Relation between ABO blood groups and Helicobacter pylori infection in symptomatic patients

Clinical and Experimental Gastroenterology Dovepress open access to scientific and medical research O r i g i n al Re s ea r c h Clinical and Experimental Gastroenterology downloaded from https://www.dovepress.com/ by 37.59.46.207 on 12-Jul-2018 For personal use only. Open Access Full Text Article Relation between ABO blood groups and Helicobacter pylori infection in symptomatic patients This article was published in the following Dove Press journal: Clinical and Experimental Gastroenterology 16 September 2011 Number of times this article has been viewed Mohamad Salih Jaff Pathology Department, College of Medicine, Hawler Medical University (formerly Salahuddin University), Erbil, Kurdistan Region, Iraq Introduction Correspondence: Mohamad Salih Jaff 25 Engineering College Staff House, Kirkuk Street, Erbil, Kurdistan Region, Iraq Mobile +964 750 477 7683 Email submit your manuscript | www.dovepress.com Dovepress http://dx.doi.org/10.2147/CEG.S23019 Powered by TCPDF (www.tcpdf.org) Abstract: Epidemiological studies have demonstrated higher frequencies of the O blood group and the nonsecretor phenotype of ABH antigens among patients suffering from peptic ulcers. Since Helicobacter pylori has been established as the main etiological factor in this disease, controversies about the associations of the ABO and Lewis blood group phenotypes and secretor and nonsecretor phenotypes in relation to susceptibility towards infection by this bacillus have been presented. The aim of this study was to verify the frequencies of ABO and Rhesus (Rh) blood groups in H. pylori seropositive symptomatic patients. The study included (n = 1108) patients with dyspepsia symptoms referred from an outpatient clinic in Erbil city for investigation. Age, sex, and residency were recorded as a routine laboratory framework. Patients underwent SD Bioline (Standard Diagnostics Inc, Kyonggi-do, South Korea) and enzyme-linked immunosorbent assay serologic tests for H. pylori. ABO blood group phenotypes were determined by a standard hemagglutination test. Results showed that 64.8% of patients (n = 718/1108) were seropositive for H. pylori infection, and (35.2%) (n = 390/1108) were seronegative. Of the seropositive patients, 40.8% (n = 293/718) were male and 59.2% (n = 425/718) were female; while of the seronegative patients, 46.7% (n = 182/390) were male and 53.3% (n = 208/390) were female. The mean age for seropositives and seronegatives was (38.0 ± 14.6) years and (37.6 ± 15.7) years respectively. The frequency of the ABO and Rh-positive (Rh+) blood groups among seropositive patients was (A = 32.0%, B = 19.5%, AB = 6.7%, O = 41.8%, and Rh+ = 92.5%) and was (A = 32.3%, B = 28.2%, AB = 8.0%, O = 31.5%, and Rh+ = 92.5%) in seronegatives. The results of this study suggest that ABO blood groups, age, and gender influence seropositivity for H. pylori infection. Keywords: age, sex, prevalence, seropositive, H. pylori The association of ABO blood groups with some infectious and noninfectious diseases has been described.1,2 Before Helicobacter pylori identification as the main etiology of peptic ulcers, chronic gastritis, and a variety of gastrointestinal symptoms,3–5 many epidemiologic studies had found that nonsecretors of ABO blood group antigens and individuals of blood group O were overrepresented among patients with peptic ulcers.6–8 These studies encouraged many researchers to investigate the relation between ABO blood groups and their secretor status with peptic ulcer. Many authors report an association between blood group O and H. pylori infection,9–13 while others failed to find such an association.14–16 Many methods are used in clinical practice to diagnose H. pylori infection, including measurement of serum immunoglobulin G (IgG) antibodies by enzyme-linked Clinical and Experimental Gastroenterology 2011:4 221–226 © 2011 Jaff, publisher and licensee Dove Medical Press Ltd. This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited. 221 Dovepress i mmunosorbent assay (ELISA)17 and Helisal rapid blood (HRB) test, which is a reliable, rapid, and inexpensive screening test of H. pylori used in epidemiological studies with greatest usefulness as a primary office diagnostic device.18 There were no local data on the epidemiology of H. pylori infection in the Kurdistan region of Iraq; therefore, the aim of this study was to verify the incidence of seropositive H. pylori infection among patients with dyspepsia symptoms and to verify the frequencies of ABO blood groups in H. pylori seropositive symptomatic patients. Subjects and methods Subjects From February 2010 to March 2011, a total of 1108 patients with the symptoms of dyspepsia or other symptoms referable to the proximal alimentary tract, from an enterology outpatient clinic, were referred for serologic diagnosis of H. pylori infection. The study was performed according to the local Ethical Committee of Medical Sciences. From each patient, a sample of 3 mL of peripheral blood was collected and centrifuged, and the sera were separated for use. Methods This study was a prospective study of patients attending the outpatient clinic for symptoms of dyspepsia for the first time, with no previous history of H. pylori infection and treatment. The study population was screened for H. pylori infection by SD Bioline H. pylori, a rapid HRB kit (MT Promedt Consulting GmbH, Ingbert, Germany) to receive treatment. For this research purpose, the positive SD Bioline H. pylori screening test results were confirmed, by estimating the serum levels of anti-H. pylori IgG, using the commercial ELISA (Trinity Biotech, Wicklow, Ireland).17 The results by this method were obtained as immune status ratio (ISR), and values of $1.1 were considered positive. Those patients who were positive for H. pylori infection by both methods were included in the seropositives, those who were negative by both methods were regarded as seronegative, and the rest (n = 38) were not included within the total study population (n = 1108). ABO and Rhesus (Rh) blood groups were determined for seropositive and seronegative patients, using standardized hemagglutination methods. The results of this study (seropositives) were compared with the seronegative patient group and with the author’s previous study on the ABO blood group frequency in the region,19 as controls for both age and sex, and blood groups. 222 Powered by TCPDF (www.tcpdf.org) submit your manuscript | www.dovepress.com Dovepress Statistical analysis Data generated from this study were analyzed using Statistical Package for Social Sciences (SPSS) (Chicago, IL). Chi square test was used to detect statistically significant differences among variables. P-values 0.05 were considered significant. Results The seropositivity for H. pylori infection was present in 718/1108 (64.8%) and absent in 390/1108 (35.2%) of these patients (by both methods). Only in 38 patient (...truncated)