Evaluation of the Pattern of EPIYA Motifs in the Helicobacter pylori cagA Gene of Patients with Gastritis and Gastric Adenocarcinoma from the Brazilian Amazon Region

Abstract

The Helicobacter pylori is associated with the development of different diseases. The clinical outcome of infection may be associated with the cagA bacterial genotype. The aim of this study was to determine the EPIYA patterns of strains isolated from patients with gastritis and gastric adenocarcinoma and correlate these patterns with the histopathological features. Gastric biopsy samples were selected from 384 patients infected with H. pylori, including 194 with chronic gastritis and 190 with gastric adenocarcinoma. The presence of the cagA gene and the EPIYA motif was determined by PCR. The cagA gene was more prevalent in patients with gastric cancer and was associated with a higher degree of inflammation, neutrophil activity, and development of intestinal metaplasia. The number of EPIYA-C repeats showed a significant association with an increased risk of gastric carcinoma (OR = 3.79, 95% CI = 1.92–7.46, and P = 0.002). A larger number of EPIYA-C motifs were also associated with intestinal metaplasia. In the present study, infection with H. pylori strains harboring more than one EPIYA-C motif in the cagA gene was associated with the development of intestinal metaplasia and gastric adenocarcinoma but not with neutrophil activity or degree of inflammation.

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

“…Nevertheless, the present study did not find any correlation between CagA EPIYA-C motif number and chronic inflammation or neutrophilic activity. Similar results have been reported in a Brazilian study6 and supported by a Greek study that shows no association between the number of EPIYA-C motif and pro-inflammatory cytokine production 7.…”

“…Similar results have been reported in Colombian studies, 8,45 unlike those obtained in South Africa, Italy, the United States, Greece, Japan and Brazil, where a significant association between the number of EPIYA-C motifs (two or three motifs) and precancerous lesions has been reported. 3,6,7,32,33,45,46 This can also be explained by the difficulty of detecting H. pylori in metaplastic and dysplastic lesions.…”

“…Some studies reported a significant association between the virulent H. pylori genotypes (vacAs1, vacAi1, vacAm1 or increasing number of EPIYA-C segments of the C-terminal part of CagA) and precancerous lesions, especially intestinal metaplasia, [4][5][6] while others failed to find an association between H. pylori genotypes and the severity of gastric epithelial damages. 7,8 In Morocco, a previous study conducted by our team on 801 patients showed a significant association between intestinal metaplasia and vacAs1 and vacAm1 in patients aged 50 years and more.…”

Helicobacter pyloriInfection, Virulence Genes’ Distribution and Accompanying Clinical Outcomes: The West Africa Situation

“…In line with a novel insertion sequence, cagA can be separated into two parts (regions) namely cag I and cag II [127] and depending on the repeat sequences of the 3′ region containing the Glu-Pro-Ile-Tyr-Ala (EPIYA) motifs, this gene can also be grouped as East-Asian-type or Western-type [127]. Although some specific EPIYA-like motifs (ESIYA and ESIYT) have been reported [128] in the C-terminal region of some isolated CagA strains elsewhere, the carcinogenic potential of CagA is greatly linked to its main polymorphic EPIYA motif variants, C and D [129]. In vitro studies have shown that the East-Asian-type CagA which contains EPIYA-D segments has an increased ability to induce morphological changes in epithelial cells and promote gastric cancer or peptic ulcer development than their Western-type counterpart that contains EPIYA-C segments [130].…”

Mix Infections of Helicobacter pylori: A Major Risk Factor Affecting Genotyping Studies

“…We read with interest the paper “ Evaluation of the pattern of EPIYA motifs in the Helicobacter pylori cagA gene of patients with gastritis and gastric adenocarcinoma from the Brazilian Amazon region ” in the volume 2014, 2014, issue of International Journal of Bacteriology [ 1 ]. In this paper, Vilar e Silva et al [ 1 ] presented that EPIYA-C motif in the cagA gene was found linked with the development of intestinal metaplasia and gastric adenocarcinoma. Remarkably, the authors mentioned that they only used monoinfected subjects in this survey.…”