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亚洲和西方人群中幽门螺杆菌hopQ基因型与临床结局的关系。

Relationship between Helicobacter pylori hopQ genotype and clinical outcome in Asian and Western populations.

作者信息

Ohno Tomoyuki, Sugimoto Mitsushige, Nagashima Aiko, Ogiwara Hiroaki, Vilaichone Ratha-Korn, Mahachai Varocha, Graham David Y, Yamaoka Yoshio

机构信息

Department of Medicine, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas 77030, USA.

出版信息

J Gastroenterol Hepatol. 2009 Mar;24(3):462-8. doi: 10.1111/j.1440-1746.2008.05762.x. Epub 2009 Feb 15.

Abstract

BACKGROUND AND AIMS

Outer membrane proteins of Helicobacter pylori mediate important pathogen-host interactions such as colonization, adhesion and the inflammatory response. hopQ genotypes have been suggested to be associated with increased risk of peptic ulcer. The aim of this study was to test the relation of hopQ genotype to H. pylori-related disease and histological changes in Asian and Western countries.

METHODS

hopQ genotype, cagA status and vacA genotype of H. pylori isolated from patients from Asian and Western countries were determined and the results were compared with the clinical presentation and gastric histology.

RESULTS

Most Asian strains possessed virulent genotypes (hopQ type I, vacA s1-m1 and cagA-positive). In Western countries, hopQ type I genotype was significantly linked with vacA s1 and m1 genotypes and cagA-positive status. Inflammatory cell infiltration and atrophy scores were significantly higher in patients with hopQ type I strains than those with type II in Western patients. However, the hopQ type I genotype was not associated with an increased risk for peptic ulcer or gastric cancer, and had no additive effects to vacA genotypes or cagA-positive status.

CONCLUSION

The expression of multiple putative virulence factors in Asian strains likely explains the relatively high incidence of clinical outcomes including gastric cancer compared with other parts of the world. Although hopQ genotype did not improve the predictive value above other genotyping for development of H. pylori-related gastroduodenal diseases, the hopQ genotype might be able to add a useful virulence marker for gastroduodenal diseases.

摘要

背景与目的

幽门螺杆菌外膜蛋白介导重要的病原体-宿主相互作用,如定植、黏附及炎症反应。有研究表明hopQ基因型与消化性溃疡风险增加有关。本研究旨在检测亚洲和西方国家中hopQ基因型与幽门螺杆菌相关疾病及组织学变化之间的关系。

方法

对来自亚洲和西方国家患者分离出的幽门螺杆菌进行hopQ基因型、cagA状态及vacA基因型检测,并将结果与临床表现和胃组织学进行比较。

结果

大多数亚洲菌株具有毒力基因型(hopQ I型、vacA s1-m1和cagA阳性)。在西方国家,hopQ I型基因型与vacA s1和m1基因型及cagA阳性状态显著相关。在西方患者中,感染hopQ I型菌株的患者炎症细胞浸润和萎缩评分显著高于感染II型菌株的患者。然而,hopQ I型基因型与消化性溃疡或胃癌风险增加无关,对vacA基因型或cagA阳性状态也无叠加作用。

结论

与世界其他地区相比,亚洲菌株中多种假定毒力因子的表达可能解释了包括胃癌在内的临床结局相对较高的发病率。尽管hopQ基因型在预测幽门螺杆菌相关胃十二指肠疾病发生方面并没有比其他基因分型更有优势,但hopQ基因型可能为胃十二指肠疾病增添一个有用的毒力标志物。

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