Cross-sectional study: CagA–positive Helicobacter pylori infection, acute coronary artery disease and systemic levels of B-type natriuretic peptide. Issue 3 (13th December 2013)

• Record Type: Journal Article
• Authors: Figura, Natale; Palazzuoli, Alberto; Vaira, Dino; Campagna, Mariastella; Moretti, Elena; Iacoponi, Francesca; Giordano, Nicola; Clemente, Salvatore; Nuti, Ranuccio; Ponzetto, Antonio
• Is Part Of: Journal of clinical pathology. Volume 67:Issue 3(2014)
• Page Start: 251
• Page End: 257
• Publication Date: 2013-12-13
• Subjects: HEART -- HELICOBACTER PYLORI -- atherosclerosis -- CYTOKINES; Pathology -- Periodicals; Pathology, Molecular -- Periodicals; 616.0705
• DOI: 10.1136/jclinpath-2013-201743
• Languages: English
• ISSNs: 0021-9746

Abstract

Abstract : Background: B-type natriuretic peptide (BNP) determination is routinely used to evaluate the severity of congestive heart failure, a possible consequence of coronary artery disease (CAD). CAD originates from vascular atherosclerotic processes and is stimulated by inflammatory events, which may also be triggered by chronic bacterial infections. Aim: To explore the effect of Helicobacter pylori infection upon systemic BNP, tumour necrosis factor-α (TNF-α) and interleukin-6 (IL-6) levels and linear homology between cardiac peptides and H pylori . Methods: A group of 103 consecutive patients with a diagnosis of non-ST elevation acute CAD (ACAD) and no other concomitant pathology was examined. BNP was measured by a commercial solid-phase sandwich immunoradiometric assay. H pylori infection, CagA serological status and circulating levels of IL-6 and TNF-α, were determined by ELISA assays. Amino acid sequence homology between human cardiac and H pylori peptides was investigated by Basic Local Alignment Search Tool (BLAST) analysis. Results: Circulating levels of BNP and IL-6, in pg/mL (interquartile difference), among infected patients with anti-CagA serum antibodies, respectively 781 (1899) and 37.7 (137.6), were significantly increased in respect to those measured in uninfected patients, respectively 325 (655) and 7.7 (23.5), (p<0.01 and p=0.025), and, with regard to BNP alone, also in patients infected by CagA negative H pylori strains, 305 (593), (p<0.01). TNF-α levels were raised in CagA positive in respect to uninfected patients. Tropomyosin and Ca2+ transporting ATPases showed strong similarities to H pylori proteins, suggesting the existence of molecular mimicry phenomena. Conclusions: Chronic infection by H pylori expressing CagA correlates with high circulating levels of BNP and IL-6 in patients with ACAD.