It is valuable to extend genotyping studies of Helicobacter pylori to strains from indigenous communities across the world to better define adaption, evolution, and associated diseases. We aimed to genetically characterize both human individuals and their infecting H. pylori from indigenous communities of Mexico, and to compare them with those from other human groups. We studied individuals from three indigenous groups, Tarahumaras from the North, Huichols from the West and Nahuas from the center of Mexico. Volunteers were sampled at their community site, DNA was isolated from white blood cells and mtDNA, Y-chromosome, and STR alleles were studied. H. pylori was cultured from gastric juice, and DNA extracted for genotyping of virulence and housekeeping genes. We found Amerindian mtDNA haplogroups (A, B, C, and D), Y-chromosome DYS19T, and Amerindian STRs alleles frequent in the three groups, confirming Amerindian ancestry in these Mexican groups. Concerning H.pylori cagA phylogenetic analyses, although most isolates were of the Western type, a new Amerindian cluster neither Western nor Asian, was formed by some indigenous Mexican, Colombian, Peruvian and Venezuelan isolates. Similarly, vacA phylogenetic analyses showed the existence of a novel Amerindian type in isolates from Alaska, Mexico and Colombia. With hspA strains from Mexico and other American groups clustered within the three major groups, Asian, African or European. Genotyping of housekeeping genes confirmed that Mexican strains formed a novel Asian-related Amerindian group together with strains from remote Amazon Aborigines. This study shows that Mexican indigenous people with Amerindian markers are colonized with H. pylori showing admixture of Asian, European and African strains in genes known to interact with the gastric mucosa. We present evidence of novel Amerindian cagA and vacA alleles in indigenous groups of North and South America.

In this descriptive study we investigated the genetic structure of 513 Mexican indigenous subjects grouped in 14 populations (Mixteca-Alta, Mixteca-Baja, Otomi, Purépecha, Tzeltal, Tarahumara, Huichol, Nahua-Atocpan, Nahua-Xochimilco, Nahua-Zitlala, Nahua-Chilacachapa, Nahua-Ixhuatlancillo, Nahua-Necoxtla, and Nahua-Coyolillo) based on mtDNA haplogroups. These communities are geographically and culturally isolated; parents and grandparents were born in the community. Our data show that 98.6% of the mtDNA was distributed in haplogroups A1, A2, B1, B2, C1, C2, D1, and D2. Haplotype X6 was present in the Tarahumara (1/53) and Huichol (3/15), and haplotype L was present in the Nahua-Coyolillo (3/38). The first two principal components accounted for 95.9% of the total variation in the sample. The mtDNA haplogroup frequencies in the Purépecha and Zitlala were intermediate to cluster 1 (Otomi, Nahua-Ixhuatlancillo, Nahua-Xochimilco, Mixteca-Baja, and Tzeltal) and cluster 2 (Nahua-Necoxtla, Nahua-Atocpan, and Nahua-Chilacachapa). The Huichol, Tarahumara, Mixteca-Alta, and Nahua-Coyolillo were separated from the rest of the populations. According to these findings, the distribution of mtDNA haplogroups found in Mexican indigenous groups is similar to other Amerindian haplogroups, except for the African haplogroup found in one population.

No abstract

Mexican children respond to H. pylori infection with a low inflammatory response, a balanced increase of T and B lymphocytes, and a high regenerative activity.

Intestinal parasitic infections and serum IgE levels showed an age-dependent association with H. pylori prevalence. In adults, but not in children, intestinal parasitic infections and increased IgE levels where associated with a reduced H. pylori prevalence.

Few studies have analyzed the immune response to Helicobacter pylori CagA and urease antigens across age groups in the same population. The aim of this study was to analyze the serologic immunoglobulin G (IgG) response to CagA and urease proteins in children and adults with gastrointestinal symptoms and belonging to the same population and similar socioeconomic levels. The serologic response was studied in 352 children and 293 adults with gastrointestinal symptoms. IgG antibodies against CagA and urease were tested by enzymelinked immunosorbent assay methods using highly purified recombinant antigens. H. pylori infection was defined as a positive result in a serologic assay using whole-cell H. pylori extracts as the antigen. We found, in H. pylori-positive children, a seroprevalence of 46.9% to CagA and 16.2% to urease, whereas in H. pylori-positive adults, a seroprevalence of 78.9% to CagA and 59% to urease was found. In children, the magnitude of the response to CagA was significantly higher and the response to urease was significantly lower than those in adults. The kinetics of serologic response to CagA and to urease across age groups was contrastably different. Whereas CagA is a strong immunogen, urease is a poor immunogen during natural infection. These differences in the humoral response may be important for the short-term or long-term outcome of the infection. These results add to our knowledge of the epidemiology of H. pylori infection.

HLA-DQ locus may play a different role in the development of H pylori-related chronic gastritis and diffuse-type gastric adenocarcinoma in the Mexican Mestizo population.

INTRODUCCIÓNLa infección por Helicobacter pylori (H. pylori) es la causa principal de gastritis y enfermedad ulcerosa en adultos, y se ha asociado al desarrollo de cáncer y linfoma gástrico (1). Para el diagnóstico se cuenta con diferentes métodos: los invasivos que requieren la realización de endoscopia y toma de biopsia para estudio histopato- RESUMENObjetivo: validar un método simplificado de la prueba en aliento con urea-13 C (PAU-13 Cs) para el diagnóstico de infección por Helicobacter pylori (H. pylori), con administración simultá-nea de 50 mg de urea-13 C y 2 g de ácido cítrico. Material y métodos: se estudiaron 88 pacientes (49 mujeres y 39 hombres); con promedio de edad 45 ± 15 años, referidos para endoscopia gastrointestinal y toma de biopsias. La PAU-13 Cs se realizó en ayuno. Se recolectaron las muestras de aire espirado en tubos de cristal de 10 ml, antes y 30 minutos después de administrar simultáneamente 50 mg de urea-13 C y 2 g de ácido cítrico disueltos en 200 ml de agua. Las muestras se analizaron por espectrometría de masas. El diagnóstico de infección se consideró cuando el cultivo y/o la biopsia y serología fueron positivas para H. pylori.Resultados: cincuenta y un pacientes (57,95%) fueron positivos, 30 (34,10%) negativos para H. pylori y 7 (7,95%) casos se consideraron indeterminados. La sensibilidad, especificidad, valor predictivo positivo y negativo de PAU- Conclusión: la administración simultánea de 50 mg de urea-13 C y 2 g de ácido cítrico, representa una alternativa para el diagnóstico no invasivo de infección por H. pylori, debido a que conserva la certeza diagnóstica de la PAU-13 C.Palabras clave: Helicobacter pylori. Urea-13 C. Prueba en aliento. Ácido cítrico. ABSTRACTObjective: to validate a simplified 13 C-urea breath test ( 13 C-UBT) method for the diagnosis of H. pylori infection.Material and methods: patients referred for gastrointestinal endoscopy and biopsy were included, and a 13 C-UBT was performed after a 6-hour fast. Breath samples were collected in 10 ml glass tubes before and 30 min after the simultaneous administration of 50 mg of 13 C-urea and 2 g of citric acid in 200 ml of water. All breath samples were analyzed using isotope ratio mass spectrometry. The diagnosis of H. pylori infection was established with a positive culture and/or positive histology and serology.Results: eighty-eight patients were included, 49 female and 39 male with a mean age of 45 ± 15 yrs. Fifty-one patients (57.95%) were positive and 30 (34.1%) negative for H. pylori. Seven cases (7.95%) were considered undetermined. The sensitivity, specificity, positive predictive value, and negative predictive value for 13 C-UBT were 90.2, 93.3, 95.83, and 84.8%, respectively. Accuracy was 91.4%.Conclusions: the simultaneous administration of 50 mg of 13 C-urea and 2 g of citric acid represents an alternative for the non-invasive diagnosis of H. pylori infection.