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The outcome of  H .  pylori  infection is closely related with bacteria's virulence factors and host immune response. The association between T cells and  H .  pylori  infection has been identified, but the effects of the nine major  H .  pylori  specific virulence factors;  cagA ,  vacA ,  oipA ,  babA ,  hpaA ,  napA ,  dupA ,  ureA ,  ureB  on T cell response in  H .  pylori  infected patients have not been fully elucidated. We developed a multiplex- PCR assay to detect nine  H .  pylori  virulence genes with in a three PCR reactions. Also, the expression levels of Th1, Th17 and Treg cell specific cytokines and transcription factors were detected by using qRT-PCR assays. Furthermore, a novel expert derived model is developed to identify set of factors and rules that can distinguish the ulcer patients from gastritis patients. Within all virulence factors that we tested, we identified a correlation between the presence of  napA  virulence gene and ulcer disease as a first data. Additionally, a positive correlation between the  H .  pylori dupA  virulence factor and IFN-γ, and  H .  pylori babA  virulence factor and IL-17 was detected in gastritis and ulcer patients respectively. By using computer-based models, clinical outcomes of a patients infected with  H .  pylori  can be predicted by screening the patient's  H .  pylori vacA m1/m2 ,  ureA  and  cagA  status and IFN-γ (Th1), IL-17 (Th17), and FOXP3 (Treg) expression levels. Herein, we report, for the first time, the relationship between  H .  pylori  virulence factors and host immune responses for diagnostic prediction of gastric diseases using computer—based models.

plos one

Multiplex-PCR-Based Screening and Computational Modeling of Virulence Factors and T-Cell Mediated Immunity in Helicobacter pylori Infections for Accurate Clinical Diagnosis