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Signifficance of anti-Helicobacter Pylori IgG and IgA measurement in patients with dyspeptic illness

Helicobacter pylori (HP) is a major cause of inflammation and peptic ulcer disease. Immune response at the mucosal level is predominantly of the IgA type. A majority of HP infected patients also respond by activating humoral immune response against the organism, and these specific anti-HP antibodies of IgG and IgA class of immunoglobulins can be measured or detected by several methods. One of diagnostic non-invasive tests is quantitative enzyme-linked immunosorbent assay. It has high specificity and sensitivity. The aim of this study was to evaluate the significance of anti-HP IgG and IgA antibody measurement in patients with dyspeptic illness by quantitative serologic method. The ELISA Pyloriset EIA-G and EIA-A (Orion Diagnostica, Finland) were used for measuring anti-HP in plasma of 88 patients with dyspeptic illness. A cut-off titer of anti-HP IgG and anti-HP IgA was 300 g/l and 250 g/l, respectively. All patients were examined endoscopically and biopsies were obtained from either ulcer edges and/or locations typical for HP growth. The data were analyzed by descriptive statistics. All study patients had IgG levels below the upper limit, and median IgG was 145.5 g/l (range 86-279 g/l). Eleven (12.5 percent) patients had specific IgA antibodies to Helicobacter pylori above the upper limit, median 130 g/l (range 86-610 g/l). Ten (11.4 percent) IgA positive patients had biopsy specimens positive for HP, suggesting different immunoreactivity in some patients who react by producing IgA antibodies rather than IgG antibodies to HP. In conclusion, testing for IgA antibody may be useful in some cases of dyspeptic illness when specific IgG antibodies are not elevated. It is not advisable to base the diagnosis and treatment solely on positive serologic tests, but they can help us in screening certain patient populations to decide on the need of endoscopy.

Helicobacter Pylori; IgG; IgA; Dyspeptic illness

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