Association of Inflammation and Cytotoxin-Associated Gene A Positive Strains of Helicobacter Pylori in Cardiac Syndrome X

cardiac syndrome X (CSX) is a condition in which patients
have the pain of angina despite normal coronary angiogram. Helicobacter
pylori (H. pylori) infection causes chronic inflammation which may play a
pathogenic role in CSX. We surveyed the association of inflammation with
H. pylori and its virulent strain (cytotoxin-associated gene A positive; CagA+)
infections with CSX.
Material and Methods: Sixty patients with CSX (38 women⁄ 22 men; mean
age: 51.8 ± 12.3) and 60 age- and gender-matched healthy controls (39
women⁄ 21 men; mean age: 48.9 ± 6.3) were enrolled.
Plasma samples were tested for the presence of IgG antibody to H. pylori
using enzyme linked immunosorbent assay (ELISA) method. IgG- positive
patients were determined by the presence of IgG antibody to CagA, also by
ELISA method. Also, plasma levels of interleukin-6 (IL-6) and tumor necrosis
factor-alpha (TNF-a) were measured by ELISA method.
Results: Patients with CSX were detected to have significantly higher
plasma IL-6 and TNF-a level in comparison with normal controls (33.6 ± 3.5
vs 3.2 ± 0.4 and 24.2 ± 2.3 vs 3.1 ± 0.4, respectively; p < 0.01). The plasma
levels of these inflammatory factors in CgA+ were significantly higher than
those in CagA) (CSX: IL-6: 43.05 ± 5.04 vs 23.97 ± 4.58 and TNF-a:
31.43 ± 3.13 vs 16.47 ± 2.93, Controls: IL-6: 3.52 ± 1.39 vs 2.90 ± 0.67 and
TNF-a: 5.39 ± 1.17 vs 2.22 ± 0.43, respectively; p < 0.05).
Conclusion: The CagA+ strain of H. pylori, can not only be a trigger, and
may also have a role via chronic inflammation in the pathogenesis of CSX.c