Detection of Cytotoxin-Associated and Vacuolating Cytotoxin Genotypes of Helicobacter pylori in Patients with Peptic Inflammatory/Ulcerative Disorders
Journal Title: The Egyptian Journal of Hospital Medicine - Year 2018, Vol 71, Issue 6
Abstract
<span>Background: </span><span>Helicobacter pylori </span><span>is a Gram negative, spiral, rod-shaped, and flagellated bacteria that colonizes the human gastric mucosa and can cause a strong inflammatory state and lesions. However, genomic and phenotypic features of different strains allow the expression of virulence factors which enable some strains, rather than others, to cause disease</span><span>. Aims: </span><span>The aim of the present study was to evaluate the role of the cytotoxicity genes, </span><span>CagA </span><span>and </span><span>VacA</span><span>, of </span><span>H. pylori </span><span>in patients with peptic inflammatory/ulcerative disorders and correlate between different genotypes and peptic lesions. </span><span>Patients and methods: </span><span>Upper gastrointestinal endoscopy and histopathological examination of gastric biopsy samples were done for 112 patients complaining of upper gastrointestinal symptoms and clinically suspected to have </span><span>H. Pylori </span><span>infection. </span><span>CagA </span><span>and </span><span>VacA </span><span>genotyping by PCR were done for 50 </span><span>H. pylori </span><span>+ve patients (diagnosed by histopathology). </span><span>Results: </span><span>CagA </span><span>gene and </span><span>VacA </span><span>gene were detected in 42.0% and 70% of </span><span>H. pylori </span><span>+ve patients respectively. There was a significant positive correlation between </span><span>CagA </span><span>and duodenal erosion and ulceration visualized by endoscopy. There was also a positive correlation between </span><span>CagA </span><span>and gastric erosion and ulceration visualized by endoscopy, but it didn`t reach a significant level. There was also a significant positive correlation between the </span><span>VacA m1s1 </span><span>subtype and duodenal erosion and ulceration detected by endoscopy. </span><span>VacA m2s2 </span><span>was correlated to presence of both gastric erosions and ulcerations and presence of metaplasia and atrophy. There was only one </span><span>H. pylori </span><span>+ve patient with gastric cancer. This patient was positive for both </span><span>CagA </span><span>and </span><span>VacA m2s2. </span><span>Conclusions: </span><span>The </span><span>CagA </span><span>gene is associated with severe forms of gastric pathology (peptic ulcer disease "PUD" and precancerous gastric lesions) and the </span><span>VacA m2s2 </span><span>subtype is associated with variable forms of gastric pathology rather than other </span><span>VacA </span><span>gene subtypes. </span><span>Recommendations: </span><span>Genotyping for </span><span>VacA </span><span>and </span><span>CagA </span><span>of </span><span>H. pylori </span><span>infected patients is helpful to determine the patients at more risk. Further studies are needed to evaluate the virulence factors in </span><span>H. pylori </span><span>with emphasis on role of </span><span>CagA </span><span>and </span><span>VacA m2s2 </span><span>both in vivo and in vitro.<br /> </span>
Authors and Affiliations
Eman Helal
Keywords
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