Clinical Relevance of Helicobacter pylori cagA and vacA Gene Polymorphisms

Basso, Daniela; Zambon, Carlo–Federico; Letley, Darren P.; Stranges, Alessia; Marchet, Alberto; Rhead, Joanne L.; Schiavon, Stefania; Guariso, Graziella; Ceroti, Marco; Nitti, Donato; Plebani, Mario; Atherton, John C.

doi:10.1053/j.gastro.2008.03.041

Cited by 347 publications

(368 citation statements)

References 38 publications

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“…In a Jordanian study, only 26.9 % of H. pylori isolates were cagA positive [34]. However, albeit relatively rare in our study population, cagA maintained a significant relation with vacA s1m1, as already stated by multiple articles [10,32,33,35]. Although cagA was found in only 31.8 % of isolates, cagPAI was more frequent since cagE was present in 45.9 %.…”

Section: Discussionsupporting

confidence: 67%

“…Mosaicism vacA s2m1 was detected in only 3 patients, confirming that this genotype is very rare [9,10,24]. Van Doorn et al established that in the Iberian Peninsula subtype s1b was the dominant one [24,44,45].…”

Section: Discussionmentioning

confidence: 95%

“…It is interesting to notice that a recent study, in Portuguese children, demonstrated a low prevalence (16.7 %) of cag-PAI in patients with non-ulcer dyspepsia comparatively to patients with peptic ulcer disease (75.4 %) [38]. In European and North American populations, cagA has been associated with more severe disease such as gastric mucosal atrophy, intestinal metaplasia and gastric cancer [6,10,39,40]. We think the same is valid for the central region of Portugal since cagA-positive status was independently associated with presence of intestinal metaplasia in the antrum, higher degrees of neutrophil activity in the antrum and chronic inflammation in the body as well as higher OLGIM stages.…”

Section: Discussionmentioning

confidence: 99%

“…Strains with vacA s1 and m1 alleles produce a large amount of toxin and epithelial damage, whereas s2 and m2 genotypes produce little or no toxin [8,9]. Most vacA s1 strains are cagA-positive, thus the two markers are closely related [9,10].…”

Section: Introductionmentioning

confidence: 99%

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Correlation of Helicobacter pylori Genotypes with Gastric Histopathology in the Central Region of a South-European Country

et al. 2014

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Background Outcome of Helicobacter pylori (H. pylori) infection results from interaction of multiple variables including host, environmental and bacterial-associated virulence factors. Aim This study aimed to investigate the correlation of cagA, cagE, vacA, iceA and babA2 genotypes with gastric histopathology and disease phenotype in the central region of a South-European country. Methods This prospective study involved 148 infected patients (110 female; mean age 43.5 ± 13.4 years) submitted to endoscopy with corpus and antrum biopsies. H. pylori was cultured and DNA extracted from the isolates. Genotypes were determined by PCR. Histopathological features were graded according to the updated Sydney system and OLGA/OLGIM classification. Only patients with single H. pylori genotypes and complete histopathological results were included.Results Antrum samples presented higher degrees of atrophy, intestinal metaplasia, chronic inflammation and neutrophil activity. Genotype distribution was as follows: cagA-31.8 %; cagE-45.9 %; vacA s1a-24.3 %; vacA s1b-19.6 %; vacA s1c-0.7 %; vacA s2-55.4 %; vacA m1-20.9 %; vacA m2-79.1 %; vacA s1m1-18.9 %; vacA s1m2-25.7 %; vacA s2m1-2 %; vacA s2m2-53.4 %; iceA1-33.8 %; iceA2-66.2 %; babA2-12.2 %. CagA genotype was significantly associated with higher degrees of intestinal metaplasia, neutrophil activity, chronic inflammation and OLGIM stages. BabA2 was linked with higher H. pylori density. Strains with vacA s1m1 or vacA s1m1 ? cagA positive genotypes had a significant association with peptic ulcer and vacA s2m2 with iron-deficient anemia. Conclusions cagA, vacA s1m1 and babA2 genotypes are relatively rare in the central region of Portugal. cagApositive strains are correlated with more severe histopathological modifications. This gene is commonly associated

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Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Correlation of Helicobacter pylori Genotypes with Gastric Histopathology in the Central Region of a South-European Country

et al. 2014

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“…The progression from normal tissue to cancerous tissue is thought to be a change from acute gastritis to chronic gastritis to IM to cancer [44,45]. The association seen here, between cagPAI and both IM and moderate–severe acute antral gastritis, agrees with previous reports that have shown an intact element is related to more severe disease [7,11,12,21,46–48]. A previous study in Alaska Native people found that over 90% of both individuals with gastric cancer and healthy individuals had antibodies against the CagA protein[19], indicating that exposure to bacteria expressing and exporting this protein is very common.…”

Section: Discussionsupporting

confidence: 89%

H. pylori-associated pathologic findings among Alaska native patients

Nolen

Bruden

Miernyk

et al. 2018

International Journal of Circumpolar Health

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Helicobacter pylori infection is common among Alaska native (AN) people, however scant gastric histopathologic data is available for this population. This study aimed to characterise gastric histopathology and H. pylori infection among AN people. We enrolled AN adults undergoing upper endoscopy. Gastric biopsy samples were evaluated for pathologic changes, the presence of H. pylori, and the presence of cag pathogenicity island-positive bacteria. Of 432 persons; two persons were diagnosed with gastric adenocarcinoma, two with MALT lymphoma, 40 (10%) with ulcers, and 51 (12%) with intestinal metaplasia. Fifty-five per cent of H. pylori-positive persons had cag pathogenicity island positive bacteria. The gastric antrum had the highest prevalence of acute and chronic moderate–severe gastritis. H. pylori-positive persons were 16 and four times more likely to have moderate–severe acute gastritis and chronic gastritis (p < 0.01), respectively. An intact cag pathogenicity island positive was correlated with moderate–severe acute antral gastritis (53% vs. 31%, p = 0.0003). H. pylori-positive persons were more likely to have moderate–severe acute and chronic gastritis compared to H. pylori-negative persons. Gastritis and intestinal metaplasia were most frequently found in the gastric antrum. Intact cag pathogenicity island positive was correlated with acute antral gastritis and intestinal metaplasia.

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A systematic review on the association between the Helicobacter pylori vacA i genotype and gastric disease

Liu

Cho

et al. 2016

FEBS Open Bio

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Helicobacter pylori ( H. pylori ) has been recognized as a cause of gastrointestinal diseases and progress of the pathology of gastrointestinal diseases is related to the genotype of H. pylori . Published studies have indicated that the H. pylori vacuolating cytotoxin gene A ( vacA ) i1/i2 genotype is associated with peptic ulcer disease (PUD) and gastric cancer (GC), but their conclusions are inconsistent. This study aimed to further assess the risk of vacA i gene for PUD and/or GC. A systematic search was conducted across three main electronic databases (PubMed, Web of Science, and CNKI). A meta‐analysis was then performed on the pooled data of the published articles to estimate the overall influence of vacA i polymorphisms on PUD and/or GC by crude odds ratio (OR) with 95% confidence intervals (CI). The reliability of the results were confirmed by publication bias and sensitivity analysis of included studies. A total of 14 studies were selected according to the specific inclusion and exclusion criteria. The pooled results revealed that patients with GC were more vulnerable to infection by H. pylori i1 genotype (OR = 5.12; 95% CI: 2.66–9.85; P < 0.001) than those with chronic gastritis or nonulcer disease. Moreover, the results of subgroup analysis indicated that the i1 genotype of H. pylori was associated with an increased GC risk (OR = 10.89; 95% CI: 4.11–20.88; P < 0.001) in the Middle Asian population. The H. pylori vacA i1 genotype is associated with an increased GC risk, especially in the Middle Asian population.

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Clinical Relevance of Helicobacter pylori cagA and vacA Gene Polymorphisms

Cited by 347 publications

References 38 publications

Correlation of Helicobacter pylori Genotypes with Gastric Histopathology in the Central Region of a South-European Country

Correlation of Helicobacter pylori Genotypes with Gastric Histopathology in the Central Region of a South-European Country

H. pylori-associated pathologic findings among Alaska native patients

A systematic review on the association between the Helicobacter pylori vacA i genotype and gastric disease

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