CagA positivity and its association with gastroduodenal disease in Turkish children undergoing endoscopic investigation

Abstract

CagA positivity is common in HP-infected Turkish children. Esophageal lesions are less common in children infected with CagA-positive strains. Although HP is associated with duodenal ulcer disease, CagA positivity does not seem to contribute to development of ulcers in children in our series.

Is there a relationship between Helicobacter pylori infection and erosive reflux disease in children?

“…In a study previously carried out by Sökücü et al., oesophageal lesions were found to be less common in children infected with H. pylori . The rates given in this study were similar to those given in studies carried out on Western populations (23). In our study, although the prevalence of H. pylori infection seemed to be relatively lower in the GERD group than in the control group, no statistically significant difference was found between the prevalence of H. pylori infection in the GERD group and that in the control group (31.3% vs. 36.7%) (p = 0.45).…”

“…A number of studies have compared the prevalence of H. pylori infection in patients with GERD and controls. These studies indicate that prevalence of H. pylori infection in patients with GERD is significantly lower than that in controls (8,10,23). This negative association is less marked in studies performed in the Western world than in the Eastern world (8).…”

“…There is some evidence that reflux disease in H. pylori ‐negative patients tends to be more severe than in H. pylori ‐positive patients (10). In addition, more virulent, cytotoxin‐associated gene A (Cag A)‐positive strains of H. pylori are associated with less‐severe reflux disease (10,22,23). In Sökücü et al.’s study, Cag A‐positivity was common in H. pylori ‐infected Turkish children, and oesophageal lesions were less common in children infected with CagA‐positive strains (23).…”

Correlation of clinical, endoscopic, and histological findings with virulence factors in children with Helicobacter pylori gastritis

“…In adults, the severity of H. pylori infection was found to be related to virulence factors such as vacA (s1a, s1b, s1c, s2, m1, and m2), cagA, cagE, babA, iceA1, and iceA2, which might all interfere with inflammatory and immunological mechanisms and accelerate the development of ulcer and malignancy. In two other Turkish pediatric studies, the positivity rate of cagA was reported as 55.6% [28] and 74.4% [29], respectively. Subtypes of H. pylori may vary in different geographic locations and ethnic groups [27].…”

Diagnosis of Helicobacter pylori

“…Indeed, attempts to correlate a specific disease with antibodies directed toward specific H. pylori antigens are still being made. It has been known for many years that, antibodies against CagA are associated with peptic ulcer disease [35] but they are not specific enough to screen these patients among dyspeptic patients [36]. A specific immunoblot pattern indicating infection with a more virulent strain was associated with active inflammation as well as atrophy and intestinal metaplasia in the antrum [37].…”