<b><i>Background:</i></b> In the recent studies, a less virulent <i>Helicobacter pylori</i> variant could still colonize the human stomach and induce gastric inflammation, suggesting the involvement of other virulence factors, such as TlyA hemolysin. Nevertheless, the association of TlyA in the pathogenesis of <i>H. pylori</i> infection remains unclear. We investigated the <i>tlyA</i> profile and determined its relationship with gastritis severity. <b><i>Methods:</i></b> An observational study was conducted using DNA stocks and secondary data from previous studies. The <i>tlyA</i> variant was examined by NGS and confirmed with polymerase chain reaction. Gastritis severity was categorized by the Updated Sydney System. The relationship between a variant of <i>tlyA</i> and gastritis severity was determined, in which discrete variables were tested using the χ<sup>2</sup> test or Fisher exact test. <b><i>Results:</i></b> Two <i>H. pylori tlyA</i> variants were observed and characterized as <i>tlyA1</i> and <i>tlyA2</i>. We noted a unique variant in the amino acid sequence 32–35 that is exclusively detected among <i>H. pylori</i> isolated from the Papua island. In addition, we observed that the <i>tlyA</i> variant had a significant association with the <i>H. pylori</i> density in the antral (<i>p</i> = 0.002). Histological analyses revealed that TlyA1 was associated with higher <i>H. pylori</i> density than TlyA2. However, we did not observe any significant association of <i>tlyA</i> with the infiltration of inflammation cells. <b><i>Conclusions:</i></b> We observed 2 <i>tlyA</i> variants (<i>tlyA1</i> and <i>tlyA2</i>). A significant association of <i>tlyA</i> with bacterial density suggested that <i>tlyA</i> plays a more significant role in the colonization process than its influence on the severity of inflammation in gastric mucosa.
Background: Gastritis is an inflammation of the stomach lining often caused by Helicobacter pylori infection. Among three H. pylori genes coding for hemolytic toxins, the clinical outcome of hp0499 and hp1490 is unclear. We conducted molecular and histological analyses to evaluate the correlation between these genes and gastritis severity. Methods: We analyzed the hp0499 and hp1490 variants of 116 Indonesian samples using next generation sequencing and validated them using polymerase chain reaction (PCR). The updated Sydney system was used to grade gastritis through histological analyses. We then calculated the influence of hp0499 and hp1490 on the gastritis severity, using multivariate analysis and cagA and vacA as major H. pylori virulence factors. Results: Two variants of each gene were identified and named hp0499-1 and -2, and hp1490-1 and -2. We noted that hp0499 expression was significantly correlated with corporal atrophy (p = 0.037). H. pylori hp1490 significantly correlated with antral acute and chronic inflammation as well as corporal density (p = 0.025, p = 0.07, p = 0.010, respectively). After adjusting for age and sex, we found that vacA s1m1 was an independent risk factor for acute antral inflammation (p = 0.032). hp1490 and vacA s1m1 were independent risk factors for chronic antral inflammation (p = 0.030 and p = 0.031, respectively). Conclusions: We identified the variants hp0499-1 and -2 and hp1490-1 and -2 and demonstrated that hp0499 plays a significant role in the severity of corporal atrophy. Moreover, hp1490 was characterized as an independent risk factor for chronic inflammation in the antral region. Therefore, hp0499 and hp1490 are new potential targets for therapeutics.
BACKGROUND: Stroke has become a serious problem in Indonesia. Its prevalence tends to increase every year. Individuals who have had a stroke are unable to live independently. In continuing their daily activities, post-stroke patients must be able to adapt and unite their desires and life goals with physical, psychological, social, role, and spiritual changes compared to before suffering a stroke. Failure in the adaptation process will make the quality of life of post-stroke patients significantly decrease. The WHO considers the potential use of health-related quality of life (HRQOL) as an instrument to measure the quality of life of post-stroke patients which has been commonly used in many studies. AIM: This study aimed to analyze the validity and reliability of HRQoL questionnaire on post-stroke patient. It also analyzes the psycho-social, role, and spiritual dimensions of the quality of life of post-stroke patients using sociology theoretical approach utilizing structural functionalism theory and social change theory. METHODS: HRQoL, consists of 37 questions including physical, psychological, social, role, and spiritual dimensions, was applied to measure the quality of life. Pearson product moment and Cronbach’s alpha were used as validity and reliability test. Analysis of the sociological approach was carried out using Talcott Parsons Sociology. RESULT: Forty-four post-first stroke attack respondents from two hospitals in Surabaya East Java and Klaten Central Java, Indonesia, were obtained. Construct validity test showed that six questions were not valid study (p > 0.05, r < 0.297) and 31 questions were valid. The reliability test exhibited that all valid questions were reliable (Cronbach’s α=0.888) CONCLUSION: The HRQoL is a reliable and valid instrument with good psychometric properties. The scale is recommended for assessing quality of life of post-stroke patients.
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