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Vacuolating cytotoxin-A (VacA) and cytotoxin-associated gene A protein (CagA) play a role in the pathogenesis of<jats:italic>H. pylori<\/jats:italic>-related gastric diseases. Also, extragastric disorders are frequent morbid complications in patients with<jats:italic>H. pylori<\/jats:italic>infection. However, the direct pathologic implication of these virulence factors in extragastric manifestations remains unclear. Our hypothesis in the present study is that VacA and CagA released by<jats:italic>H. pylori<\/jats:italic>in the gastric mucosa leak into the systemic circulation, and therefore they can be measured in serum.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty-two subjects were enrolled. They were allocated into<jats:italic>the H. pylori-positive and H. pylori-negative groups<\/jats:italic>. VacA and CagA were measured by immunoassays. The serum levels of VacA and CagA above an upper limit cut-off (mean plus two standard deviations of the mean in patients without<jats:italic>H. pylori<\/jats:italic>infection) were considered positive for antigen circulating level. Five out of 25<jats:italic>H. pylori<\/jats:italic>-positive patients were positive for both serum VacA and serum CagA. The serum levels of VacA and CagA were significantly correlated with the serum levels of anti-<jats:italic>H. pylori<\/jats:italic>antibody and interleukin-12p70 among all<jats:italic>H. pylori-positive and H. pylori<\/jats:italic>-negative patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study suggests that spill-over of VacA and CagA antigens in the systemic circulation may occur in some patients with<jats:italic>H. pylori<\/jats:italic>infection.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s13099-022-00519-8","type":"journal-article","created":{"date-parts":[[2022,12,3]],"date-time":"2022-12-03T15:37:04Z","timestamp":1670081824000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Helicobacter pylori infection: is there circulating vacuolating cytotoxin A or cytotoxin-associated gene A protein?"],"prefix":"10.1186","volume":"14","author":[{"given":"Ichiro","family":"Imoto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoko","family":"Oka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaki","family":"Katsurahara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Misaki","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taro","family":"Yasuma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junko","family":"Akada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corina N.","family":"D\u2019Alessandro-Gabazza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaaki","family":"Toda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriyuki","family":"Horiki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esteban C.","family":"Gabazza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshio","family":"Yamaoka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,12,3]]},"reference":[{"issue":"1","key":"519_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s00535-013-0897-8","volume":"49","author":"M Asaka","year":"2014","unstructured":"Asaka M, Kato M, Sakamoto N. 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