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Abstract
Background
Helicobactor pylori(H. pylori) virulence markers would be useful to predict peptic ulcer disease (PUD) or gastric cancer.
Aim
In Egypt, since inadequate data are present regardingH. pylorivirulence-related genes in different age group patients with gastro-duodenal diseases, it becomes crucial to study the clinical status ofcagA,vacAandiceA1 genotypes ofH. pyloristrains recovered from patients with dyspepsia.
Subjects and methods
The study included 113 dyspeptic patients who were exposed to upper gastrointestinal endoscopic examination. Four antral biopsies were obtained from each patient for the analysis ofH. pyloriinfection by rapid urease test and detection of16S rRNA.
Results
Sixty (53.1%) patients were confirmed to be infected withH. pylori. Upon endoscopy, gastritis was revealed in 27 patients (45%) and10 patients (16.7%) had PUD. Of the 60H. pyloristrains, 39 (65%) had at least one virulence gene. Six different genotypic forms were recognized;vacA(9/60), iceA1(1/60),vacA/cagA(7/60),vacA/iceA1(13/60),vacA/cagA/iceA1(8/60) only one ofcagA/iceA typeand we could not detectcagA. The overallvacA,iceA1andcagAgenes identified were 61.6%, 38.8%, 26.6% respectively, by PCR-based molecular testing. ThevacAgene status was highly significant related to gastritis patient (P<=0.036). ThevacA s1m1ands2m2alleles were significantly found in 50% ofH. pyloriinfected patients with PUD and with gastritis 57.1% respectively (P<=0.01).
Conclusion
In conclusion, the main genotype combinations in the studied Egyptian patients were;vacAs2m2/iceA1,vacAs1m1/cagA,mostly associated with gastritis, andvacAs1/cagA/icA, mainly in PUD. The less virulent(s2, s2m2) H. pylorigenotypes were found in patients aged over 43years.