Helicobacter pylori CagA antigen detection of gastric infected patients and its association to severity of disease in Iraq


Kawkab A. Al Saadi1 , Ali H. Shelab 2 and Mohammed B. Shahid AlKateb 3
1,3 Department of Biology, College of Science, University of Kerbala, Kerbala, Iraq.
2 Gastroenterology and Hepatology Center, Merjan Hospital, Babylon, Iraq.


Objective: Helicobacter pylori (H.pylori) is associated with various upper gastrointestinal tract disorders. Many studies have measured anti-cytotoxin-associated gene A (CagA) antibody concentration as signs of CagA antigen presence, but our study aimed to find an association between the CagA antigen and the severity of H. pylori gastric infections in Iraqi patients by measuring the CagA antigen itself instead of anti-CagA antibody.

Methods: Ninety three samples were selected of the mentioned number included antral biopsies and blood from patient with age range of 11 to 85 years. Rapid urease test (RUT) and) gene polymerase chain reaction (PCR) of phosphoglucosamine mutase (glmM) used for H. pylori detection. cagA gene detection have been used to detecting whether there were association between symptoms and cagA gene presence. Serum CagA antigen level have been measured by ELISA technique.

Results: Serum CagA antigen detection indicated a significant difference between asymptomatic and symptomatic groups (p≤0.000). There were strong association between CagA antigen concentration and severity of disease. The significant difference between gastric ulcer and duodenal ulcer, gastric ulcer and gastritis and duodenal ulcer and gastritis was (p≤0.006), (p≤0.000) and (p≤0.01), respectively. Although there was no significant difference between males and females of asymptomatic group, in symptomatic patients the mean concentration was significantly higher (p≤0.002) in females than in male. Conclusion: This study show strong association between presence of cagA gene and its product and peptic symptoms of Iraqi patients.