Gomes Luciana I, Rocha Gifone A, Rocha Andreia M C, Soares Taciana F, Oliveira Celso A, Bittencourt Paulo F S, Queiroz Dulciene M M
Laboratory of Research in Bacteriology, Faculdade de Medicina, Universidade Federal de Minas Gerais, Av. Alfredo Balena, 190/4026, CEP 30130-100, Belo Horizonte, MG, Brazil.
Int J Med Microbiol. 2008 Apr;298(3-4):223-30. doi: 10.1016/j.ijmm.2007.05.006. Epub 2007 Sep 25.
Duodenal ulcer-promoting gene (dupA) was recently described as a new putative Helicobacter pylori virulence marker associated with an increased risk for duodenal ulcer and reduced risk for gastric carcinoma in Japan and Korea. Since differences regarding the association among H. pylori markers and H. pylori-associated diseases have been demonstrated around the world, we evaluated the presence of the gene in 482 strains from Brazilian children (34 with duodenal ulcer and 97 with gastritis) and adults (126 with duodenal ulcer, 144 with gastritis and 81 with gastric carcinoma) by PCR using the described primers and an additional set of primers based on Brazilian strain sequences. The results were confirmed by sequencing. The presence of cagA was investigated by PCR and also included in the analysis. dupA was present in 445 (92.32%) and absent in 29 (6.02%) strains. All samples from children with and without duodenal ulcer were dupA-positive (p=1.0). No association was observed among the strains from adults with gastritis (92.36%), duodenal ulcer (87.30%, p=0.30) and gastric carcinoma (87.65%, p=0.31). Conversely, cagA-positve status remained independently associated with duodenal ulcer (children: odds ratios (OR)=5.58, 95% confidence intervals (CI)=1.67-18.50; adults: OR=3.33, 95% CI=2.14-5.19) and gastric carcinoma (OR=6.58, 95% CI=3.51-12.30) in multivariate analyses. The presence of dupA was significantly higher in strains from children than in those from adults (p=0.01). In conclusion, dupA is highly frequent and not associated with H. pylori-associated diseases in both Brazilian adults and children, which points to regional differences in the distribution of the gene.
十二指肠溃疡促进基因(dupA)最近被描述为一种新的假定幽门螺杆菌毒力标志物,在日本和韩国,它与十二指肠溃疡风险增加及胃癌风险降低相关。由于世界各地已证实幽门螺杆菌标志物与幽门螺杆菌相关疾病之间的关联存在差异,我们使用所述引物及基于巴西菌株序列的另一组引物,通过聚合酶链反应(PCR)评估了来自巴西儿童(34例十二指肠溃疡患者和97例胃炎患者)及成人(126例十二指肠溃疡患者、144例胃炎患者和81例胃癌患者)的482株菌株中该基因的存在情况。结果通过测序得以证实。通过PCR检测cagA的存在情况,并将其纳入分析。dupA存在于445株(92.32%)菌株中,29株(6.02%)菌株中不存在。所有患十二指肠溃疡和未患十二指肠溃疡儿童的样本均为dupA阳性(p = 1.0)。在患有胃炎的成人(92.36%)、十二指肠溃疡的成人(87.30%,p = 0.30)和胃癌的成人(87.65%,p = 0.31)的菌株中未观察到关联。相反,在多变量分析中,cagA阳性状态仍与十二指肠溃疡(儿童:比值比(OR)= 5.58,95%置信区间(CI)= 1.67 - 18.50;成人:OR = 3.33,95% CI = 2.14 - 5.19)和胃癌(OR = 6.58,95% CI = 3.51 - 12.30)独立相关。儿童菌株中dupA的存在率显著高于成人菌株(p = 0.01)。总之,dupA在巴西成人和儿童中均高度常见,且与幽门螺杆菌相关疾病无关,这表明该基因的分布存在区域差异。