Serum Levels of High-Sensitivity C-Reactive Protein (hs-CRP) in Helicobacter pylori-Infected Peptic Ulcer Patients and Its Association with Bacterial CagA Virulence Factor
- 227 Downloads
Objective CRP is a marker of inflammation and infection of the gastric mucosa with Helicobacter pylori, which causes an inflammatory reaction. It has been reported that CagA + H. pylori strains induce more severe gastric inflammation and are also associated with higher risks of peptic ulcer and gastric cancer. The purpose of this study was to compare serum concentrations of hs-CRP in H. pylori-infected peptic ulcer (PU) patients, H. pylori-infected asymptomatic (AS) carriers, and a healthy control group, and their association with bacterial virulence factor CagA. Material and Methods A total of 60 H. pylori-infected PU patients (30 patients were positive for anti-CagA antibody and 30 were negative for anti-CagA antibody), 53 H. pylori-infected AS carriers (25 subjects were positive for anti-CagA antibody and 28 were negative for anti-CagA antibody), and 22 healthy H. pylori-negative subjects (as a control group) were enrolled in the study. Serum concentrations of hs-CRP were measured by use of an ELISA method. Results The mean serum level of hs-CRP in all PU patients (124.9 ± 32.4 μg/dl) was significantly higher than that in all AS subjects (18.6 ± 2.6 μg/dl; P < 0.001) and the healthy uninfected control group (10.7 ± 2.9 μg/dl; P < 0.0001). Moreover, the mean serum level of hs-CRP in the AS group was significantly higher than that observed in the uninfected control group (P < 0.04). No significant difference was observed between mean serum levels of hs-CRP of PU patients with positive test for anti-CagA antibody (132.6 ± 49.4 μg/dl) and PU patients with negative test for anti-CagA antibody (117.1 ± 42.9 μg/dl). Moreover, mean serum levels of hs-CRP were similar in AS subjects with positive test for anti-CagA (18.4 ± 3.1 μg/dl) and in those who were negative for anti-CagA antibody (18.9 ± 4.1 μg/dl). Conclusion The results of this study showed that mean serum concentrations of hs-CRP in PU patients and in H. pylori-infected AS carriers were higher than in a healthy control group. Although H. pylori infection is associated with higher serum levels of hs-CRP, serum concentrations of this inflammatory marker were not affected by expression of bacterial CagA virulence factor.
KeywordsHelicobacter pylori Peptic ulcer Hs-CRP Anti-CagA
The authors are grateful to Mohammad Ahmad-Beaygi and Mohammad Taghi Rezayati and authorities of the endoscopy unit of Rafsanjan Ali-ebn-Abitaleb Hospital for invaluable help.
- 2.International Agency for Research on Cancer Working Group on the Evaluation of Carcinogenic Risks to Humans. Schistosomes, liver flukes and Helicobacter pylori: infection with Helicobacter pylori. IARC Monogr Eval Carcinog Risks Hum. 1994;61:177–240.Google Scholar
- 6.Kaklikkaya N, Cubukcu K, Aydin F, et al. Significance of CagA status and vacA subtypes of Helicobacter pylori in determining gastric histopathology: virulence markers of H. pylori and histopathology. J Gastroenterol Hepatol. 2006;21(6):1042–1047. doi: 10.1111/j.1440-1746.2006.04199.x.CrossRefPubMedGoogle Scholar
- 8.Jimenze F, Demaria JL, Ahumada C, et al. Seroprevalence of Helicobacter pylori anti-CagA antibodies and its relationship with epidemiologic factors in Santa Fe. Acta Gastroenterol Latinoam. 2004;34:16–20.Google Scholar
- 15.Ishida Y, Suzuki K, Taki K, Niwa T, Kurotsuchi S, Ando H, Iwase A, Nishio K, Wakai K, Ito Y, Hamajima N. Significant association between Helicobacter pylori infection and serum C-reactive protein. Int J Med Sci. 2008;5(4):224–229.Google Scholar
- 19.Jafarzadeh A, Salari M. Seroprevalence of anti-Helicobacter pylori and anti-CagA antibodies in peptic ulcer and healthy subjects in the city of Rafsanjan. J Res Med Sci. 2006;11:285–291.Google Scholar
- 20.Jafarzadeh A, Sajadi M. Evaluation of the serum Interleukin-18 levels in Helicobacter pylori-infected peptic ulcer patients and its association with bacterial CagA virulence factor. Iran J Immunol. 2006;3:15–22.Google Scholar
- 22.Kim JM, Kim JS, Jung HC, Song IS, Kim CY. Virulence factors of Helicobacter pylori in Korean isolates do not influence proinflammatory cytokine gene expression and apoptosis in human gastric epithelial cells, nor do these factors influence the clinical outcome. J Gastroenterol. 2000;35(12):898–906. doi: 10.1007/s005350070003.CrossRefPubMedGoogle Scholar