Systemic and local immune responses against Helicobacter pylori urease in patients with chronic gastritis:: distinct IgA and IgG productive sites

Background-Helicobacter pylori urease is a major target for immune responses among various bacterial components in H pylori infected patients. Aims-To analyse the relation between systemic and local humoral immune responses to H pylori urease and grades of chronic gastritis. Patients-Seventy five patients with chronic gastritis associated with H pylori infection were classified into three groups (grade I, superficial gastritis; II, atrophic gastritis, quiescent; or III, atrophic gastritis, active). Methods-Anti-H pylori urease specific antibodies in the serum, gastric juice, and biopsy specimens were determined by ELISA or western blotting analysis. The sites for H pylori urease and its specific antibody producing B lymphocytes were confirmed by immunohistochemical analysis. Results-In the sera of patients with grade I gastritis, weak IgG but relatively strong IgA responses to H pylori urease were observed; dominant strong IgG responses were detected in grade II gastritis. In grade III gastritis, significant IgG and IgA responses were obtained. A similar pattern of IgA and IgG responses was detected in gastric juice and tissue, H pylori urease specific, antibody producing B cells were not found in the gastric mucosa of patients with grade I gastritis despite the presence of such B cells in the duodenal bulb. Specific B cells were observed in the gastric mucose of patients with grade II and III gastritis with atrophy. Conclusions-Purified H pylori urease, together with localisation of its specific antibody producing B cells, are useful for serological testing and histopathological analysis for determining the stage of chronic gastritis and studying the pathogenesis of H pylori infection.