Clinical Relevance of CagA EPIYA Motifs In Helicobacter pylori Among the Dyspeptic Patients in Kenya
Journal Title: International Journal of Medical and Health Sciences - Year 2015, Vol 4, Issue 4
Abstract
Introduction: The Helicobacter pylori cytotoxin-associated gene A (cagA) has been associated with disease severity and its oncogenic potential has been linked to its polymorphic EPIYA motifs whose combinations differ geographically. The aim of this study was to determine the frequency of cagA-positive Helicobacter pylori isolated from dyspeptic patients in Kenya and to assess the association of cagA EPIYA motif patterns with clinical outcome. Materials and Methods: H. pylori positivity was determined by histology and molecular diagnostic method directly from the gastric pathologies. The cagA presence and EPIYA Motif patterns were analyzed by polymerase chain reaction from the H. pylori positive samples. Results: The cagA gene was identified in 48.75% of the H. pylori- patients. The cagA per se was not significantly associated with the gastroduodenal diseases. The most occurring EPIYA pattern was the ABC (56.41%) followed by ABCC at 43% and AB at 28.21%. The presumed virulent ABCCC pattern was rare (5.13%). Increase in the number of EPIYA C (more than one C repeat) repeats was significantly associated gastric cancer (OR=6.577 95% CI 1.620-26.704, p=0.008). Conclusion: All the Kenyan cagA EPIYA patterns were of Western type. We found that infection by H. pylori cagA strains with multiple EPIYA C repeats to be associated with gastric cancer but not peptic ulcer in Kenya; but the low prevalence of these strains might contribute to the low incidence of gastric cancer in this country. Determining the EPIYA motifs in CagA, rather than detecting cagA gene alone, would be a better marker for assessing the risk of serious gastric pathology.
Authors and Affiliations
Lawrence Guantai M’itonga, Andrew Nyerere Kimanga, Caroline Wangari Ngugi, Thomas M. Mutie
Keywords
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