EPIYA motifs of Helicobacter pylori cagA genotypes and gastrointestinal diseases in the Iranian population: a systematic review and meta-analysis

Abstract

Helicobacter pylori is one of the best risk factors for gastric cancer. Recent studies have examined the relationship between virulence factors, in particular CagA toxin, and the development of gastrointestinal diseases. According to the literature, there is a significant relationship between the polymorphism of cagA -EPIYA motifs and progression to severe clinical outcomes. The main goal of our study was to determine the possible association between cagA genotypes and the risk of severe clinical outcomes in the Iranian population. We investigated these ambiguities using a comprehensive meta-analysis study, in which we evaluated data from 1762 Iranian patients for a potential correlation between all cagA gene genotypes and gastrointestinal diseases. According to statistical analysis, the frequencies of cagA genotypes including ABC, ABCC, AB and ABCCC in the Iranian population were estimated at 80.18%, 22.81%, 5.52% and 2.76%, respectively; the ABD genotype was not detected in these PCR-based studies. There was a significant relationship between cagA genotypes ABCC and ABCCC and severe clinical outcomes of infection such as peptic ulcer and gastric cancer. Overall, it can be concluded that there is a positive correlation with the number of copies of EPIYA-C and the increase of gastric cancer. Therefore, according to our results, it seems that the EPIYA-ABCCC motif has a strong positive relationship with gastric cancer in the Iranian population.

H. pylori Infection and Virulence Factors cagA and vacA (s and m Regions) in Gastric Adenocarcinoma from Pará State, Brazil

“…However, Dabiri et al found no association between the presence of cagA and the neoplasm, demonstrating that the presence of this virulence factor is still controversial for the increased risk of developing gastric cancer and more accelerated disease progression [58]. A hypothesis to justify the divergent results may be the genetic variability that is not normally observed in most studies, such as the number of copies of cagA (ranging from 1 to 4) and the ignored variability in regions of low coverage by sequencing [60,61]. On the other hand, the involvement of other virulent factors cannot be ignored [24,29,62].…”

Statistical proof of Helicobacter pylori eradication in preventing metachronous gastric cancer after endoscopic resection in an East Asian population

“…In 1994, the International Agency for Research on Cancer (IARC) identified this bacterium as a group I gastric carcinogen[ 5 ]. There is ample evidence about the positive relationship between H. pylori infection and gastric cancer; primary infection with this bacterium has been proven to lead to cancer by inducing atrophic gastritis, intestinal metaplasia, and dysplasia[ 6 ]. According to previous randomized controlled trials (RCTs), it seems that the eradication of this pathogen is not effective in preventing the occurrence of primary gastric cancer[ 7 - 12 ].…”

Probiotics as the live microscopic fighters against Helicobacter pylori gastric infections

“…Chronic infection can stimulate the immune system to create favorable conditions to support the growth of bacteria [ 125 – 127 ]. Bacterial virulence factors can disrupt the signaling pathways and cell junctions, leading to the formation of pre-cancerous lesions as hummingbird phenotype [ 128 , 129 ]. Curing H. pylori infection is considered as the main strategy for preventing gastric MALT lymphoma and can decrease the risk of secondary gastric cancer or relapse of gastric ulcers [ 130 , 131 ].…”