The importance of vacA, cagA, and iceA genotypes of Helicobacter pylori infection in peptic ulcer disease and gastroesophageal reflux disease

Abstract

Multiple strain infection is common. H. pylori strains possessing the vacA s1 genotype and/or cagA are associated with PUD. GERD patients, infected with H. pylori, mostly carry less virulent strains possessing neither cagA nor iceA1. Our findings support the hypothesis that virulent strains protect against the development of GERD.

The role of cagA Helicobacter pylori strains in gastro-oesophageal reflux disease

“…Some studies that analysed reflux populations and controls without GORD found that gastric infection with H. pylori cagA-positive may be a protective factor against the most severe forms of GORD, including Barrett's oesophagus [1,9,13,14]. In this study, by analysing a patient population with peptic ulcer and erosive gastritis/ duodenitis, we intend to verify, by means of H. pylori detection by polymerase chain reaction (PCR), whether there is a relationship between H. pylori cagA strains and GORD.…”

Clinical Usefulness of Virulence Factors of Helicobacter pylori as Predictors of the Outcomes of Infection. What is the Evidence?

“…Studies that did not evaluate CagA antibodies found that H. pylori infection prevalence was lower in patients with oesophageal neoplasm (32), GERD and Barrett's disease (33,34), and Barrett's adenocarcinoma (35) than in control patients. Studies of a series of cases that evaluated the presence of CagA antibodies, observed also a protective effect of colonization by CagA positive strains against Barrett's oesophagus (36,37) and GERD (38). Finally, a case-control study (Table II) based on population controls, observed that H. pylori infection with CagA positive strain was significantly associated with a reduced risk of oesophageal and gastric cardia adenocarcinoma (39).…”

“…The prevalence of infection (86) with strains type I (expressing CagA and VagA) is very high (79%), irrespective of the gastroduodenal disease of the host, showing that these virulent factors cannot be used as markers of the risk of severity. In other countries, on the contrary, in a series of cases vacA s1, cagA genotypes of H. pylori were more likely associated with peptic ulcer (24) and less likely associated with GERD (38). A study with patients infected by H. pylori in Colombia and Portugal (62) found that H. pylori vacA s1 and vacA m1 genotypes were associated with higher H. pylori density, atrophy, inflammatory infiltrates and epithelial damage.…”

Prevalence of Helicobacter pylori genotypes in patients with gastroduodenal pathology in Kazan

“…Раз-личают две аллельные формы этого гена -iceA1 и iceA2. Известно, что iceA1 чаще ас-социирован с язвенной болезнью, iceA2 -с развитием хронического гастрита [7][8][9][10].…”

“…Эти показатели оказались ниже, чем у взрослых, среди которых iceA1 встречался в 55,2% случаев (32 пациента), что в значительной мере согласуется с по-лученными ранее в нашем регионе резуль-татами [20], а также с литературными дан-ными [7][8][9][10].…”