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Clinical and Diagnostic Laboratory Immunology, September 2003, p. 866-869, Vol. 10, No. 5
1071-412X/03/$08.00+0     DOI: 10.1128/CDLI.10.5.866-869.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

Immune Responses to Differentiated Forms of Helicobacter pylori in Children with Epigastric Pain

Department of Microbiology,¹ Department of Paediatrics, Faculty of Medicine, National University of Singapore,² The Children's Medical Institute, National University Hospital,³ Communicable Diseases Branch, Epidemiology and Disease Control Division, Ministry of Health, Singapore, Republic of Singapore⁴

Received 20 December 2002/ Returned for modification 7 May 2003/ Accepted 10 June 2003

Helicobacter pylori infection affects human populations of all ages. This gastric bacterium exists in spiral form and the reported viable but nonculturable coccoid form. The present study aims to examine the probable role of the coccoid form in H. pylori infection by comparing the seroprevalences of the spiral and the coccoid forms in children with epigastric pain. Four hundred eighty-nine children (mean age, 8.5 years) with epigastric pain formed the basis of this study. Five hundred ninety-nine schoolchildren of comparable ages and with no record of dyspepsia served as controls. The seroprevalence of antigens prepared from both morphological forms was examined by enzyme-linked immunosorbent assay. The results showed that 65 (13.3%) and 273 (55.8%) of 489 symptomatic children were seropositive for antigens of the H. pylori spiral and coccoid forms, respectively. In contrast, only 7.0% of the control group had elevated levels of immunoglobulin G antibodies against the spiral form, while 26.5% were positive for antibodies against the coccoid form. There were no significant differences between genders or among ethnic groups. The study showed a rise in seroprevalence corresponding with age: 7.1% for those 5 years to 21.4% for those 11 years. The seroprevalence of antigens of the H. pylori spiral and coccoid forms in children with epigastric pain was twofold higher than that in the control subjects. Interestingly, there was a fourfold increase in seropositivity for coccoid-form antigen compared to that for the spiral-form antigen among the symptomatic pediatric patients as well as the control group, indicating a possible infective role of the coccoid form of H. pylori in the pediatric patients with epigastric pain.