The distribution ofcagAanddupAgenes inHelicobacter pyloristrains in Kurdistan region, northern Iraq

Abstract

BACKGROUND AND OBJECTIVESHelicobacter pylori is a Gram negative bacteria that causes peptic ulceration and gastric adenocarcinoma. H pylori virulence factors, such as cagA and dupA, are important to study in populations as they contribute to disease risk. This study aimed to look at the distribution of the cagA and dupA genes in H pylori strains isolated from patients suffering from gastroduodenal diseases in Kurdistan region, Iraq.DESIGN AND SETTINGSA cross-sectional study conducted between June 2011 and January 2012. Biopsies were collected from the Endoscopy Department in Duhok and Sulaimania hospitals, Kurdistan region, northern Iraq.PATIENTS AND METHODSUpper gastrointestinal (GI) endoscopy examination was performed and 4 gastric biopsies (2 from the antrum and 2 from the corpus) were obtained from 204 patients. H pylori positivity was examined by CLO test; then the association between disease status and virulence factors was assessed by polymerase chain reaction.RESULTS154 (75%) of our samples were found to be H pylori + by CLO test. Endoscopic diagnoses for those who were positive were as follows: peptic ulcer disease (PUD) including duodenal ulcer, 45; gastric ulcer, 23; and no ulcer (NPUD), 86. The overall prevalence rates of cagA and dupA were 72.7% and 18.8%, respectively. While a significant association between cagA and PUD was observed (P ≤ .017; OR=0.4; CI=0.18–0.85), no relationship between dupA and PUD could be seen.CONCLUSIONThese data suggested that the presence of cagA may be a predictor of clinical outcome in Kurdistan region, northern Iraq.

Duodenal ulcer promoting gene 1 (dupA1) is associated with A2147G clarithromycin-resistance mutation but not interleukin-8 secretion from gastric mucosa in Iraqi patients

“…We looked within our populations for the associations between virulence factors and PUD. In agreement with previous reports from Iraq [19–21] , a significant association between cagA status and PUD was observed. Also, research from a neighbouring country, Turkey, has shown results similar to those from Iraq [3] .…”

Detection of Helicobacter pylori and its virulence genes (cagA, dupA, and vacA) among patients with gastroduodenal diseases in Chris Hani Baragwanath Academic Hospital, South Africa

“…In line with our study, some authors were unable to regard dup A as a predictor of duodenal ulceration in Belgium, South Africa, China and North America [55]. We recorded 53.4% dup A positive isolates in our study, while the lower prevalence of dup A (18.8%) was reported in Northern Iraq [26] and as well as 39% in Iran [56].…”

Novel virulence factor dupA of Helicobacter pylori as an important risk determinant for disease manifestation: An overview

“…One study from Kurdistan region of Northern Iraq reported that cagA gene was significantly associated with peptic ulcer disease rather than dupA , which contradict the result of Hussein et al[ 29 ] (2008). This might be due to the differences in sample size and also in the geographical location of Iraq[ 34 ]. In the Shiraz area of Iran, a significant relationship was found between strains with dupA , CagA motif (ABC types) and DU disease, which supports the previous finding in this region[ 35 ].…”