Open AccessClinical relevance of the cag A, vac A and ice A genotypes of Helicobacter pylori in Brazilian clinical isolates
Author(s) -
Ribeiro Marcelo Lima,
Godoy Anita Paula Ortiz,
Benvengo Yune Helena Borges,
Mendonça Sergio,
Pedrazzoli José
Publication year - 2003
Publication title -
fems immunology & medical microbiology
Language(s) - English
Resource type - Journals
eISSN - 1574-695X
pISSN - 0928-8244
DOI - 10.1016/s0928-8244(03)00029-4
Subject(s) - caga , helicobacter pylori , genotype , virulence , gerd , gastroenterology , gastritis , spirillaceae , medicine , disease , biology , odds ratio , reflux , gene , genetics
Infection with Helicobacter pylori strains harboring determinants of pathogenicity may lead to a strong inflammatory response in gastric mucosa. In this work, we examined the frequency of the cag A, vac A and ice A genotypes in H. pylori strains isolated from Brazilian patients and correlated these with the clinical manifestations. H. pylori was isolated from 165 patients [30 with non‐ulcer dyspepsia cases (NUD); 93 peptic ulcer disease (PUD): 31 gastric ulcers (GU) and 62 duodenal ulcer disease (DU); 18 with erosive gastritis (EG); and 24 gastroesophageal reflux disease (GERD)]. Allelic variants of cag A, vac A and ice A were identified using the polymerase chain reaction. More than one H. pylori strain was detected in 28 cases (17%), and these were excluded from the statistical analysis. We were unable to confirm an association between ice A status and clinical outcome. There was a strong association between the genotype cag A‐positive vac A s1 and PUD. However, logistic regression analysis showed that vac A s1 was the only predictive factor for PUD ( OR=4.19 ; 95% CI 1.95–8.98). The presence of the less virulent strain vac A s2 was related to GERD ( OR=8.59 ; 95% CI 2.85–25.91). Our results support the hypothesis that virulent strains may protect against the development of GERD.