Association between Chronic Urticaria and Helicobacter pylori Infection among Patients Attending a Tertiary Hospital in Tanzania

Background. Chronic urticaria (CU) is a common skin disease; however, its etiology is rarely recognized. Infection due to Helicobacter pylori (H. pylori) has been shown in some studies to play a significant role in the pathogenesis of CU. Objective. This study was conducted to determine the association between CU and H. pylori infection among patients attending the Regional Dermatology Training Center, Northern Tanzania, from October 2018 to April 2019. Methodology. A matched case-control study that included 55 cases and 55 controls matched by age and sex was conducted. Data were collected through direct interviews, and the results of laboratory investigations were recorded in the extraction sheet. An enzyme-linked immunosorbent assay test was used to detect H. pylori antigen in the stool samples. Conditional logistic regression was used to measure the association between CU and H. pylori. Results. The total number of participants in this study was 110 patients (55 cases and 55 controls), whereby the median age was 31 (IQR 27–45) among controls versus 34 (IQR: 22–46) years among the cases. Both cases and controls had the same number of females and males. There was no significant association between CU and baseline characteristics of the participants. There was an association between CU and H. pylori infection, such that subjects with CU had a higher number of positive H. pylori test (15/55 = 27%) versus controls (6/55 = 10.1%) (p=0.0225). The adjusted odds of CU among patients who were positive for H. pylori were sixfolds higher (OR = 6.9; CI: 1.3–36.2; p=0.021) than those of patients who were negative for H. pylori.Conclusion. There was a strong and significant association between CU and H. pylori infection. We recommend investigating for H. pylori in all cases of CU and conducting further trials on H. pylori eradication.

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A Novel Line Immunoassay Based on Recombinant Virulence Factors Enables Highly Specific and Sensitive Serologic Diagnosis of Helicobacter pylori Infection

Clinical and Vaccine Immunology ◽

10.1128/cvi.00433-13 ◽

2013 ◽

Vol 20 (11) ◽

pp. 1703-1710 ◽

Cited By ~ 26

Author(s):

Luca Formichella ◽

Laura Romberg ◽

Christian Bolz ◽

Michael Vieth ◽

Michael Geppert ◽

...

Keyword(s):

Helicobacter Pylori ◽

Immune Responses ◽

Virulence Factors ◽

Gastrointestinal Disease ◽

Individual Risk ◽

Enzyme Linked Immunosorbent Assay ◽

Type I ◽

Serologic Test ◽

Content Type ◽

H Pylori

ABSTRACTHelicobacter pyloricolonizes half of the world's population, and infection can lead to ulcers, gastric cancer, and mucosa-associated lymphoid tissue (MALT) lymphoma. Serology is the only test applicable for large-scale, population-based screening, but current tests are hampered by a lack of sensitivity and/or specificity. Also, no serologic test allows the differentiation of type I and type II strains, which is important for predicting the clinical outcome.H. pylorivirulence factors have been associated with disease, but direct assessment of virulence factors requires invasive methods to obtain gastric biopsy specimens. Our work aimed at the development of a highly sensitive and specific, noninvasive serologic test to detect immune responses to importantH. pylorivirulence factors. This line immunoassay system (recomLine) is based on recombinant proteins. For this assay, six highly immunogenic virulence factors (CagA, VacA, GroEL, gGT, HcpC, and UreA) were expressed inEscherichia coli, purified, and immobilized to nitrocellulose membranes to detect serological immune responses in patient's sera. For the validation of the line assay, a cohort of 500 patients was screened, of which 290 (58.0%) wereH. pylorinegative and 210 (42.0%) were positive by histology. The assay showed sensitivity and specificity of 97.6% and 96.2%, respectively, compared to histology. In direct comparison to lysate blotting and enzyme-linked immunosorbent assay (ELISA), therecomLine assay had increased discriminatory power. For the assessment of individual risk for gastrointestinal disease, the test must be validated in a larger and defined patient cohort. Taking the data together, therecomLine assay provides a valuable tool for the diagnosis ofH. pyloriinfection.

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Influence of Helicobacter pylori Infection on the Small Intestinal Mucosa

ISRN Endoscopy ◽

10.5402/2013/408931 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5

Author(s):

Mitsunori Maeda ◽

Masakazu Nakano ◽

Hideyuki Hiraishi

Keyword(s):

Helicobacter Pylori ◽

Negative Relationship ◽

Mucosal Injury ◽

Enzyme Linked Immunosorbent Assay ◽

Small Intestinal Mucosa ◽

Significant Negative Relationship ◽

Positive Rate ◽

Intestinal Mucosal Injury ◽

Small Intestinal ◽

H Pylori

Background/Aims. To investigate the role of Helicobacter pylori infection in the development of enteritis (small intestinal mucosal injury). Methodology. Between April 2007 and January 2013, 99 patients undergoing capsule endoscopy (CE) were tested for anti-H. pylori immunoglobulin G antibody (Hp-IgG) using an enzyme-linked immunosorbent assay (ELISA). None of the patients had been treated for H. pylori infection or diagnosed as having Crohn’s disease or any other clinically apparent small intestinal disorders prior to the CE. Results. The overall Hp-IgG-positive rate was 26.3%. The incidence of enteritis, as diagnosed by CE, tended to be lower in the Hp-IgG-positive patients (23.1%) than in the Hp-IgG-negative patients (38.4%) (). When patients receiving aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs), well-known causes of enteritis, were excluded, the incidence of enteritis in the Hp-IgG-positive patients (11.7%) was significantly lower than that in the Hp-IgG-negative patients (43.7%) (). A binomial logistic regression analysis revealed a significant negative relationship between Hp-IgG positivity and the presence of enteritis in patients receiving neither aspirin nor NSAIDs (). Conclusions. Our data indicated that H. pylori positivity was inversely associated with the prevalence of enteritis.

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Preliminary Serological Study of Helicobacter pylori Infection in Some University Students

Recent Advances in Biology and Medicine ◽

10.18639/rabm.2020.958557 ◽

2020 ◽

Vol 6 ◽

pp. 1

Author(s):

Abdullah A Mahrazi ◽

Mohammad A Khibrani ◽

Khatib S Ismail ◽

Emad Abada ◽

◽

...

Keyword(s):

Helicobacter Pylori ◽

University Students ◽

Large Scale ◽

Confirmatory Test ◽

Enzyme Linked Immunosorbent Assay ◽

Blood Collection ◽

Igg Antibodies ◽

Igm Antibodies ◽

H Pylori

Helicobacter pylori has been associated with peptic ulcer and gastric carcinoma. This study aimed to find the seroprevalence of H. pylori infection in some male students of Jazan University, Saudi Arabia. Twenty students were enrolled in the study (n = 20). Informed consent was obtained from the students. About 2 ml blood was collected intravenously in Improvacuter® evacuated blood collection tubes. The blood was allowed to clot at room temperature. The serum was collected and stored at –20°C for further use. The separated serum was used to detect IgG and IgM antibodies by Enzyme Linked Immunosorbent Assay (ELISA) against H. pylori for the in vitro diagnosis. A total of 11 (55.00%) students tested positive for IgG antibodies against H. pylori indicating previous infection. All the samples tested negative for IgM antibodies against H. pylori indicating no active infection. The seroprevalance of IgG antibodies against H. pylori was found to be very high in some male university students and is a cause of concern regarding their health. Obesity (p < 0.05; Value statistically significant), stress and bad eating habits, eating out, drinking carbonated beverages, and eating spicy food were some of the factors found to be associated with IgG seropositive students. The students were counseled and were instructed to undergo a confirmatory test and get medical intervention. Further large-scale studies need to be performed to plan action against this disease causing organism and to improve the health of students.

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Good diagnostic accuracy of a chemiluminescent immunoassay in stool samples for diagnosis of Helicobacter pylori infection in patients with dyspepsia

Journal of Investigative Medicine ◽

10.1136/jim-2015-000004 ◽

2016 ◽

Vol 64 (2) ◽

pp. 388-391 ◽

Cited By ~ 6

Author(s):

María José Ramírez-Lázaro ◽

Josep Lite ◽

Sergio Lario ◽

Pepa Pérez-Jové ◽

Antònia Montserrat ◽

...

Keyword(s):

Helicobacter Pylori ◽

Gold Standard ◽

Rapid Urease Test ◽

Diagnostic Reliability ◽

Predictive Values ◽

Urease Test ◽

Stool Samples ◽

H Pylori ◽

Good Diagnostic Accuracy ◽

Sensitivity Specificity

Laboratory-based chemiluminescence immunoassays (CLIA) are widely used in clinical laboratories. Some years ago, a CLIA test was developed for the detection of Helicobacter pylori in stool samples, known as LIAISON H. pylori SA, but little information on its use has been reported. To evaluate the accuracy of the LIAISON H. pylori SA assay for diagnosing H. pylori infection prior to eradication treatment. Diagnostic reliability was evaluated in 252 untreated consecutive patients with dyspepsia. The gold standard for diagnosing H. pylori infection was defined as the concordance of the rapid urease test (RUT), histopathology and urea breath test (UBT). The CLIA assay was performed according to the manufacturer's instructions. Sensitivity, specificity, positive and negative predictive values, and 95% CIs were calculated. According to the gold standard selected, 121 patients were positive for H. pylori infection and 131 negative. LIAISON H. pylori SA had a sensitivity of 90.1% and a specificity of 92.4%, with positive and negative predictive values of 91.6% and 90.1%, respectively. The accuracy of the LIAISON H. pylori SA chemiluminescent diagnostic assay seems comparable to that of ELISA or the best-performing LFIAs. Its sensitivity and specificity, however, seem slightly lower than those of histology, RUT or UBT. The advantages of the assay are that it is cheap, automated, and minimally labor-intensive.

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Repeat-Associated Plasticity in the Helicobacter pylori RD Gene Family

Journal of Bacteriology ◽

10.1128/jb.00706-09 ◽

2009 ◽

Vol 191 (22) ◽

pp. 6900-6910 ◽

Cited By ~ 3

Author(s):

Joshua R. Shak ◽

Jonathan J. Dick ◽

Richard J. Meinersmann ◽

Guillermo I. Perez-Perez ◽

Martin J. Blaser

Keyword(s):

Helicobacter Pylori ◽

Gene Family ◽

Repetitive Dna ◽

Enzyme Linked Immunosorbent Assay ◽

Insertion And Deletion ◽

Amino Acid Repeats ◽

H Pylori ◽

Multiple Strains ◽

Nucleotide Repeats ◽

Sterilizing Immunity

ABSTRACT The bacterium Helicobacter pylori is remarkable for its ability to persist in the human stomach for decades without provoking sterilizing immunity. Since repetitive DNA can facilitate adaptive genomic flexibility via increased recombination, insertion, and deletion, we searched the genomes of two H. pylori strains for nucleotide repeats. We discovered a family of genes with extensive repetitive DNA that we have termed the H. pylori RD gene family. Each gene of this family is composed of a conserved 3′ region, a variable mid-region encoding 7 and 11 amino acid repeats, and a 5′ region containing one of two possible alleles. Analysis of five complete genome sequences and PCR genotyping of 42 H. pylori strains revealed extensive variation between strains in the number, location, and arrangement of RD genes. Furthermore, examination of multiple strains isolated from a single subject's stomach revealed intrahost variation in repeat number and composition. Despite prior evidence that the protein products of this gene family are expressed at the bacterial cell surface, enzyme-linked immunosorbent assay and immunoblot studies revealed no consistent seroreactivity to a recombinant RD protein by H. pylori-positive hosts. The pattern of repeats uncovered in the RD gene family appears to reflect slipped-strand mispairing or domain duplication, allowing for redundancy and subsequent diversity in genotype and phenotype. This novel family of hypervariable genes with conserved, repetitive, and allelic domains may represent an important locus for understanding H. pylori persistence in its natural host.

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Serological evidence of association between Helicobacter pylori infection and coronary artery disease

African Journal of Clinical and Experimental Microbiology ◽

10.4314/ajcem.v21i2.2 ◽

2020 ◽

Vol 21 (2) ◽

pp. 88-96

Author(s):

S.M. EL-Ageery ◽

N.S. Gouda ◽

I.M. Fawzy ◽

A. Bahy-Eldeen ◽

R. Mahmoud

Keyword(s):

Coronary Artery Disease ◽

Helicobacter Pylori ◽

Coronary Artery ◽

Density Lipoprotein ◽

Enzyme Linked Immunosorbent Assay ◽

Control Group ◽

Serological Evidence ◽

Autoimmune Reaction ◽

Artery Disease ◽

H Pylori

Background: Studies have reported relationship between chronic Helicobacter pylori infection and coronary artery disease (CAD). The cytotoxin-associated gene A product (CagA) is an immunodominant protein which indicates infection with virulent H. pylori strains. Significant associations of CagA-positive H. pylori strains with coronary artery disorders have been widely reported. H. pylori is also known to produce different heat shock proteins (HSPs) which can stimulate the production of specific antibody against microbial proteins and capable of eliciting autoimmune reaction against human tissue expressing HSPs such as vascular endothelial cells. The objectives of this study are to investigate the association between H. pylori and CagA with coronary atherosclerosis and CAD, and to determine the possible role of H. pylori HSP60 protein in increasing the risk of CAD development. Methods: This study included 70 patients with stable angina and 70 age and gender-matched controls. Each group was evaluated by clinical history, physical examination, cardiac echocardiography (ECHO) and electrocardiography (ECG) with and without exercise. Fasting blood glucose, total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL) and triglycerides (TG) were estimated by automated enzymatic methods. H. pylori IgG, CagA IgG and HSP60 IgG were measured by enzyme-linked immunosorbent assay (ELISA) for both groups. Results: The seroprevalence of H. pylori infection was high in both groups; 75.7% in case and 68.6% in control (p=0.346). Serum IgG levels were significantly higher for CagA (p=0.028) and HSP60 (p<0.001) in cases than in controls. There was significant association between H. pylori and CagA IgGs in cases (p=0.007) but no association in controls (p=0.700). Higher HSP60 IgG level was significantly associated with both positive H. pylori IgG (p<0.001) and CagA IgG (p<0.001) in cases but no significant association was found with H. pylori (p=0.815) or CagA (p=0.332) IgG levels in the control group. Serum values were significantly higher for TC (p<0.001), TG (p<0.001) and LDL (p=0.004) while value for HDL was significantly lower (p<0.001) in H. pylori IgG-positive subjects (case and control). Conclusion: There is serological evidence that H. pylori infection may pose a significant risk factor for CAD. Since H. pylori can be eliminated by specific treatment, this may be a good preventive approach for CAD.Key words: H. pylori, coronary artery disease, CagA, HSP60, serology.

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Correlates of infection with Helicobacter pylori positive and negative cytotoxin-associated gene A phenotypes among Arab and Jewish residents of Jerusalem

Epidemiology and Infection ◽

10.1017/s0950268819001456 ◽

2019 ◽

Vol 147 ◽

Cited By ~ 2

Author(s):

K. Muhsen ◽

R. Sinnereich ◽

G. Beer-Davidson ◽

H. Nassar ◽

W. Abu Ahmed ◽

...

Keyword(s):

Helicobacter Pylori ◽

Former Soviet Union ◽

Enzyme Linked Immunosorbent Assay ◽

Igg Antibodies ◽

Multinomial Regression ◽

Igg Antibody ◽

Sibship Size ◽

Cross Sectional ◽

Cytotoxin Associated Gene A ◽

H Pylori

Abstract We examined the prevalence and correlates of Helicobacter pylori (H. pylori) infection according to cytotoxin-associated gene A (CagA) phenotype, a main virulence antigen, among the ethnically diverse population groups of Jerusalem. A cross-sectional study was undertaken in Arab (N = 959) and Jewish (N = 692) adults, randomly selected from Israel's national population registry in age-sex and population strata. Sera were tested for H. pylori immunoglobulin G (IgG) antibodies. Positive samples were tested for virulence IgG antibodies to recombinant CagA protein, by enzyme-linked immunosorbent assay. Multinomial regression models were fitted to examine associations of sociodemographic factors with H. pylori phenotypes. H. pylori IgG antibody sero-prevalence was 83.3% (95% confidence interval (CI) 80.0%–85.5%) and 61.4% (95% CI 57.7%–65.0%) among Arabs and Jews, respectively. Among H. pylori positives, the respective CagA IgG antibody sero-positivity was 42.3% (95% CI 38.9%–45.8%) and 32.5% (95% CI 28.2%–37.1%). Among Jews, being born in the Former Soviet Union, the Middle East and North Africa, vs. Israel and the Americas, was positively associated with CagA sero-positivity. In both populations, sibship size was positively associated with both CagA positive and negative phenotypes; and education was inversely associated. In conclusion, CagA positive and negative infection had similar correlates, suggesting shared sources of these two H. pylori phenotypes.

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Relationship of Anti-Lewis x and Anti-Lewis y Antibodies in Serum Samples from Gastric Cancer and Chronic Gastritis Patients toHelicobacter pylori-Mediated Autoimmunity

Infection and Immunity ◽

10.1128/iai.69.8.4774-4781.2001 ◽

2001 ◽

Vol 69 (8) ◽

pp. 4774-4781 ◽

Cited By ~ 25

Author(s):

Michael A. Heneghan ◽

Ciaran F. McCarthy ◽

Daiva Janulaityte ◽

Anthony P. Moran

Keyword(s):

Gastric Cancer ◽

Helicobacter Pylori ◽

Gastric Mucosa ◽

Antibody Production ◽

Enzyme Linked Immunosorbent Assay ◽

Serum Samples ◽

Lewis Y ◽

H Pylori ◽

Negative Controls ◽

Relationship Of

ABSTRACT Lewis (Le) antigens have been implicated in the pathogenesis of atrophic gastritis and gastric cancer in the setting ofHelicobacter pylori infection, and H. pylori-induced anti-Le antibodies have been described that cross-react with the gastric mucosa of both mice and humans. The aim of this study was to examine the presence of anti-Le antibodies in patients with H. pylori infection and gastric cancer and to examine the relationships between anti-Le antibody production, bacterial Le expression, gastric histopathology, and host Le erythrocyte phenotype. Anti-Le antibody production and H. pylori Le expression were determined by enzyme-linked immunosorbent assay, erythrocyte Le phenotype was examined by agglutination assays, and histology was scored blindly. Significant levels of anti-Lex antibody (P < 0.0001, T = 76.4, DF = 5) and anti-Ley antibody (P < 0.0001, T = 73.05, DF = 5) were found in the sera of patients with gastric cancer and other H. pylori-associated pathology compared with H. pylori-negative controls. Following incubation of patient sera with synthetic Le glycoconjugates, anti-Lex and -Ley autoantibody binding was abolished. The degree of the anti-Lex and -Leyantibody response was unrelated to the host Le phenotype but was significantly associated with the bacterial expression of Lex (r = 0.863,r 2 = 0.745, P < 0.0001) and Ley (r = 0.796,r 2 = 0.634, P < 0.0001), respectively. Collectively, these data suggest that anti-Le antibodies are present in most patients with H. pyloriinfection, including those with gastric cancer, that variability exists in the strength of the anti-Le response, and that this response is independent of the host Le phenotype but related to the bacterial Le phenotype.

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Seroprevalence of Helicobacter pylori infection in patients with chronic nonspecific pharyngitis: preliminary study

The Journal of Laryngology & Otology ◽

10.1017/s0022215107006743 ◽

2007 ◽

Vol 122 (1) ◽

pp. 61-64 ◽

Cited By ~ 6

Author(s):

İ Aladag ◽

Y Bulut ◽

M Guven ◽

A Eyibilen ◽

K Yelken

Keyword(s):

Helicobacter Pylori ◽

Treatment Strategies ◽

Enzyme Linked Immunosorbent Assay ◽

Control Group ◽

Control Groups ◽

Chi Square ◽

Control Subjects ◽

The Difference ◽

H Pylori ◽

And Control

AbstractBackground and objectives:Chronic nonspecific pharyngitis is a chronic inflammation of the pharynx. It is found worldwide, and treatment is difficult. The underlying aetiopathogenesis is still controversial. The aim of this study was to investigate Helicobacter pylori seroprevalence in chronic nonspecific pharyngitis patients without other possible causative factors for chronic pharyngeal irritation and without H pylori gastric mucosal infection.Materials and methods:Forty-one patients with symptoms of chronic nonspecific pharyngitis and 30 healthy control subjects were enrolled in this prospective, controlled, clinical study. In both study and control groups, selected patients were shown to have gastric mucosa uninfected by H pylori, as demonstrated by the 14C-urea breath test. Comprehensive otorhinolaryngological examination did not elicit any factor contributing to the chronic pharyngeal complaint. Serum H pylori immunoglobulin G antibody titres were assayed using serum enzyme-linked immunosorbent assay. The difference between the study and control groups was analysed by the chi-square test (the likelihood ratio was used).Results:Thirty-two of the 41 patients (78 per cent) and 14 of the 30 control subjects (46.7 per cent) were found to be H pylori positive. Patients with chronic nonspecific pharyngitis were found to have a significantly higher rate of H pylori seropositivity than the control group (p = 0.016).Conclusion:These data may be important in developing future treatment strategies for chronic nonspecific pharyngitis.

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Immunoglobulin G Antibody against Helicobacter pylori: Clinical Implications of Levels Found in Serum

Clinical and Vaccine Immunology ◽

10.1128/cdli.9.5.1044-1048.2002 ◽

2002 ◽

Vol 9 (5) ◽

pp. 1044-1048 ◽

Cited By ~ 2

Author(s):

Tseng-Shing Chen ◽

Fen-Yau Li ◽

Full-Young Chang ◽

Shou-Dong Lee

Keyword(s):

Helicobacter Pylori ◽

Chronic Gastritis ◽

Predictive Value ◽

Linear Regression Analysis ◽

Serum Antibody ◽

Quantitative Detection ◽

Enzyme Linked Immunosorbent Assay ◽

Multivariate Linear Regression Analysis ◽

H Pylori ◽

Antibody Levels

ABSTRACT The clinical significance of high levels of antibody against Helicobacter pylori is still unclear. We sought to evaluate whether the serum antibody levels could predict the presence of macroscopic gastroduodenal disease, to identify factors that correlate with antibody levels in a multivariate context, and to determine the predictive value of antibody levels for diagnosing H. pylori infection. The grades of gastritis and density of H. pylori colonization were scored separately using the updated Sydney system for antral and body mucosa. An enzyme-linked immunosorbent assay (ELISA) for the quantitative detection in serum of IgG antibodies to H. pylori was performed. Of the 170 dyspeptic patients, 105 (62%) had H. pylori infection. There was no difference in antibody levels among endoscopic findings of normal mucosa, chronic gastritis, and duodenal ulcer. On multivariate linear regression analysis, the status of H. pylori infection, mononuclear cell infiltration of body mucosa, and age correlated with antibody levels. The negative predictive value for antibody levels of <30 U/ml is 94%, and the positive predictive value of antibody levels of >70 U/ml is 98%. We conclude that serum antibody levels do not predict the severity of gastroduodenal diseases or the density of H. pylori colonization in H. pylori-infected dyspeptic patients. Higher levels are associated with the presence of H. pylori infection, the chronic gastritis score of the corpus, and older age. Setting a gray zone is necessary for ELISA, since the accuracy in this zone does not allow a precise determination of H. pylori status.

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