Serologic detection of infection with cagA+ Helicobacter pylori strains

T. L. Cover, Y. Glupczynski, A. P. Lage, A. Burette, M. K.R. Tummuru, G. I. Perez-Perez, M. J. Blaser

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286 Scopus citations


Approximately 60% of Helicobacter pylori isolate s possess the cagA gene and express its 120- to 14 0-kDa product (CagA). In this study, the cagA gene was detected in H. pylori isolates from 26 (81.3%) of 32 patients with duodenal ulcers (DU), 17 (68 .0%) of 25 patients with gastric ulcers, and 23 (5 9.0%) of 39 patients with nonulcer dyspepsia (NUD). By Western blotting (immunoblotting) with antiserum to CagA, in vitro CagA expression was demonstrated for 95.5% of cagA+ strains compared with 0% of strains lacking cagA. Sera from patients infected with cagA+ strains (n = 66) reacted with recombinant CagA in an enzyme-linked immunosorbent assay to a significantly greater extent than either sera from patients infected with strains lacking cagA (n = 30) or sera from uninfected persons (n = 25) (P < 0.001). A strain lacking cagA was isolated from eight patients who had serum immunoglobulin G antibodies to CagA, which suggests that these patients were infected with multiple strains. Serum immunoglobulin G antibodies to CagA were present in 87.5, 76.0, and 56.4% of patients with DU, gastric ulcers, and NUD, respectively (odds ratio, 5.41; 95% confidence interval, 1.44 to 24.72; P = 0.004 [DU versus NUD]). These data demonstrate an association between infection with cagA+ H. pylori and the presence of duodenal ulceration and indicate that serologic testing is a sensitive method for detecting infection with cagA+ strains.

Original languageEnglish (US)
Pages (from-to)1496-1500
Number of pages5
JournalJournal of clinical microbiology
Issue number6
StatePublished - 1995
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)


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