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Association between Chronic Atrophic Gastritis and Serum Antibodies to 15 Helicobacter pylori Proteins Measured by Multiplex Serology

Divisions of ¹ Clinical Epidemiology and Aging Research and ² Genome Modifications and Carcinogenesis, German Cancer Research Center, Heidelberg, Germany

Requests for reprints: Hermann Brenner, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Bergheimer Str. 20, D-69115 Heidelberg, Germany. Phone: 49-6221-548140; Fax: 49-6221-548142; E-mail: h.brenner{at}dkfz-heidelberg.de.

Key Words: Helicobacter pylori • chronic atrophic gastritis • virulence factor • helicobacter cysteine-rich protein C • chaperonin GroEL

Infection with Helicobacter pylori is a major risk factor for chronic atrophic gastritis (CAG), a precursor lesion of intestinal gastric cancer. The pathogenicity of the bacterium is thought to play an important role in determining the extent and severity of clinical outcome. We aimed to assess the associations between CAG and the serostatus of antibodies to 15 H. pylori proteins. The analyses were based on 534 cases with serologically defined CAG and 1,068 age-matched and sex-matched controls participating in a population-based study conducted in Saarland, Germany among 9,953 men and women ages 50 to 74 years. A newly developed H. pylori multiplex serology method was used to detect antibodies specific to 15 H. pylori antigens. Significant associations were observed between seropositivity for all 15 specific antibodies and the presence of CAG. Exclusion of severe cases, who might have lost the infection in the course of CAG progression, substantially increased the observed associations. In H. pylori–seropositive subjects, cytotoxin-associated gene A (CagA), vacuolating toxin (VacA), helicobacter cysteine-rich protein C (HcpC), and the chaperonin GroEL were identified as independent virulence factors for CAG with adjusted odds ratios (95% confidence interval) of 3.52 (2.01–6.10), 3.19 (1.44–7.05), 4.03 (1.53–10.65), and 2.65 (1.06–6.62), respectively; the simultaneous presence of all four independent virulence factors was associated with an 18-fold risk of CAG. In conclusion, HcpC and GroEL were identified as new independent virulence factors, and in combination with the established virulence factors, CagA and VacA, were strongly associated with CAG. [Cancer Res 2009;69(7):2973–80]

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				L. Gao, A. Michel, M. N. Weck, V. Arndt, M. Pawlita, and H. Brenner Helicobacter pylori Infection and Gastric Cancer Risk: Evaluation of 15 H. pylori Proteins Determined by Novel Multiplex Serology Cancer Res., August 1, 2009; 69(15): 6164 - 6170. [Abstract] [Full Text] [PDF]