表达细胞毒素相关基因A（CagA）的幽门螺杆菌菌株感染在自身免疫性甲状腺疾病女性中非常普遍。

The infection by Helicobacter pylori strains expressing CagA is highly prevalent in women with autoimmune thyroid disorders.

作者信息

Figura N, Di Cairano G, Lorè F, Guarino E, Gragnoli A, Cataldo D, Giannace R, Vaira D, Bianciardi L, Kristodhullu S, Lenzi C, Torricelli V, Orlandini G, Gennari C

机构信息

Institute of Internal Medicine, University of Siena, Policlinico le Scotte, Italy.

出版信息

J Physiol Pharmacol. 1999 Dec;50(5):817-26.

PMID:10695561

Abstract

UNLABELLED

H. pylori infection is putatively associated with extra-digestive disorders and may also play a role in the development of autoimmune thyroid diseases (ATD). It was recently found that monoclonal antibodies to an H. pylori strain with cagA-positivity reacted with follicular cells of the thyroid gland, and that an H. pylori organism possessing the cag pathogenicity island carried a gene encoding for an endogenous peroxidase. The aims of this study was (1); To ascertain whether the infection by strains endowed with an increased inflammatory potential (those expressing CagA) could further enhance the risk of developing ATD (2); To verify the possible existence of an immune cross-reactivity between autoantibodies to peroxidase and thyroglobulin and H. pylori antigens (3). To establish whether thyroid colloid antigens could cross-react with an anti-H. pylori serum. The study was partly designed retrospectively. We examined 41 consecutive women with ATD, and, as a control, 33 consecutive age- and socio-economic class-matched women without autoimmune thyroid disorders, living in the same area as patients, occurred at the same institution in the same period (six months). Both patients and controls were examined serologically for H. pylori infection and CagA status by Western blotting. Some serum samples were absorbed with H. pylori to determine whether the antibody levels decreased. Colloid proteins were resolved electrophoretically and matched with a hyperimmune serum raised in rabbits against a CagA-positive H. pylori. Thirty-two patients (78.0%) tested seropositive for H. pylori infection, vs. 16 controls (48.4%) (P = 0.008, OR = 3.78, RR = 1.61). The prevalence of anti-CagA antibodies was 71.8% in infected patients, and 50% in infected controls (P = 0.161, n.s.). The overall prevalence of infection by CagA-positive H. pylori was significantly higher in patients with ATD (23/41, or 56.0%) than that in controls (8/33, or 24.2%) (P = 0.006, OR = 3.99, RR = 2.31). The other tests gave negative or inexplicable results.

IN CONCLUSION

CagA-positive H. pylori infection increases the risk of ATD development.

摘要

未标记

幽门螺杆菌感染被推测与消化系统外疾病有关，也可能在自身免疫性甲状腺疾病（ATD）的发展中起作用。最近发现，针对具有cagA阳性的幽门螺杆菌菌株的单克隆抗体与甲状腺滤泡细胞发生反应，并且携带cag致病岛的幽门螺杆菌生物体携带一种编码内源性过氧化物酶的基因。本研究的目的是：（1）确定具有更高炎症潜能的菌株（那些表达CagA的菌株）感染是否会进一步增加患ATD的风险；（2）验证抗过氧化物酶和甲状腺球蛋白自身抗体与幽门螺杆菌抗原之间是否可能存在免疫交叉反应；（3）确定甲状腺胶体抗原是否能与抗幽门螺杆菌血清发生交叉反应。该研究部分采用回顾性设计。我们检查了41例连续的ATD女性患者，并作为对照，检查了33例年龄和社会经济阶层匹配、无自身免疫性甲状腺疾病、与患者居住在同一地区、同期（六个月）在同一机构就诊的女性。通过蛋白质印迹法对患者和对照进行血清学检查，以检测幽门螺杆菌感染和CagA状态。一些血清样本用幽门螺杆菌进行吸收，以确定抗体水平是否降低。胶体蛋白通过电泳分离，并与兔抗CagA阳性幽门螺杆菌产生的超免疫血清进行匹配。32例患者（78.0%）幽门螺杆菌感染血清学检测呈阳性，而对照组为16例（48.4%）（P = 0.008，OR = 3.78，RR = 1.61）。抗CagA抗体在感染患者中的患病率为71.8%，在感染对照组中为50%（P = 0.161，无统计学意义）。ATD患者中CagA阳性幽门螺杆菌感染的总体患病率（23/41，即56.0%）显著高于对照组（8/33，即24.2%）（P = 0.006，OR = 3.99，RR = 2.31）。其他检测结果为阴性或无法解释。