Characterization of a novel Helicobacter pylori East Asian-type CagA ELISA for detecting patients infected with various cagA genotypes

Dalla Doohan, Muhammad Miftahussurur, Yuichi Matsuo, Yasutoshi Kido, Junko Akada, Takeshi Matsuhisa, Than Than Yee, Kyaw Htet, Hafeza Aftab, Ratha korn Vilaichone, Varocha Mahachai, Thawee Ratanachu-ek, Lotay Tshering, Langgeng Agung Waskito, Kartika Afrida Fauzia, Tomohisa Uchida, Ari Fahrial Syam, Yudith Annisa Ayu Rezkitha, Yoshio Yamaoka

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

Currently, Western-type CagA is used in most commercial Helicobacter pylori CagA ELISA kits for CagA detection rather than East Asian-type CagA. We evaluated the ability of the East Asian-type CagA ELISA developed by our group to detect anti-CagA antibody in patients infected with different cagA genotypes of H. pylori from four different countries in South Asia and Southeast Asia. The recombinant CagA protein was expressed and later purified using GST-tag affinity chromatography. The East Asian-type CagA-immobilized ELISA was used to measure the levels of anti-CagA antibody in 750 serum samples from Bhutan, Indonesia, Myanmar, and Bangladesh. The cutoff value of the serum antibody in each country was determined via Receiver-Operating Characteristic (ROC) analysis. The cutoff values were different among the four countries studied (Bhutan, 18.16 U/mL; Indonesia, 6.01 U/mL; Myanmar, 10.57 U/mL; and Bangladesh, 6.19 U/mL). Our ELISA had better sensitivity, specificity, and accuracy of anti-CagA antibody detection in subjects predominantly infected with East Asian-type CagA H. pylori (Bhutan and Indonesia) than in those infected with Western-type CagA H. pylori predominant (Myanmar and Bangladesh). We found positive correlations between the anti-CagA antibody and antral monocyte infiltration in subjects from all four countries. There was no significant association between bacterial density and the anti-CagA antibody in the antrum or the corpus. The East Asian-type CagA ELISA had improved detection of the anti-CagA antibody in subjects infected with East Asian-type CagA H. pylori. The East Asian-type CagA ELISA should, therefore, be used in populations predominantly infected with East Asian-type CagA.

Original languageEnglish
JournalMedical Microbiology and Immunology
DOIs
Publication statusAccepted/In press - 1 Jan 2019

Keywords

  • Anti-CagA antibody
  • East Asian-type CagA
  • ELISA
  • Helicobacter pylori

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