We have examined the antibody response to Helicobacter pylori lipopolysaccharide (LPS) during natural infection in humans. The sera of over 70% of H. pylori-infected individuals were found to contain immunoglobulin G antibodies against the LPS fractions isolated from smooth strains of H. pylori but not against those derived from rough strains, as determined by enzyme-linked immunosorbent assay. These results taken together with the immunoblot data indicated that the polysaccharide region of H. pylori LPS is antigenic in humans. However, the antigenicity of the polysaccharide varied, depending on the strain. We found that smooth H. pylori strains isolated from the tumors of patients with gastric cancer showed significantly lower antigenicity than smooth strains derived from patients with chronic gastritis and gastric and duodenal ulcers. The results suggest that the levels of antigenicity of the polysaccharide region of H. pylori LPS in humans correlate with the nature of the gastroduodenal diseases and that they allow a particular distinction to be made between gastric cancer and other gastroduodenal diseases, especially chronic gastritis
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