Diagnostic value of an immunoassay to detect anti Campylobacter pylori antibodies in non-ulcer dyspepsia

An enzyme-linked immunosorbent assay (ELISA) for detection of IgG antibodies against Campylobacter pylori was used to examine sera from 70 patients with non-ulcer dyspepsia. 48 patients had C pylori associated gastritis according to culture or histology; mean optical density (OD) of the ELISA was significantly higher than that for the 22 patients with normal antral mucosa and absence of C pylori. Positive and negative predictive values for campylobacter-associated gastritis were 100% above OD 2.10 and below OD 1.00, respectively. Serology might replace endoscopy in the diagnosis of campylobacter-associated gastritis.

The role of serology in the diagnosis of Campylobacter pylori infection

Circulating antibodies to Campylobacter pylori in patients with campylobacter-associated gastritis are sufficiently specific to allow serodiagnosis of this condition. This is possible by various techniques, the most convenient being enzyme-linked immunosorbent assay. Applications of serodiagnosis are in two areas--in clinical practice, where proper evaluation is still required, and in epidemiology. Here serodiagnosis shows the prevalence of C. pylori in the general population and in specific population groups. A study of C. pylori and dyspeptic symptoms in a group of healthy blood donors showed a significant association between C. pylori and history of peptic ulceration. However in most donors the gastritis was clinically silent.

Local immune response to gastric Campylobacter in non-ulcer dyspepsia

Colonising Campylobacter pyloridis were identified histologically in gastric biopsy specimens from 89% of 83 patients with non-ulcer dyspepsia and chronic gastritis, but not in 58 dyspeptic patients with normal mucosa. The presence and population density of organisms was associated with the presence of intraepithelial neutrophils. In vivo coating of the organisms by host immunoglobulin was investigated by immunoperoxidase staining of IgA, IgG, and IgM in 54 biopsy specimens. IgA coated bacteria were seen in all cases of active gastritis, and in 60% of biopsy specimens without intraepithelial neutrophils. Coating with IgG or IgM, or both, was correlated with activity of gastritis and was rarely seen in the absence of a neutrophil infiltrate.

Systemic and local antibody responses to gastric Campylobacter pyloridis in non-ulcer dyspepsia

Antibody titres to Campylobacter pyloridis in serum and gastric juice were estimated by an enzyme linked immunosorbent assay (ELISA) to whole organisms obtained from bacterial culture in 39 patients with non-ulcer dyspepsia. Whereas 20 of the 21 patients with chronic gastritis had gastric C pyloridis, 17 patients with no C pyloridis had normal histology in the gastric antrum and body. Significantly raised serum IgG and IgA antibody titres to C pyloridis were found in colonised patients with gastritis. Patients with raised IgG antibody to C pyloridis were also shown to have significantly raised titres to other Campylobacter species, suggesting antigenic cross reactivity. Gastric juice antibodies were also studied and IgA titres to C pyloridis were detected in a proportion of patients with gastritis, together with low levels of IgM, but no IgG.

[Hepatic clearance of 99mTc-p-butyl HIDA in liver diseases. Correlations with routine hematochemical parameters of liver function]

The aim of the present investigation was to study the clearance of 99mTc-p-butyl IDA in some acute and chronic liver diseases, it being considered that the typical parameters obtained with this method are as indicative as any of the others put forward for the study of liver function using radioisotopes. 46 subjects were examined: 6 with acute hepatitis, 10 with chronic hepatitis, 18 with liver cirrhosis and 12 with dyspepsia but otherwise normal haematochemical tests. Two basic 99mTc-p-butyl IDA clearance parameters, Tu (semi-take up time) and Te (semi-excretion time), were determined plotting the data obtained using a Gamma-Camera on semi-logarithmic paper. Mean Tu values were as follows: 5'06'' +/- 1'24'' in dyspeptics, 12'30'' +/- 6'31'' in subjects with acute hepatitis, 6'30'' +/- 1'45'' in subjects with chronic hepatitis and 13'30'' +/- 4'30'' in subjects with cirrhosis. The values were: 34'30'' +/- 4'30'' in dyspeptics, 49'54'' +/- 2'36'' in subjects with acute hepatitis, 42'24'' +/- 12'24'' in subjects with chronic hepatitis and 65'30'' +/- 39'36'' in subjects with cirrhosis. The Tu parameter was found to be delayed more significantly in cirrhotic patients and less in subjects with acute or chronic hepatitis, compared to dyspeptics with normal haematochemical parameters. Te was significantly delayed in subjects with cirrhosis and acute hepatitis, while there was no difference for subjects with chronic hepatitis. Of the routine haematochemical tests, the albumin/gamma-globulin ratio and unconjugated bilirubin were found to correlate significantly with the Tu parameter, whereas conjugated bilirubin was found to bear a significant correlation to the Te parameter.