Affiliation:
1. Fatih University, Faculty of Science, Department of Biology/Microbiology Unit
2. Department of Medicine, Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas 77030
3. Department of Gastroenterology, SSK Samatya Hospital Istanbul, Turkey
Abstract
ABSTRACT
The predominant
Helicobacter pylori
strains circulating among geographic locations differ in regard to genomic structure. The association of the
cagA
-positive,
vacA
s1 genotypes with peptic ulcer disease (PUD) and gastric cancer was reported in Western countries but not in East Asian countries. Strains from Western countries predominantly possessed
cagA
type 2a,
vacA
s1a or s1b/m1a, or
vacA
m2a genotypes, whereas strains from East Asia possessed
cagA
type 1a,
vacA
s1c/m1b, or
vacA
m2b genotypes. Whether the Turkish strains possessed such genotypes was investigated and correlated with the disease outcome. Seventy-three patients from Turkey were enrolled.
H. pylori
was detected in 65 (89%) patients (22 with gastritis, 33 with PUD, and 10 with gastric cancer) by any of the following tests:
Campylobacter
-like organism test, culture, or PCR. Among the
H. pylori-
positive patients, presence of the
cagA
gene (78%) was significantly associated with PUD (
P
< 0.00001), gastric cancer (
P
< 0.001), and
vacA
s1a genotypes (
P
< 0.0001). Multiple
vacA
genotypes were more prevalent in PUD and gastric cancer patients than in patients with gastritis. Restriction fragment length polymorphism analysis of the
cagA
gene revealed three different patterns with no significant association with clinical outcome. Turkish strains examined predominantly possessed
cagA
type 2a,
vacA
s1a/m1a, or
vacA
m2a genotypes, which were typical genotypes in strains from Western countries. This fact might be one of the reasons for the low prevalence of severe gastroduodenal diseases in Turkey compared to the East Asian countries.
Publisher
American Society for Microbiology
Cited by
76 articles.
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