Different Distribution of Helicobacter pylori EPIYA- cagA Motifs and dupA Genes in the Upper Gastrointestinal Diseases and Correlation with Clinical Outcomes in Iranian Patients
AbstractBackground: Pathogenicity ofthe Helicobacter pylori-cagA positive was associated with EPIYAmotifs and higher number of EPIYA-C segments is a risk for gastric cancer,while duodenal ulcer-promoting gene (dupA) is determinedas a protective factor against gastric cancer. Our aim was to determine the EPIYA-cagAPhosphorylation sites and dupA gene in H. pylori isolates amongpatients with upper gastrointestinal diseases. Materials and methodsA total of 128 non repeated gastric biopsies obtained from patientsundergoing endoscopy were included in the study from January 2013 till July2013. Samples were cultured on selective horse blood agar. Isolated organismswere identified as H. pylori by Gram staining and positive oxidase,catalase, and urease tests. Variousmotif types of cagA and prevalence of dupA were determined by PCR method. ResultsOf 120 H. pylori isolates,35.9% were dupA positive and 56.26% werecagA positive, while cagAwithABC and ABCC motifswere 55.5% and 44.5%, respectively. Fifty six percent of isolates with the ABCC motif have had dupAgenesand we also found a significant relationship betweenstrains with genotypes of dupA-ABCand DU disease (p = 0.007). ConclusionTheresults of this study showed that theprevalence of cagA-positive H. pylori in Shiraz are as high as inwestern countries and Higher numbers of EPIYA-C segments were seen in GCpatients. Wealso can use dupA as a prognosticand pathogenic marker for duodenal ulcer disease and cagA with the segment C forgastric cancer and gastric ulcer in thisregion.
Helicobacter pylori, Gastric Cancer, cagAmotifs, dupA gene, gastrointestinal disease