Correlation of Helicobacter pylori Genotypes with Gastric Histopathology in the Central Region of a South-European Country

Abstract

Background Outcome of Helicobacter pylori (H. pylori) infection results from interaction of multiple variables including host, environmental and bacterial-associated virulence factors. Aim This study aimed to investigate the correlation of cagA, cagE, vacA, iceA and babA2 genotypes with gastric histopathology and disease phenotype in the central region of a South-European country. Methods This prospective study involved 148 infected patients (110 female; mean age 43.5 ± 13.4 years) submitted to endoscopy with corpus and antrum biopsies. H. pylori was cultured and DNA extracted from the isolates. Genotypes were determined by PCR. Histopathological features were graded according to the updated Sydney system and OLGA/OLGIM classification. Only patients with single H. pylori genotypes and complete histopathological results were included.Results Antrum samples presented higher degrees of atrophy, intestinal metaplasia, chronic inflammation and neutrophil activity. Genotype distribution was as follows: cagA-31.8 %; cagE-45.9 %; vacA s1a-24.3 %; vacA s1b-19.6 %; vacA s1c-0.7 %; vacA s2-55.4 %; vacA m1-20.9 %; vacA m2-79.1 %; vacA s1m1-18.9 %; vacA s1m2-25.7 %; vacA s2m1-2 %; vacA s2m2-53.4 %; iceA1-33.8 %; iceA2-66.2 %; babA2-12.2 %. CagA genotype was significantly associated with higher degrees of intestinal metaplasia, neutrophil activity, chronic inflammation and OLGIM stages. BabA2 was linked with higher H. pylori density. Strains with vacA s1m1 or vacA s1m1 ? cagA positive genotypes had a significant association with peptic ulcer and vacA s2m2 with iron-deficient anemia. Conclusions cagA, vacA s1m1 and babA2 genotypes are relatively rare in the central region of Portugal. cagApositive strains are correlated with more severe histopathological modifications. This gene is commonly associated

VacA genotypes and cagA‐EPIYA‐C motifs of Helicobacter pylori and gastric histopathological lesions

“…Several studies suggest that the evolution of gastric lesions is related to the genetic diversity of H. pylori. 4,35,36 This data do not support results of studies conducted in Portugal, 4 in Italy, 5 in Netherlands, 37 in Greece 7 and in Colombia 38 who report a significant association between vacAs1 and neutrophilic activ- With regard to toxic habits, only tobacco consumption was found to be a risk factor of neutrophilic activity that confirms our preliminary results 9 and is supported by a functional study that revealed a significant association between the mRNA expression of epithelial neutrophil-activating protein 78 and smoking. 39 However, other studies reported that smoking status was a significant predictor for intestinal metaplasia and dysplasia 40,41 and is associated with glandular atrophy.…”

Helicobacter pylori pathogenicity and primary antimicrobial resistance in Northern Spain

“…6 We found a significant association between cagA-positive strains and severity of the disease: 35.3% vs 81.8% in the mild-and severe-disease group, respectively. 30 Infection experiments showed that 22.2% cagA-positive strains were unable to translocate CagA into the host cells, showing non-expression of cagA or a non-functionality of the cag-T4SS of these strains. [4][5][6] Other study, conducted in South of Spain in patients with milddisease symptom, reported a prevalence of 37.3% of cagApositive and 18.6% cagA/vacAs1m1, 25 and similar data were reported in Portugal in 2015.…”

“…[4][5][6] Other study, conducted in South of Spain in patients with milddisease symptom, reported a prevalence of 37.3% of cagApositive and 18.6% cagA/vacAs1m1, 25 and similar data were reported in Portugal in 2015. 30 Infection experiments showed that 22.2% cagA-positive strains were unable to translocate CagA into the host cells, showing non-expression of cagA or a non-functionality of the cag-T4SS of these strains. The babA gene holds two different alleles, only the babA2 encodes the functional BabA and the formation of chimera between babA2 and the homologous babB and babC genes regulates protein expression on transcriptional level.…”

Rapid Detection of H. Pylori in Antral Biopsy Specimens by Amplification of a Conserved Sequence in the Dupa Gene

“…Urea breath test, fecal antigen test and serology are among those non-invasive methods [15]. PCR method has a higher sensitivity and specificity which can cover many other queries such as needing to rapid and non-invasive diagnosis, determination of mutations related to the antibiotic resistance alongside virulence factors encoding genes, and genotyping [16][17][18].…”