Utjecaj CagA antigena bakterije Helicobacter pylori u razvoju aterosklerotske karotidne bolesti [Influence of CagA-positive Helicobacter pylori strains on atherosclerotic carotid disease]

Bago Rožanković, Petra (2011) Utjecaj CagA antigena bakterije Helicobacter pylori u razvoju aterosklerotske karotidne bolesti [Influence of CagA-positive Helicobacter pylori strains on atherosclerotic carotid disease]. PhD thesis, Sveučilište u Zagrebu.

Preview

PDF Download (2MB) | Preview

Abstract

Citotoxin-associated gene-A (CagA)-positive Helicobacter pylori strains have been associated with occurrence and destabilization of coronary atherosclerotic plaques. However, data on the relationship between CagA positive H. pylori infection and carotid artery instability are lacking. Thus, the role of CagA antigen in patients with symptomatic and asymptomatic carotid atherosclerotic plaques was investigated. A total of 64 patients with advanced carotid artery stenosis, including 33 patients with symptomatic and 31 patients with asymptomatic internal carotid artery stenosis, verified by duplex ultrasound, all undergoing carotid endarterectomy, were studied. The control group consisted of 65 subjects without a history or presence of vascular diseases. Serology for H. pylori and CagA antigen was assessed in all participants. Specimens of atherosclerotic plaques obtained from all patients during carotid endarterectomy were analyzed immunohistochemically using anti-CagA monoclonal antibodies. The ultrasonographic plaque characteristics were also estimated. CagA antibody titers were significantly higher in symptomatic patients (8.8; range, 5.8–32.7) compared to asymptomatic patients (4.7; range, 2.1–8.8; P = 0.005) and the control group (5.0; range 2.2–7.9; P<0.001). There was significant difference in echolucency (≥25% soft material) between the symptomatic and asymptomatic groups (P = 0.034) by ultrasonographic evaluation. Positive immunoreactivity between monoclonal CagA antibodies and antigens within atherosclerotic specimens was significantly higher among symptomatic patients compared to asymptomatic patients (97.0 vs. 74.2%; P = 0.009). The results of this study indicate that H. pylori may play a role in the pathogenesis of the atherosclerotic process due to autoimmune mechanisms and even contribute to destabilization of carotid atherosclerotic plaques.

Abstract in Croatian

Dosadašnji rezultati upućuju na mogući utjecaj citotoksin pridružen gen-A (CagA) pozitivnih sojeva bakterije Helicobacter pylori na pojavu i destabilizaciju koronarnih aterosklerotskih plakova. Ipak, nedostaju podaci o povezanosti CagA pozitivne H. pylori infekcije i nestabilnosti plakova karotidne arterije. Stoga je istražena uloga CagA antigena u bolesnika sa simptomatskim i asimptomatskim karotidnim aterosklerotskim plakovima. U ispitivanje je uključeno ukupno 64 bolesnika s uznapredovalom stenozom karotidne arterije, uključujući 33 bolesnika sa simptomatskom i 31 bolesnik s asimptomatskom stenozom unutarnje karotidne arterije, potvrđeno ultrazvučnom metodom, liječenih karotidnom endarterektomijom. Kontrolnu grupu su činila 65 ispitanika bez anamneze ili prisutnosti vaskularnih oboljenja. Svim ispitanicima je učinjena serologija na bakteriju H. pylori i na CagA antigen bakterije. Uzorci aterosklerotskih plakova, dobiveni od svih bolesnika tijekom karotidne endarterektomije, obrađeni su imunohistokemijski uz primjenu anti-CagA monoklonskih protutijela. Također su određena i ultrazvučna obilježja plaka. Titrovi CagA protutijela značajnije su viši u simptomatskih bolesnika (8.8; raspon, 5.8–32.7) uspoređujući s asimptomatskim bolesnicima (4.7; raspon, 2.1–8.8; P = 0.005) i kontrolnom skupinom (5.0; raspon 2.2–7.9; P<0.001). Postojala je značajna razlika u eholuscenciji plaka (≥25% mekog materijala) između simptomatske i asimptomatske skupine (P = 0.034) utvrđeno ultrazvučnim pregledom. Pozitivna imunoreaktivnost između monoklonalnih CagA protutijela i antigena unutar aterosklerotskih uzoraka bila je izraženija kod simptomatskih bolesnika uspoređujući s asimptomatskim bolesnicima (97.0 vs. 74.2%; P = 0.009). Rezultati ovog istraživanja pokazuju da H. pylori može imati ulogu u patogenezi aterosklerotskog procesa preko autoimunog mehanizma te dodatno doprinijeti destabilizaciji karotidnog aterosklerotskog plaka.

Actions (login required)

View Item

Downloads