Association of Helicobacter pylori IgA antibodies with the risk of peptic ulcer disease and gastric cancer.
OBJECTIVE
To compare the prevalence of Helicobacter pylori (H pylori) IgG and IgA antibodies between adult subjects, with defined gastric diseases, non-defined gastric disorders and those representing the population.


METHODS
Data on H pylori IgG and IgA antibodies, determined by enzyme immunoassay, were analyzed in 3,252 subjects with DGD including 482 patients with gastric ulcer, 882 patients with duodenal ulcer, 1,525 patients with chronic gastritis only and 363 subjects with subsequent gastric cancer, 19,145 patients with NoDg and 4,854 POPUL subjects. The age-adjusted prevalences were calculated for 1- and 20-year age cohorts.


RESULTS
The prevalences of IgG antibodies were equally high (89-96%) in all 20-year age cohorts of the DGD groups, whereas the prevalences of IgG antibodies were lower and increased by age in the POPUL and NoDg groups. The prevalences of IgA antibodies were also higher in the DGD groups; among them CA (84-89%) and GU groups (78-91%) showed significantly higher prevalences than DU (68-77%) and CG patients (59-74%) (OR 2.49, 95%CI 1.86-3.34 between the GU and DU groups). In the CA, GU, and DU groups, the IgA prevalences showed only minor variation according to age, while they increased by age in the CG, POPUL, and NoDg groups (P<=0.0001). The IgA response, but not the IgG response, was associated with an increased risk of CA (OR 2.41, 95%CI 1.79-3.53) and GU (OR 2.57, 95%CI 1.95-3.39) in comparison with CG patients.


CONCLUSIONS
An IgA antibody response during H pylori infection is significantly more common in CA and GU patients as compared with CG patients.
Kosunen
Timo U
TU
Department of Bacteriology and Immunology, University of Helsinki, PO Box 21, FIN-00014 Helsinki, Finland. timo.kosunen@helsinki.fi
Seppala
Kari
K
Sarna
Seppo
S
Aromaa
Arpo
A
Knekt
Paul
P
Virtamo
Jarmo
J
Salomaa-Rasanen
Anniina
A
Rautelin
Hilpi
H
D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood*; D000942:Antigens, Bacterial / Q000276:immunology; D005387:Finland; D016481:Helicobacter Infections / Q000276:immunology*; D016480:Helicobacter pylori / Q000276:immunology*; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood*; D007074:Immunoglobulin G / Q000276:immunology; D008875:Middle Aged; D010437:Peptic Ulcer / Q000276:immunology / Q000382:microbiology*; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000276:immunology / Q000382:microbiology*
D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D007070:Immunoglobulin A; D007074:Immunoglobulin G