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Background  In 2005, the first disease-specific  Helicobacter pylori  virulence factor that induced duodenal ulcer and had a suppressive action on gastric cancer has been identified, and was named duodenal ulcer promoting gene ( dupA ). However, the importance of the  dupA  gene on clinical outcomes is conflicting in subsequent studies. The aim of this study was to estimate the magnitude of the risk for clinical outcomes associated with  dupA  gene.    Methods  A meta-analysis of case-control studies which provided raw data on the infection rates with the  dupA -positive  H. pylori  detected by polymerase chain reaction was performed.    Results  Seventeen studies with a total of 2,466 patients were identified in the search. Infection with the  dupA -positive  H. pylori  increased the risk for duodenal ulcer by 1.41-fold (95% confidence interval [CI], 1.12-1.76) overall. Subgroup analysis showed that the summary odds ratio (OR) was 1.57 (95% CI, 1.19-2.06) in Asian countries and 1.09 (95% CI, 0.73-1.62) in Western countries. There was no association between the presence of the  dupA  gene and gastric cancer and gastric ulcer. Publication bias did not exist.    Conclusion  Our meta-analysis confirmed the importance of the presence of the  dupA  gene for duodenal ulcer, especially in Asian countries.

Systematic review and meta-analysis: the relationship between the Helicobacter pylori dupA gene and clinical outcomes