A SENSITIVE AND SPECIFIC SEROLOGIC TEST FOR DETECTION OF CAMPYLOBACTER-PYLORI INFECTION
A SENSITIVE AND SPECIFIC SEROLOGIC TEST FOR DETECTION OF CAMPYLOBACTER-PYLORI INFECTION
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DOI：
10.1016/0016-5085(89)91616-8
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发表时间：
1989-04-01
期刊：
影响因子：
29.4
通讯作者：
KLEIN, PD
中科院分区：
文献类型：
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作者：
EVANS, DJ;EVANS, DG;KLEIN, PD
幽门弯曲杆菌与胃炎、十二指肠溃疡、胃溃疡和非溃疡性消化不良有关。证据表明，C。幽门螺杆菌可能是消化性溃疡的病原体，或者至少是消化性溃疡的一个主要促成因素，这使得人们对开发检测幽门螺杆菌的可靠方法产生了浓厚的兴趣。幽门感染我们建立了一种特异、敏感的酶联免疫吸附试验（ELISA），用于检测血清中针对C.幽门。我们以盲法检测了300名患者的血清，发现所有147名HM-CAP ELISA阴性患者的C. pylori，如尿素呼气试验阴性所证明的; 153例C. pylori阳性（通过尿素呼气试验）个体为HM-CAP ELISA阳性。从两名ELISA阴性但感染的患者中培养出幽门弯曲杆菌，这些分离株确实具有HM-CAP抗原，表明这两名患者未能发生血清转化。因此，HM-CAP ELISA的特异性和阳性预测值均为100%;测定的灵敏度为98.7%，阴性预测值为98.6%。HM-CAP ELISA和尿素呼气试验均被证明对检测C有价值。幽门螺杆菌感染，尿素呼气试验是一种更直接的方法，而ELISA更便宜，更容易执行。此外，血清学试验（如HM-CAP ELISA）的结果不会受到近期摄入铋化合物或抗菌治疗的影响，这些可能会抑制C。幽门螺杆菌，并导致短暂的假阴性结果在尿素呼气试验。
Campylobacter pylori has been associated with gastritis, duodenal ulcer, gastric ulcer, and nonulcer dyspepsia. Evidence that C. pylori may be the causative agent or at least a major contributory factor in peptic ulcer disease has generated intense interest in the development of reliable methods for detecting C. pylori infections. We have developed a specific and sensitive enzyme-linked immunosorbent assay (ELISA) that detects serum immunoglobin G antibodies directed against high molecular weight cell-associated proteins (HM-CAP) of C. pylori. In a blinded fashion we tested sera from 300 individuals and found that all of 147 HM-CAP ELISA-negative individuals were also negative for C. pylori, as documented by a negative urea breath test; also, 151 of 153 C. pylori-positive (by urea breath test) individuals were HM-CAP ELISA-positive. Campylobacter pylori was cultured from the two ELISA-negative but infected patients and these isolates did possess HM-CAP antigens, showing that these two individuals had failed to seroconvert. Thus, the specificity and positive predictive value of the HM-CAP ELISA were each 100%; the sensitivity of the assay was 98.7%, and the negative predictive value was 98.6%. The HM-CAP ELISA and the urea breath test both proved valuable for detecting C. pylori infection, the urea breath test being a more direct method whereas the ELISA is less expensive and easier to perform. Furthermore, the results of a serologic test such as the HM-CAP ELISA would not be influenced by recent ingestion of bismuth compounds or antimicrobial therapy, which might suppress C. pylori and cause a transient false-negative result in the urea breath test.