Increased levels of Helicobacter pylori IgG antibodies in aqueous humor of patients with primary open-angle and exfoliation glaucoma

Purpose. A prospective, nonrandomized, comparative study was carried out to investigate the levels of anti-H. pylori-specific IgG antibodies in the aqueous humor and serum of patients with primary open-angle glaucoma (POAG) and patients with exfoliation glaucoma (XFG), and to compare them with those in age-matched cataract patients. Methods. Aqueous humor was aspirated at the beginning of glaucoma surgery from 26 eyes of 26 patients with POAG, 27 eyes of 27 patients with XFG, and at the beginning of phakoemulsification cataract surgery from 31 eyes of 31 age-matched normotensive cataract patients. Serum samples were obtained the day before surgery from all patients. Anti-H. pylori IgG concentration in the aqueous humor and serum was measured by means of an enzyme-linked immunosorbent assay. Results. The mean concentration (+/- SE) of anti-H. pylori-specific IgG was significantly greater in the aqueous humor samples from patients with POAG (14.27+/-3.86 U/ml) and XFG (14.25+/-3.39 U/ml) than in those from age-matched control cataract patients (4.67+/-1.07 U/ml); (P=0.006 and P=0.003, respectively). No difference was observed in the levels of H. pylori-specific IgG antibodies between POAG and XFG aqueous humor samples (P=0.5). Similarly, the serum concentration of anti-H. pylori antibodies was significantly greater in patients with POAG (69.96+/-9.69 U/ml; P=0.013) and XFG (81.37+/-10.62 U/ml; P=0.002) than in the cataract controls (44.16+/-6.48 U/ml). The mean vertical cupping correlated significantly with the titer of anti-H. pylori-specific IgG in the aqueous humor in the POAG patients. Conclusion. H. pylori-specific IgG antibody levels are significantly increased in the aqueous humor and serum of patients with POAG and XFG. Moreover, the titer of anti-H. pylori antibody in the aqueous humor might reflect the severity of glaucomatous damage in POAG patients. These findings support a role for H. pylori infection in the pathobiology of these two common glaucomas.