Editor,—In a recent issue ofGut, Zheng et alreported that peptic ulcer disease was associated with increased expression of Lewis (Le) antigens but notcagA, iceA, orvacA in Chinese patients infected withHelicobacter pylori((2000) Gut 47:18–22.OpenUrlAbstract/FREE Full Text). These data raise as many questions as they answer and add further controversy to an intriguing area of microbiology and gastroenterology.

Le^x and/or Le^y blood group determinants are commonly found on the lipopolysaccharide (LPS) of H pylori isolates. These determinants have been identified on approximately 80–90% of isolates from all patient series examined to date.1-3 In our own series, 74/84 (88%) isolates expressed either Le^x or Le^y, with 47/84 (56%) of isolates coexpressing both determinants.4 No difference was identified in the prevalence of Le^x or Le^yexpression on H pylori strains isolated from ulcer patients and those strains isolated from patients with chronic gastritis, nor was an association demonstrated between host and bacterial Lewis phenotype. Since the report of Zhenget al we have reviewed our raw data regarding the prevalence of strains expressing two or more Lewis antigens. We found that two or more …