Saribasak Huseyin, Salih Barik A, Yamaoka Yoshio, Sander Ersan
Fatih University, Faculty of Science, Department of Biology/Microbiology Unit, Istanbul, Turkey.
J Clin Microbiol. 2004 Apr;42(4):1648-51. doi: 10.1128/JCM.42.4.1648-1651.2004.
The predominant Helicobacter pylori strains circulating among geographic locations differ in regard to genomic structure. The association of the cagA-positive, vacA s1 genotypes with peptic ulcer disease (PUD) and gastric cancer was reported in Western countries but not in East Asian countries. Strains from Western countries predominantly possessed cagA type 2a, vacA s1a or s1b/m1a, or vacA m2a genotypes, whereas strains from East Asia possessed cagA type 1a, vacA s1c/m1b, or vacA m2b genotypes. Whether the Turkish strains possessed such genotypes was investigated and correlated with the disease outcome. Seventy-three patients from Turkey were enrolled. H. pylori was detected in 65 (89%) patients (22 with gastritis, 33 with PUD, and 10 with gastric cancer) by any of the following tests: Campylobacter-like organism test, culture, or PCR. Among the H. pylori-positive patients, presence of the cagA gene (78%) was significantly associated with PUD (P < 0.00001), gastric cancer (P < 0.001), and vacA s1a genotypes (P < 0.0001). Multiple vacA genotypes were more prevalent in PUD and gastric cancer patients than in patients with gastritis. Restriction fragment length polymorphism analysis of the cagA gene revealed three different patterns with no significant association with clinical outcome. Turkish strains examined predominantly possessed cagA type 2a, vacA s1a/m1a, or vacA m2a genotypes, which were typical genotypes in strains from Western countries. This fact might be one of the reasons for the low prevalence of severe gastroduodenal diseases in Turkey compared to the East Asian countries.
不同地理位置流行的主要幽门螺杆菌菌株在基因组结构方面存在差异。在西方国家，cagA阳性、vacA s1基因型与消化性溃疡病（PUD）和胃癌有关，但在东亚国家并非如此。西方国家的菌株主要具有cagA 2a型、vacA s1a或s1b/m1a，或vacA m2a基因型，而东亚国家的菌株具有cagA 1a型、vacA s1c/m1b，或vacA m2b基因型。研究了土耳其菌株是否具有此类基因型，并将其与疾病结局相关联。招募了73名来自土耳其的患者。通过以下任何一种检测方法在65名（89%）患者中检测到幽门螺杆菌（22例胃炎、33例PUD和10例胃癌）：类弯曲杆菌检测、培养或PCR。在幽门螺杆菌阳性患者中，cagA基因的存在（78%）与PUD（P<0.00001）、胃癌（P<0.001）和vacA s1a基因型（P<0.0001）显著相关。多种vacA基因型在PUD和胃癌患者中比在胃炎患者中更普遍。cagA基因的限制性片段长度多态性分析显示出三种不同模式，与临床结局无显著关联。检测的土耳其菌株主要具有cagA 2a型、vacA s1a/m1a，或vacA m2a基因型，这些是西方国家菌株中的典型基因型。这一事实可能是土耳其严重胃十二指肠疾病患病率低于东亚国家的原因之一。
