Yin Yan, Zhang Jian-zhong, Wang Zhen-yu, Xia Hua-xiang, Lin Zhao-xin
Institute Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2003 Feb;24(2):123-6.
A number of putative virulence factors have been postulated to be relevant to the clinical outcome of Helicobacter pylori infection based on strains identified in the western countries. The aim of this study was to investigate the association between genotypes of vacA, cagA and iceA and duodenal ulcer disease in patients from Hong Kong.
Seventy-two dyspeptic patients with or without duodenal ulcer disease, with proven H.pylori infection, were studied. Gastric biopsy specimens were analyzed by specific polymerase chain reaction and Southern blot to determine the genotypes of these virulence factors.
Except 6 (8.3%) cases with evidence of multiple infections, all of the remaining 66 cases had vacA signal sequence s1 type strains. Twenty-seven (90%) of the 30 cases with duodenal ulcers were infected with cagA-positive strains, compared with 32 (88.9%) of 36 with non-ulcer dyspepsia (P > 0.05). Similarly, vacA middle region sequences were detected with no significant difference in the two groups, 9 (30.0%) versus 13 (36.1%) for m1b and 21 (70.0%) versus 23 (63.9%) for m2 type. IceA1 subtype was detected in the same frequency in 42 (63.6%) of the 66 cases. Neither cagA nor vacA and iceA were associated with duodenal ulcer disease.
No clear differences were found in the distribution of cagA, vacA and iceA genotypes among patients with duodenal ulcer or non-ulcer dyspepsia. The association of these virulence genes and duodenal ulcer disease needs reappraisal, particularly under geographic considerations.
基于在西方国家鉴定出的菌株，已推测出一些假定的毒力因子与幽门螺杆菌感染的临床结局相关。本研究的目的是调查香港患者中vacA、cagA和iceA基因型与十二指肠溃疡疾病之间的关联。
对72例经证实感染幽门螺杆菌的消化不良患者进行研究，这些患者有或无十二指肠溃疡疾病。通过特异性聚合酶链反应和Southern印迹法分析胃活检标本，以确定这些毒力因子的基因型。
除6例（8.3%）有多重感染证据的病例外，其余66例均为vacA信号序列s1型菌株。30例十二指肠溃疡患者中有27例（90%）感染了cagA阳性菌株，相比之下，36例非溃疡性消化不良患者中有32例（88.9%）感染了cagA阳性菌株（P>0.05）。同样，两组中vacA中间区域序列的检测结果无显著差异，m1b型分别为9例（30.0%）和13例（36.1%），m2型分别为21例（70.0%）和23例（63.9%）。66例中的42例（63.6%）以相同频率检测到IceA1亚型。cagA、vacA和iceA均与十二指肠溃疡疾病无关。
十二指肠溃疡患者和非溃疡性消化不良患者中cagA、vacA和iceA基因型的分布没有明显差异。这些毒力基因与十二指肠溃疡疾病的关联需要重新评估，特别是考虑到地理因素。
