title: Association of circulating VacA-neutralizing antibodies with gastric cancer and duodenal ulcer.
abstract: OBJECTIVE
  To study the association between anti-VacA antibodies and pre-neoplastic lesions (IM), gastric cancer (GC), and duodenal ulcer (DU).
  
  
  METHODS
  A case-control study that included 347 patients, 90 with IM, 60 with GC, 52 with DU, and 145 with non-atrophic gastritis was conducted. For the analysis, a polytomous logistic regression models were used. Anti-VacA antibodies were identified in sera from these patients, either by Western blot assay (WB), using antigens produced by H. pylori s1m1 strain, or by neutralization assay challenging HeLa cells with H. pylori VacA s1m1 cytotoxin.
  
  
  RESULTS
  Results of the WB assay showed no association between WB-anti-VacA antibodies and gastroduodenal diseases. In contrast, when antibodies that neutralize VacA cytotoxic activity were studied, a significant association was found with IM (OR 2.7, 95% CI 1.4-5.1) and DU (OR 2.3, 95% CI 1.1-4.9) and an even stronger association with GC (OR 3.9, 95% CI 1.8-8.5). A significant association with histological subtypes of GC (diffuse and intestinal) and of IM (complete and incomplete) was also found. In addition, the association showed a significant dose-response effect in the case of GC, but not of DU or IM. These associations did not change substantially after adjustment for confounding factors.
  
  
  CONCLUSIONS
  This study showed that VacA-neutralizing antibodies are significantly associated with gastroduodenal diseases, especially GC, and that they might be used as risk markers of GC and DU.
authors.affiliation: Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Universidad No. 655, entre Cerrada Los Pinos y Caminera. Col. Santa María Ahuacatitlán, CP 62100, Cuernavaca, Morelos, Mexico. gayala@insp.mx
authors.forename: Guadalupe
authors.initials: G
authors.lastname: Ayala
authors.forename: Lourdes
authors.initials: L
authors.lastname: Flores-Luna
authors.forename: Dulce
authors.initials: D
authors.lastname: Hernández-Amaro
authors.forename: Guillermo
authors.initials: G
authors.lastname: Mendoza-Hernández
authors.forename: Lilia
authors.initials: L
authors.lastname: Chihu-Amparán
authors.forename: Fernando
authors.initials: F
authors.lastname: Bernal-Sahagún
authors.forename: Margarita
authors.initials: M
authors.lastname: Camorlinga
authors.forename: Eduardo
authors.initials: E
authors.lastname: Lazcano-Ponce
authors.forename: Javier
authors.initials: J
authors.lastname: Torres
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood*; D057134:Antibodies, Neutralizing / Q000097:blood*; D000942:Antigens, Bacterial / Q000276:immunology; D001426:Bacterial Proteins / Q000276:immunology*; D016022:Case-Control Studies; D004381:Duodenal Ulcer / Q000276:immunology* / Q000382:microbiology*; D005260:Female; D016481:Helicobacter Infections / Q000276:immunology; D016480:Helicobacter pylori / Q000276:immunology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000276:immunology* / Q000382:microbiology*
chemical_list: D000907:Antibodies, Bacterial; D057134:Antibodies, Neutralizing; D000942:Antigens, Bacterial; D001426:Bacterial Proteins; C074689:VacA protein, Helicobacter pylori