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Anti-CagA positivity in duodenal ulcer and functional dyspepsia patients infected with Helicobacter pylori and its effect on the outcome of eradication treatment

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Author(s): Elif Doğan | Ayşe Kefeli | Yaşar Nazlıgül | Abdullah Özgür Yeniova | Metin Küçükazman | Zeynep Çizmeci | Servet Güreşci | Cihan Fidan

Journal: Dicle Medical Journal
ISSN 1300-2945

Volume: 38;
Issue: 1;
Start page: 7;
Date: 2011;
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Keywords: CagA | duodenal ulcer | functional dyspepsia | Helicobacter pylori eradication

ABSTRACT
Objectives: CagA positive H. pylori strains are considered to be more virulent than other strains. In this study, we aimed to investigate the rate of CagA positivity in duodenal ulcer (DU) and functional dyspepsia (FD), and its effect on H. pylori eradication response.Materials and methods: The study was performed on H. pylori positive 60 patients with DU and 50 patients with FD, who underwent upper gastrointestinal endoscopy. H. pylori infection was identified by histology. All patients received a quadriple therapy consisted of esomeprazole 20 mg b.i.d., colloidal bismuth subcitrate 600 mg b.i.d., tetracycline 500 mg q.i.d. and metronidazole 500 mg t.i.d. for 7 days. H.pylori status was rechecked using C14-urea breath test 6 weeks after the end of treatment to confirm cure. Specific IgG antibodies for CagA status were determined by enzyme linked immunosorbent assay.Results: CagA positivities in the patients with DU and FD were calculated respectivily 70% and 68% (P>0.05). H. pylori was eradicated in 85.5% of the patients infected with CagA (+) strains, in 50% of those infected with CagA (-) strains (P=0.001). The eradication rates were 95.2% and 55.6% in CagA positive and negative DU subgroups (P=0.001), and 73.5% and 43.8% in CagA positive and negative FD subgroups (P=0.04).Conclusion: CagA positivities were not different in duodenal ulcer and functional dyspepsia. CagA (+) strains was susceptible to the eradication treatment. The titres of serum anti-CagA antibodies may be used in the prediction of eradication outcome, and the modification of eradication therapy.

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Tangokurs Rapperswil-Jona

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