Retrospective Cohort Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pathophysiol. Aug 15, 2016; 7(3): 288-295
Published online Aug 15, 2016. doi: 10.4291/wjgp.v7.i3.288
Does the antibody production ability affect the serum anti-Helicobacter pylori IgG titer?
Hyun Ah Chung, Sun-Young Lee, Hee Won Moon, Jeong Hwan Kim, In-Kyung Sung, Hyung Seok Park, Chan Sup Shim, Hye Seung Han
Hyun Ah Chung, Sun-Young Lee, Jeong Hwan Kim, In-Kyung Sung, Hyung Seok Park, Chan Sup Shim, Department of Internal Medicine, Konkuk University School of Medicine, Seoul 05030, South Korea
Hee Won Moon, Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul 05030, South Korea
Hye Seung Han, Department of Pathology, Konkuk University School of Medicine, Seoul 05030, South Korea
Author contributions: Chung HA and Lee SY wrote the manuscript; Lee SY designed research; Chung HA, Moon HW and Han HS analyzed data; Kim JH, Sung IK, Park HS and Shim CS supervised the study.
Supported by Konkuk University in 2015, No. KU2015-A019-0 270.
Institutional review board statement: The study was reviewed and approved for publication by the institutional review board of the Konkuk University School of Medicine (KUH1010625).
Clinical trial registration statement: This study was registered at ClinicalTrials.gov ID: KCT0001302 (https://cris.nih.go.kr) after the approval by the institutional review board of the Konkuk University School of Medicine (KUH1010625).
Informed consent statement: Written informed consent was obtained from all the participants before the procedure as described in the MATERIALS AND METHODS section.
Conflict-of-interest statement: No authors have any conflict of interest.
Data sharing statement: The original anonymized database is available for collaborative studies via the corresponding author, sunyoung@kuh.ac.kr.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Sun-Young Lee, MD, PhD, Department of Internal Medicine, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, South Korea. sunyoung@kuh.ac.kr
Telephone: +82-2-20307747 Fax: +82-2-20307748
Received: December 27, 2015
Peer-review started: December 28, 2015
First decision: January 30, 2016
Revised: June 5, 2016
Accepted: July 11, 2016
Article in press: July 13, 2016
Published online: August 15, 2016
Abstract

AIM: To investigate the relationship between serum titers of anti-Helicobacter pylori (H. pylori) immunoglobulin G (IgG) and hepatitis B virus surface antibody (HBsAb).

METHODS: Korean adults were included whose samples had positive Giemsa staining on endoscopic biopsy and were studied in the hepatitis B virus surface antigen (HBsAg)/HBsAb serologic assay, pepsinogen (PG) assay, and H. pylori serologic test on the same day. Subjects were excluded if they were positive for HBsAg, had a recent history of medication, or had other medical condition(s). We analyzed the effects of the following factors on serum titers of HBsAb and the anti-H. pylori IgG: Age, density of H. pylori infiltration in biopsy samples, serum concentrations of PG I and PG II, PG I/II ratio, and white blood cell count.

RESULTS: Of 111 included subjects, 74 (66.7%) exhibited a positive HBsAb finding. The serum anti-H. pylori IgG titer did not correlate with the serum HBsAb titer (P = 0.185); however, it correlated with the degree of H. pylori infiltration on gastric biopsy (P < 0.001) and serum PG II concentration (P = 0.042). According to the density of H. pylori infiltration on gastric biopsy, subjects could be subdivided into those with a marked (median: 3.95, range 0.82-4.00) (P = 0.458), moderate (median: 3.37, range 1.86-4.00), and mild H. pylori infiltrations (median: 2.39, range 0.36-4.00) (P < 0.001). Subjects with a marked H. pylori infiltration on gastric biopsy had the highest serological titer, whereas in subjects with moderate and mild H. pylori infiltrations titers were correspondingly lower (P < 0.001). After the successful eradication, significant decreases of the degree of H. pylori infiltration (P < 0.001), serum anti-H. pylori IgG titer (P < 0.001), and serum concentrations of PG I (P = 0.028) and PG II (P = 0.028) were observed.

CONCLUSION: The anti-H. pylori IgG assay can be used to estimate the burden of bacteria in immunocompetent hosts with H. pylori infection, regardless of the HBsAb titer after HBV vaccination.

Keywords: Antibody, Helicobacter pylori, Hepatitis B, Immunoglobulin G, Pepsinogen

Core tip: Koreans receive a routine childhood immunization program, including hepatitis B vaccinations, but serum hepatitis B virus (HBV) surface antibody responses are variable. It is unclear whether the beneficial functional immune aspects inherent in vaccine responders can be translated into a robust immune response after Helicobacter pylori (H. pylori) infection. In this study, the serum anti-H. pylori immunoglobulin G (IgG) titer appears to be significantly linked to the bacterial load of the stomach, regardless of the ability of antibody production after HBV vaccination. The serum anti-H. pylori IgG assay can be used to estimate the burden of bacteria in immunocompetent hosts with H. pylori infection.