Synergistic Effect of Helicobacter pylori Virulence Factors and Interleukin‐1 Polymorphisms for the Development of Severe Histological Changes in the Gastric Mucosa (original) (raw)
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Journal of Infection and Public Health, 2012
Introduction: Several factors have been suggested to account for differences in the virulence of Helicobacter pylori infections in various populations. Evidence suggests the existence of different strains of H. pylori with different degrees of virulence. The present study aimed to investigate the gastric histopathology in Iranian patients infected with H. pylori and to investigate the relationship between the severity of gastritis and four different bacterial virulence-associated genotypes. Methods and materials: All of the patients with positive results from a pathological examination, a rapid urease test, and PCR analysis for H. pylori infection were consecutively included into the study. The classification and grading of gastritis were performed according to the Sydney System. Esophagitis was classified endoscopically according to the Savary-Miller grading system. The primers used in this study targeted 16S rRNa ), Urease A (411 bp), Cag A (400 bp), and 26 kDa (303 bp). JIPH-145; No. of Pages 6 2 H. Khedmat et al.
Frequency of virulence factors in Helicobacter pylori-infected patients with gastritis
Microbial Pathogenesis, 2015
The outcome of Helicobacter pylori infection has been related to specific virulence-associated bacterial genotypes. The vacuolating cytotoxin (vacA), cagA gene, oipA and babA2 gene are important virulence factor involving gastric diseases. The objective of this study was to assess the relationship between virulence factors of H. pylori and histopathological findings. Material and methods: Gastroduodenoscopy was performed in 436 dyspeptic patients. Antrum biopsy was obtained for detection of H. pylori, virulence factors and for histopathological assessment. The polymerase chain reaction was used to detect virulence factors of H. pylori using specific primers. Results: vacA genotypes in patients infected with H. pylori were associated with cagA, iceA1 and iceA2. In the patients with H. pylori infection there was a significant relationship between cagA positivity and neutrophil activity (P ¼ 0.004) and chronic inflammation (P ¼ 0.013) and with H. pylori density (P ¼ 0.034). Neutrophil infiltration was found to be more severe in the s1 group than in the s2 group (P ¼ 0.042). Also was a significant relationship between oipA positivity and neutrophil activity (P ¼ 0.004) and with H. pylori density (P ¼ 0.018). No significant relationships were observed between other vacA genotypes and histopathological parameters. Conclusion: H. pylori strains showing cagA, vacA s1 and oipA positivity are associated with more severe gastritis in some histological features but virulence factors of H. pylori do not appear to determine the overall pattern of gastritis.
Helicobacter pylori Infection and Related Gastrointestinal Diseases
Journal of Clinical Gastroenterology, 2007
Helicobacter pylori has been implicated in the pathogenesis of a number of digestive tract disorders, such as chronic active gastritis, peptic ulceration, gastric cancer, and mucosa-associated lymphoid tissue lymphoma. Disease outcome is dependent on many factors, including bacterial genotype, host physiology and genetics, and environmental factors such as diet. Researchers continue to explore the complexities of H. pylori infection, seeking to explain why some individuals have asymptomatic infection, whereas others experience clinical disease. The importance of treating H. pylori infection in patients with gastrointestinal problems has been confirmed in recent years, with clinical trials showing that cure of infection can prevent duodenal ulcer and, to a lesser extent, gastric ulcer recurrence; cure early stage mucosa-associated lymphoid tissue lymphoma; and reduce the chances of developing gastric cancer in high-risk individuals.
Prevalence of Helicobacter pylori infection and intestinal
AIM: To investigate the seroprevalence of Helicobacter pylori (H pylori ) infection and its more virulent strains as well as the correlation with the histologic features among patients who had undergone surgery for gastric cancer (GC). METHODS: Samples from 317 (184 males, 133 females, mean age 69±3.4 years) consecutive patients who had undergone surgery for gastric non-cardia adenocarcinoma were included in the study. Five hundred and fifty-five (294 males, 261 females, mean age 57.3±4.1 years) patients consecutively admitted to the Emergency Care Unit served as control. Histological examination of tumor, lymph nodes and other tissues obtained at the time of surgery represented the diagnostic “gold standard”. An enzyme immunosorbent assay was used to detect serum anti-H pylori (IgG) antibodies and Western blotting technique was utilized to search for anti-CagA protein (IgG). RESULTS: Two hundred and sixty-one of three hundred and seventeen (82.3%) GC patients and 314/555 (56.5%) controls were seropositive for anti-H pylori (P <0.0001; OR, 3.58; 95%CI, 2.53-5.07). Out of the 317 cases, 267 (84.2%) were seropositive for anti-CagA antibody vs 100 out of 555 (18%) controls (P <0.0001; OR, 24.30; 95%CI, 16.5-35.9). There was no difference between the frequency of H pylori in intestinal type carcinoma (76.2%) and diffuse type cancer (78.8%). Intestinal metaplasia (IM) was more frequent but not signifi cant in the intestinal type cancer (83.4% vs 75.2% in diffuse type and 72.5% in mixed type). Among the patients examined for IM, 39.8% had IM type I, 8.3% type II and 51.9% type Ⅲ (type Ⅲvs others, P = 0.4). CONCLUSION: T h i s s t u d y c o n f i r m s a h i g h seroprevalence of H pylori infection in patients suffering from gastric adenocarcinoma and provides further evidence that searching for CagA status over H pylori infection might confer additional benefit in identifying populations at greater risk for this tumor
Pattern of gastritis as manipulated by current state of Helicobacter pylori infection
wseas.us
Helicobacter pylori (H. pylori) infection prevails from 60-80% in patients with gastric ulcer and 90-100% in those having duodenal ulcer. Patients with such type of chronic infection are at increased risk to develop peptic ulcers or gastric adenocarcinomas. The present work aims mainly to identify the pattern of chronic gastritis and potential effect of H. pylori infection using certain biomarkers, histological and immunochemical tests. Fifty eight individuals, clinically diagnosed as having chronic gastritis, were participated in the present study. They were categorized into 2 groups, the first one (31%) demonstrated positive reaction to IgM antibodies of Helicobacter pylori (H. pylori) (>40u/ml) and the second group (69%) demonstrated negative reaction. Blood and antral biopsy samples were collected, directed to determination of serum gastrin, pepsinogen I (PgI), pepsinogen II (PgII), prostaglandin E 2 (PGE 2) and interlukin-6 (IL-6). Immunohistochemistry technique was also done in antral biopsy to demonstrate the expression of inducible nitric oxide synthase (iNOS), nitrotyrosine, DNA fragmentation, myeloperoxidase and histopathological examination. Serum gastrin, PgI, PgII, PGE 2 , IL-6 demonstrated significant increase in gastritis patients as compared to normal group. PgI, PgII showed significant increase joined with slight increase of IL-6 in IgM positive group as compared to negative one. Immunostaining testes in antral biopsy showed strong positive reactions for the above mentioned markers as compared to IgM negative group (mild positive reaction). In conclusion, gastritis patients who express IgM antibodies for H. pylori infection showed higher gastrinaemia and more pronounced atrophic, inflammatory and apoptotic damage than those not expressing IgM antibodies.
Helicobacter pylori Endemic and Gastric Disease
Digestive Diseases and Sciences, 2005
infection of the stomach is widespread among human populations including Iranians and is considered to play a major role in the pathogenesis of gastric diseases such as peptic ulcer, adenocarcinoma, and MALT lymphoma. The association between H. pylori virulence markers and disease has been studied in other populations around the world. The aim of this study was to investigate the distribution of H. pylori vacA and cagA genotypes and their association with clinical outcomes in Iran. H. pylori was cultured from gastric biopsy specimens obtained from 137 Iranian patients (58 with duodenal ulcer, 61 with nonulcer dyspeptic [NUD], and 18 with gastric adenocarcinoma). The vacA alleles and cagA genotypes were determined by PCR. The vacA sl allele was present in 107 of the 137 subjects (78%). Multiple strains (m1 and m2) were detected in H. pylori isolates from the patients. VacA s1 genotypes were more frequent in patients with peptic ulcer (46/58; 79%) than in NUD patients (47/61; 77%). CagA was present in 44% of the patients. NUD patients had a frequency of cagA positivity similar to that of the overall population (46%). CagA was present more frequently more than cagA-negative (20% vs. 8%, respectively) in patients with gastric carcinoma (20%) than cagAnegative in patients with gastric carcinoma (8%). This is the first comprehensive study to demonstrate the frequency of colonization with mixed strain, vacA s1, m1 and m2 as the dominant genotype in these Iranian patients, where a high rate of H. pylori infection exists and is similar to the region with a low rate of H. pylori infection. Therefore, host genetics, environmental factors, and the substantial genetic heterogeneity among different H. pylori strains may contribute to the different clinical outcomes.
Alimentary Pharmacology and Therapeutics, 2004
Background: The host genetic factors that determine the clinical outcomes of Helicobacter pylori-infected individuals remain unclear. Aim: To elucidate the risks of host interleukin-1 (IL-1) genetic polymorphisms and H. pylori infection in the development of gastric cancer. Methods: In a case-control study of 164 controls and 142 patients with gastric cancer, the IL-1B-511 biallelic polymorphisms and the IL-1RN penta-allelic variable number of tandem repeats were genotyped. Results: The carriage of IL-1RN*2, male gender, old age and H. pylori infection independently increased the risk of gastric cancer, with odds ratios of 3.3 [95% confidence interval (CI), 1.4-7.7], 2.1 (95% CI, 1.2-3.8), 5.3 (95% CI, 3.1-9.0) and 2.2 (95% CI, 1.3-3.8), respectively. H. pylori-infected individuals who were carriers of IL-1RN*2 showed increased risks of both intestinal and diffuse types of gastric cancer, with odds ratios of 11.0 and 8.7, respectively. In addition, these individuals also had a higher score of intestinal metaplasia in the corpus than did uninfected non-carriers. Conclusions: This study is the first to verify IL-1RN*2 as an independent factor governing the development of gastric cancer in Asian individuals. A combination of H. pylori testing and host genotyping may target the eradication of H. pylori to high-risk individuals.