Antibody reactivity against Helicobacter pylori proteins in a sample of the Spanish adult population in 2008‐2013

Nerea Fernández‐de‐Larrea, Angelika Michel, Beatriz Romero, Julia Butt, Michael Pawlita, Beatriz Pérez‐Gómez, Gemma Castaño‐Vinyals, Victor Moreno, Vicente Martín, Pilar Amiano, Jesús Castilla, Guillermo Fernández‐Tardón, Trinidad Dierssen‐Sotos, Juan Clofent, Juan Alguacil, José María Huerta, José Juan Jiménez‐Moleón, Aurelio Barricarte, Amaia Molinuevo, Tania Fernández‐Villa, Delphine Casabonne, Ángeles Sierra, Manolis Kogevinas, Silvia de Sanjosé, Marina Pollán, Rosa del Campo, Tim Waterboer, Nuria Aragonés

Differences in Helicobacter pylori protein expression have been related to the risk of severe gastric diseases. In Spain, a marked geographic pattern in gastric cancer mortality has long been reported. To characterize antibody reactivity patterns against 16 H. pylori proteins, by age, sex, and region of birth, in a large sample of the Spanish adult population. Antibody reactivity was quantified by H. pylori multiplex serology in a sample from the control group of the multicase-control study MCC-Spain. For this analysis, 2555 population-based controls were included. Each participant was classified as seropositive or seronegative for each protein according to specific cutoffs. Overall H. pylori seroprevalence was defined as positivity against ≥4 proteins. Descriptive analyses by age, sex, and region of birth were performed for both seroprevalence and seroreactivity (continuous measure). Differences among groups were tested by logistic and linear regression models. Overall H. pylori seroprevalence increased with age in both sexes. For ages 55-74, seroprevalence was lower in women than in men (84% vs 92%, P<.001). Region of birth explained 7% of the variability in seroprevalence. Among H. pylori seropositive subjects, proteins with the highest seroprevalence were GroEL, NapA, HP231, and Omp. Seropositivity for most of the proteins increased or remained stable with age, rising mainly for CagA, GroEL, and HyuA in women. A clear cohort effect was not observed. This is the first study to describe the antibody patterns against 16 H. pylori proteins in the Spanish population. We found variability in the H. pylori antibody profiles according to both individual factors such as age and sex, and environmental factors such as the region of birth. The slightness of the reduction in seropositivity with decreasing age highlights the ongoing importance of this infection.