Seroreactivity to specific antigens of Helicobacter pylori infection is associated with an increased risk of the dyspeptic gastrointestinal diseases

SummaryObjectivesThe correlation between seroreactivity to Helicobacter pylori-specific antigens and clinical outcomes in gastrointestinal disease remains unresolved. We investigated the anti-H. pylori antibody profile in northeast Thai dyspeptic patients with gastrointestinal disease in order to identify any H. pylori antigens that may be associated with an increased risk of gastrointestinal disease.Patients and methodsEighty-nine H. pylori-infected dyspeptic patients (44 non-ulcer, 23 peptic ulcer, 22 gastric cancer) were included in the study. Patients were considered to have H. pylori infection when at least one invasive method (i.e., culture, rapid urease test, and histology on biopsy specimens) and serological tests including a commercial ELISA (Pyloriset EIA-GIII) and a commercial immunoblot (Helicoblot 2.1; Genelabs Diagnostics), were positive. In addition, the sera of 20 H. pylori-infected blood donors and 10 H. pylori-non-infected blood donors were also randomly collected and analyzed for H. pylori infection by ELISA and Helicoblot 2.1.ResultsImmunoreactive protein bands at 116-kDa, 89-kDa, 37-kDa, 35-kDa, 30-kDa, 19.5-kDa, and the current infection marker for H. pylori-infected patients had average frequencies of 97.8%, 77.5%, 36.0%, 25.8%, 79.8%, 58.4%, and 69.7%, respectively. The immunoreactive patterns obtained from the H. pylori-infected patients and H. pylori-infected blood donors were similar. The antibodies to VacA and CagA antigens were not significantly different among the H. pylori-infected gastroduodenal patient groups. The simultaneous presence of antibody to 19.5-kDa antigen and absence of antibody to 35-kDa antigen was associated with an increased risk of gastric cancer (p<0.05). The immunoreactive band to 35-kDa antigen was found at significantly higher levels in peptic ulcer patients, and the 37-kDa antigen was found at significantly higher levels in non-ulcer patients (both p<0.05). Significantly low levels of antibodies to 23-kDa and 85-kDa antigens were found associated with peptic ulcer (p<0.05).ConclusionsWe confirm that the universal presence of CagA and VacA in H. pylori-infected patients in Thailand is independent of the gastroduodenal disease. The presence or absence of antibodies to H. pylori-specific antigens may be useful as indirect markers in the screening of H. pylori-infected patients, and may have specific protection roles in H. pylori-related gastroduodenal diseases

Rapid Clinical Screening of Burkholderia pseudomallei Colonies by a Bacteriophage Tail Fiber-Based Latex Agglutination Assay

Melioidosis is a life-threatening disease in humans caused by the Gram-negative bacterium Burkholderia pseudomallei. As severe septicemic melioidosis can lead to death within 24 to 48 h, a rapid diagnosis of melioidosis is critical for ensuring that an optimal antibiotic course is prescribed to patients. Here, we report the development and evaluation of a bacteriophage tail fiber-based latex agglutination assay for rapid detection of B. pseudomallei infection. Burkholderia phage E094 was isolated from rice paddy fields in northeast Thailand, and the whole genome was sequenced to identify its tail fiber (94TF). The 94TF complex was structurally characterized, which involved identification of a tail assembly protein that forms an essential component of the mature fiber. Recombinant 94TF was conjugated to latex beads and developed into an agglutination-based assay (94TF-LAA). 94TF-LAA was initially tested against a large library of Burkholderia and other bacterial strains before a field evaluation was performed during routine clinical testing. The sensitivity and specificity of the 94TF-LAA were assessed alongside standard biochemical analyses on 300 patient specimens collected from an area of melioidosis endemicity over 11 months. The 94TF-LAA took less than 5 min to produce positive agglutination, demonstrating 98% (95% confidence interval [CI] of 94.2% to 99.59%) sensitivity and 83% (95% CI of 75.64% to 88.35%) specificity compared to biochemical-based detection. Overall, we show how a Burkholderia-specific phage tail fiber can be exploited for rapid detection of B. pseudomallei. The 94TF-LAA has the potential for further development as a supplementary diagnostic to assist in clinical identification of this life-threatening pathogen. IMPORTANCE Rapid diagnosis of melioidosis is essential for ensuring that optimal antibiotic courses are prescribed to patients and thus warrants the development of cost-effective and easy-to-use tests for implementation in underresourced areas such as northeastern Thailand and other tropical regions. Phage tail fibers are an interesting alternative to antibodies for use in various diagnostic assays for different pathogenic bacteria. As exposed appendages of phages, tail fibers are physically robust and easy to manufacture, with many tail fibers (such as 94TF investigated here) capable of targeting a given bacterial species with remarkable specificity. Here, we demonstrate the effectiveness of a latex agglutination assay using a Burkholderia-specific tail fiber 94TF against biochemical-based detection methods that are the standard diagnostic in many areas where melioidosis is endemic.ISSN:0099-2240ISSN:1098-533