Relationship between the presence of antibodies to the CagA virulence factor of H.pylori and the stage of chronic gastritis according to the OLGA system in H.pylori-infected patients in Moscow population

Abstract

Background: H.pylori infection causes chronic gastritis in all patients. However, the development of atrophic gastritis is associated both with the duration of the disease and, possibly, with the presence of virulence factors of H.pylori. CagA is one of the most significant virulence factors of H.pylori.
Aim: To determine the influence of presence antibodies to CagA virulence factor in H.pylori-infected patients on the development of atrophic gastritis.
Methods: 377 patients (174 men and 203 women) were examined in A.S. Loginov Moscow Clinical Scientific Center from June 2022 to July 2025, mean age 47,71±13,12 years (from 19 to 73 years). H.pylori-positive status of the patients was confirmed by a 13C-urease breath test (DOB value ≥ 4%). All patients underwent endoscopy with gastric biopsy and morphological examination using the OLGA system and serological study of total antibodies to CagA virulence factor of H.pylori (JSC «Vector-Best», Russia), normal level is<0.41 conventional unit. All patients were divided into 5 groups according to the gastritis stage by OLGA system (from 0 to IV stage).
Results: Antibodies to CagA antigen were detected in 211 of 377 patients (55.97%). The proportion of CagA-positive patients was higher in groups with atrophic gastritis and increased with increasing OLGA stage: 0- 44.16%; I- 52.68%; II- 71.42%; III- 56.41%; IV- 87.5% (table1), Kendall’s correlation coefficient between presence of antibodies to CagA antigen and atrophy stage is 0,176 (p<0,01). There is trend of increasing mean age in groups from 0 stage to IV stage, Kendall’s correlation coefficient between age and stage of atrophy is 0.255 (p<0.01).
Conclusion: We found positive relationship between the presence of antibodies to CagA antigen and the development of more severe atrophy by OLGA system in H.pylori gastritis patients.