Helicobacter pylori antibody responses and evolution of precancerous gastric lesions in a Chinese population.

Helicobacter pylori-specific proteins are involved in gastric carcinogenesis. To investigate the seroprevalence of six H. pylori-specific antibodies in patients with different gastric histology, and the impact of seropositivities on the evolution of precancerous gastric lesions, a follow-up study was conducted in Linqu County, China. The seropositivities for CagA, VacA, GroEL, UreA, HcpC and gGT were assessed by recomLine analysis in 573 H. pylori-positive subjects and correlated with evolution of precancerous gastric lesions. We found that the score of H. pylori recomLine test was significantly increased in subjects with chronic atrophic gastritis (CAG, p < 0.0001) or intestinal metaplasia (IM, p = 0.0125), and CagA was an independent predictor of advanced gastric lesions, adjusted odds ratios (ORs) were 2.54 (95% CI = 1.42-4.55) for IM and 2.38 (95% CI = 1.05-5.37) for dysplasia (DYS). Moreover, seropositivities for CagA and GroEL were identified as independent predictors for progression of gastric lesions in a longitudinal study, and ORs were 2.89 (95% CI = 1.27-6.59) and 2.20 (95% CI = 1.33-3.64), respectively. Furthermore, the risk of progression was more pronounced in subjects with more than three positive antigens (p(for) trend = 0.0003). This population-based study revealed that seropositivities for CagA and GroEL might be potential markers to identify patients infected with high-risk H. pylori strains, which are related to the development of GC in a Chinese high-risk population, and recomLine test might serve as a tool for risk stratification.

Complementation of a Borrelia afzelii OspC mutant highlights the crucial role of OspC for dissemination of Borrelia afzelii in Ixodes ricinus.

Alteration of the outer surface protein (Osp) composition--especially that of OspA and OspC--seems to be important for the adaptation of Borrelia burgdorferi sensu lato to its endothermic hosts (mammals) and poikilothermic vectors (ticks). OspA possibly mediates adherence to tick midgut cells thus enabling the borreliae to survive in the vector, while OspC is associated with borrelial invasion of the tick salivary glands and infection of the mammalian hosts. Here we describe the first successful transformation and complementation of a Borrelia afzelii ospC mutant with the wild-type ospC in trans. To test the influence of OspC on the dissemination behavior in ticks, unfed Ixodes ricinus nymphs were artificially infected by capillary feeding either with B. afzelii wild type, the B. afzelii ospC mutant or the ospC-complemented clone. Tick midguts and salivary glands were investigated after different time intervals for the presence of borreliae and for OspA and OspC by immunfluorescence staining with monoclonal antibodies. While the B. afzelii wild-type strain exhibiting abundant OspC on its surface disseminated to the salivary glands, the OspC-negative mutant was only present in the tick midguts. The ospC-complemented clone which constitutively expresses the wild-type ospC was again able to colonize the salivary glands. This finding demonstrates that OspC is crucial for dissemination of B. afzelii from the tick midgut to the salivary glands, a prerequisite for infection of the warm-blooded host. A summary of the detailed data presented here has already been given in Goettner et al. [2006. OspC of B. afzelii is crucial for dissemination in the vector as shown by transformation and complementation of a European OspC-deficient B. afzelii strain. Int. J. Med. Microbiol. 296S1(Suppl. 40), 122-124].

Molecular analysis of decorin-binding protein A (DbpA) reveals five major groups among European Borrelia burgdorferi sensu lato strains with impact for the development of serological assays and indicates lateral gene transfer of the dbpA gene.

The Borrelia (B.) burgdorferi adhesin DbpA (decorin-binding protein A) is a valuable antigen for serodiagnosis of Lyme borreliosis and a promising candidate for a vaccine. To investigate the heterogeneity of DbpA, we aligned DNA sequences of 83 different dbpA genes (37 from the database, where the majority of sequences belong to B. burgdorferi sensu stricto and 46 were newly sequenced). Analysis of 25 sequences from the species B. burgdorferi s.s., 16 from B. afzelii, 40 from B. garinii, and two from the recently described human pathogenic genospecies A14S revealed five distinct DbpA groups. Group I comprises B. burgdorferi s.s. and group II B. afzelii. B. garinii is divided into groups III and IV, whereas A14S strains form group V. Formation of groups is mainly due to insertions of whole sequence sections. Comparison of dbpA sequences with ospC sequences from a subset of 59 strains revealed all kinds of cross-connections indicating processes of lateral gene transfer among strains. The extent of sequence identity within the dbpA genes decreases from the DNA (67%) to the amino acid (AA) level (44%) by about 23%, in contrast ospC sequence identities differed only by about 10%. This might be an indication that DbpA plays an important role in immune escape. Immunoblots using four recombinant DbpAs representing groups I-IV show that DbpA proteins are sensitive and specific antigens and complement one another in their reactivity. Part of the sera showed group-specific reactivity which could also be demonstrated with monoclonal antibodies.

Improvement of Lyme borreliosis serodiagnosis by a newly developed recombinant immunoglobulin G (IgG) and IgM line immunoblot assay and addition of VlsE and DbpA homologues.

We developed and evaluated a recombinant Borrelia line immunoblot assay based on 18 homologues of seven different antigens, i.e., p100, p58, p41i, BmpA, VlsE, OspC, and DbpA. Each recombinant antigen can be detected separately and is distinct even from homologues with identical molecular weights. This blot was compared to the recently described recombinant Borrelia Western immunoblot assay (U. Schulte-Spechtel, G. Lehnert, G. Liegl, V. Fingerle, C. Heimerl, B. J. Johnson, and B. Wilske, J. Clin. Microbiol. 41:1299-1303, 2003). To verify sensitivity and specificity, both blots were evaluated for reactivity with Borrelia-specific immunoglobulin G (IgG) and IgM antibodies with 85 sera from patients with different manifestations of Lyme borreliosis and 110 controls. According to European interpretation criteria for Borrelia Western blots, which define a serum as positive when it recognizes at least two bands, sensitivity increased significantly from 70.6% (Western blot) to 84.7% (line blot) for IgG (P = 0.042) and from 40.0% (Western blot) to 73.8% (line blot) for IgM (P < 0.005). The increased sensitivity for IgG detection is due to the new line blot technique, whereas the improvement in detection of IgM is mainly achieved through incorporation of the additional antigens. Notably, the recombinant VlsE of Borrelia garinii strain PBi displayed the highest sensitivity of all antigens tested for IgG detection and is also one of the most useful antigens for IgM. Due to its excellent sensitivity and specificity combined with ease of evaluation, this line immunoblot assay offers a useful improvement in serodiagnosis of Lyme borreliosis.