Performance of multiplex serology in discriminating active vs past Helicobacter pylori infection in a primarily African American population in the southeastern United States
Performance of multiplex serology in discriminating active vs past Helicobacter pylori infection in a primarily African American population in the southeastern United States
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DOI：
10.1111/hel.12671
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发表时间：
2020-02-01
期刊：
影响因子：
4.4
通讯作者：
Epplein, Meira
中科院分区：
文献类型：
--
作者：
Butt, Julia;Blot, William J.;Epplein, Meira
目的为了在大规模队列研究中分析幽门螺杆菌与疾病的相关性，需要对现有生物样本中幽门螺杆菌的感染率进行评估。然而，传统上，血清学无法区分活动感染和既往感染。我们试图确定血清阳性对幽门螺杆菌蛋白的敏感性，以检测活动性感染。方法对接受尿素呼气试验(UBT)的患者同时采集训练组(n=78)和验证组(n=49)的血清标本，采用多重血清学方法检测其对幽门螺杆菌13种蛋白的抗体反应。为了确定对幽门螺杆菌蛋白的血清阳性对活动性感染的敏感性，应用截断值达到90%的特异性。在基线后6个月，对一组参与者(n=16)进行了抗体水平的重新检测。结果幽门螺杆菌VacA、GroEL、HCPC、HP1564四种蛋白的血清阳性率为100%~75%，特异度为91%。联合检测这些蛋白的阳性(4例中2例阳性)，特异度为90%，敏感度为100%。验证集复制了训练集的结果。在基线后成功根除幽门螺杆菌的参与者中，6个月后评估时，VacA、HCPC和HP1564的抗体水平显著下降。结论利用与UBT比较所建立的血清阳性界值，对Hp蛋白VacA、GroEL、Hpc和HP1564中>；=2的血清阳性判定具有很高的特异度和敏感度，可能与大队列中Hp活动性感染的患病率相近。
Purpose To feasibly analyze associations of Helicobacter pylori (H. pylori) with disease in large cohort studies, assays are needed to assess H. pylori prevalence in existing biospecimens. However, serology has traditionally been unable to distinguish active from past infection. We sought to determine the sensitivity of seropositivity to H. pylori proteins to detect active infection. Methods We measured antibody responses to 13 H. pylori proteins using multiplex serology in serum samples of a training (n = 78) and validation set (n = 49) collected concurrently from patients undergoing urea breath test (UBT). To determine sensitivity of seropositivity to H. pylori proteins for active infection, a cutoff was applied to achieve 90% specificity. Antibody levels were retested in a subset of participants (n = 16) 6 months after baseline. Results With a specificity of 91%, seropositivity to H. pylori proteins VacA, GroEl, HcpC, and HP1564 ascertained active infection from 100% to 75% sensitivity. Positivity to a combination of these proteins (>= 2 out of the 4) resulted in specificity of 90% and sensitivity of 100%. The validation set replicated results from the training set. Among those participants with successful H. pylori eradication after baseline, antibody levels decreased significantly for VacA, HcpC, and HP1564 when assessed 6 months later. Conclusion Utilizing the cutoffs for seropositivity established through comparison with UBT, seropositivity to >= 2 of the H. pylori proteins VacA, GroEl, HcpC, and HP1564 determines active H. pylori infection at high specificity and sensitivity and may approximate the prevalence of active H. pylori infection in large cohorts.