ANTIBODY-RESPONSE TO SPECIFIC HELICOBACTER-PYLORI ANTIGENS IN FUNCTIONAL DYSPEPSIA, DUODENAL-ULCER DISEASE, AND HEALTH

Objective: The relationship between H. pylori and functional dyspepsia remains controversial. The aim of this study was to identify a potent ial link between the antibody response to specific H. pylori antigens and functional dyspepsia. Methods: A total of 50 consecutive patients with functional dyspepsia, 50 patients with duodenal ulcer (DU), and 1 50 healthy blood donor control subjects with no history of peptic ulce ration were studied. H. pylori status was determined by IgG antibodies using a validated ELISA. In H. pylori-positive subjects, antibodies a gainst specific H. pylori antigens were identified by Western blot. Re sults: All DU patients (100%; 95%; CI, 93-100), 30 of 50 patients with functional dyspepsia (60%; 95% CI, 45-74) and 65 of 150 (43.3%; 95% C I, 34.3-51) blood donor controls tested positive for H. pylori. Forty- six of 50 (92%; 95% CI, 81-98) DU patients tested positive for the 91 kDa antigen (vacA) compared with 46 of 65 (69%; 95% CI, 58-81) control subjects and 22 of 30 (73%; 95% CI, 54-88) functional dyspepsia patie nts (p < 0.01 DU versus controls). Similarly, the 120 kDa antigen (cag A) tended (p < 0.15) to be more prevalent in DU patients (82%: 95% CI, 69-91) compared with controls (69%; 95% CI, 57-80) but not functional dyspepsia (77%; 95% CI, 57-90). No specific H. pylori antigens were a ssociated with dyspepsia subgroups. Conclusion: No specific H. pylori antigens are linked to functional dyspepsia. (Am J Gastroenterol 1998; 93:1222-1227. (C) 1998 by Am. Coll. of Gastroenterology).