Background: Cytotoxin-associated gene A (CagA)-positive strains of Helicobacter pylori are associated with gastroduodenal diseases. Evidences have suggested that the type of H. pylori CagA EPIYA motifs may be associated with recurrent dyspepsia (i.e. gastritis, peptic ulcer, or gastric cancer). We investigated the prevalence of different EPIYA motifs (A, B, C, or D) in H. pylori strains isolated from patients with recurrent dyspepsia who underwent upper gastrointestinal (GI) endoscopy. We investigated the prevalence of different EPIYA motifs (A, B, C, or D) in H. pylori strains isolated from patients with recurrent dyspepsia who underwent upper gastrointestinal (GI) endoscopy. Materials and Method: H. pylori strains were isolated from biopsy specimens of 220 patients with recurrent dyspepsia. The presence of glmM gene, as a housekeeping gene, CagA gene, and pattern of CagA EPIYA motifs were determined using polymerase chain reaction (PCR) method. The association between the type of motifs and disease state was determined by the Chi-square test, Fisher's exact test, and logistic regression. Results: CagA-positive H. pylori strains were identified in 125 (57%) of patients, including 36 (28.6%) gastritis, 31 (24.6%) duodenal ulcer, and 58 (46.4%) gastric cancer. The frequency of pattern of CagA EPIYA motifs were detected as 39 (31.2%) AB motifs, 54 (43.2%) ABC motifs, 32 (25.6%) ABCC motifs,and no D motifs. The risk of gastric cancer occurrence was estimated to be 2.57 times higher in patients infected by strains with ABCC motif when compared with gastritis and duodenal ulcer patients (p=0.03). Moreover, patients with C-containing motifs were 2.27 times more likely to be afflicted with gastric cancer than with duodenal ulcer. AB motif was more associated with gastritis and duodenal ulcer than ABC and ABCC motifs. Conclusion:The results suggested that CagA-EPIYA ABCC might be associated with gastric cancer, while EPIYA-AB might be associated with duodenal ulcer.

Th17/IL-23 axis is an important pro-inflammatory pathway in atherosclerosis. IL-23 receptor (IL-23R) pathway has an important role in T-helper cells 17 (Th17) differentiation and survival. We compared normal subjects and patients with atherosclerosis in terms of the R381Q variant of the IL-23R gene as a functional single-nucleotide polymorphism (SNP). This case-control study recruited 200 patients who presented with cardiovascular symptoms to Afshar Hospital, Yazd, Iran. The participants were allocated to five groups based on angiographic results. The severity of the disease was determined according to the numbers of involved vessels. Patients with normal coronary arteries, minimal coronary artery involvement, one involved vessel, two involved vessels and three-vessel disease were allocated to groups I-V, respectively. DNA was extracted from whole blood samples by the salting-out method. Genotyping was performed by polymerase chain reaction followed by restriction fragment length polymorphism assay and multinomial logistic regression for analyses The presence of SNP A>G rs11209026 of IL-23 receptor gene was significantly associated with disease severity (P = 0.008). The frequencies of the heterozygous (AG) genotype in the control group and subjects with minimal involvement, and patients with one-, two-, and three-vessel disease were 22.5%, 12.5%, 10%, 10.24% and 4.8%, respectively. Our results indicated an association between the rs11209026 G>A polymorphism of the IL-23 receptor gene and the risk of atherosclerosis. This genetic variant may in fact cause protection against atherosclerosis progression. However, further studies on gene polymorphism and cell expression are required to clarify the mechanisms involved in the pathogenesis of atherosclerosis.