylori solely in the mucus.
  
  
  RESULTS
  CagA antibodies were present in 154 (52.5%) of the patients. There was no significant difference in colonisation density and cagA status: grade I, 23 (14%); grade II, 78 (50.6%); grade III, 42 (27.5%); and grade IV, 11 (7.2%) in the cagA(+) strains and 29 (21.2%), 57 (40.8%), 38 (27%), and 15 (11%), respectively, in the cagA(-) strains. There was no difference in topographic localisation between cagA(+) and cagA(-)H pylori. Mean anti-CagA titres were 0.84, 0.84, 0.89, and 0.73 in patients with grades I-IV bacterial density, respectively.
  
  
  CONCLUSIONS
  Antibody titres do not correlate with H pylori density and there is no difference in density between cagA(+) and cagA(-)H pylori strains. In addition there is no difference in topographic localisation between cagA(+) and cagA(-) H pylori strains.
authors.affiliation: Department of Internal Medicine, de Heel Zaans Medisch Centrum Zaandam, PO Box 210, 1500 EE Zaandam, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Twisk
authors.forename: J G
authors.initials: JG
authors.lastname: Kusters
authors.forename: A G
authors.initials: AG
authors.lastname: Balk
authors.forename: E J
authors.initials: EJ
authors.lastname: Kuipers
authors.forename: R J
authors.initials: RJ
authors.lastname: Loffeld
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood*; D000942:Antigens, Bacterial; D001399:Azure Stains; D001426:Bacterial Proteins / Q000097:blood*; D001706:Biopsy; D002648:Child; D015169:Colony Count, Microbial; D005260:Female; D005750:Gastric Juice / Q000382:microbiology; D005753:Gastric Mucosa / Q000382:microbiology; D016481:Helicobacter Infections / Q000097:blood / Q000382:microbiology*; D016480:Helicobacter pylori / Q000235:genetics* / Q000276:immunology / Q000302:isolation & purification; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011706:Pyloric Antrum / Q000382:microbiology / Q000473:pathology
chemical_list: D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D001399:Azure Stains; D001426:Bacterial Proteins; D007074:Immunoglobulin G; C080866:cagA protein, Helicobacter pylori