在突尼斯患者中幽门螺杆菌 vacA、cagA、iceA 和 oipA 基因型的流行情况。
Prevalence of Helicobacter pylori vacA, cagA, iceA and oipA genotypes in Tunisian patients.
机构信息
Microbiology laboratory/UR04SP08 Rabta University Hospital, Tunis, Tunisia.
出版信息
Ann Clin Microbiol Antimicrob. 2010 Mar 19;9:10. doi: 10.1186/1476-0711-9-10.
BACKGROUND
Distinct virulence factors of H. pylori have been described: the vaculating cytotoxin (vacA), the cytotoxin associated gene (cagA), the induced by contact with epithelium factor Antigen (iceA gene) and the outer membrane protein oipA. In Tunisia, there are no data regarding the pattern of H. pylori genotypes; therefore, this prospective and multicentre study was the first to be done in Tunisia and aimed to investigate the prevalence of the vacA, cagA, iceA and oipA genotypes of H. pylori isolates from Tunisian patients with peptic ulceration, gastric cancer, MALT lymphoma and gastritis.
METHODS
H. pylori was cultured from endoscopic biopsies obtained from 281 Tunisian patients. The vacA alleles, cagA, iceA and oipA genotypes were determined by PCR.
RESULTS
The vacA s1m1, s1m2 and s2m2 were respectively found in 10.7%, 12.5% and 45.6% of strains. The s2m1 genotype was not detected in our study. The cagA was found in 61.6% of isolates. The iceA1 and the iceA2 genotypes were respectively isolated in 60.2% and in 16% of strains. The oipA genotype was detected in 90.8% of strains. Considering the vacA and iceA genotypes, the presence of multiple H. pylori strains in a single biopsy specimen was found respectively in 31.4% and 23.8%. The comparison between strains isolated from antrum and fundus showed that Tunisian patients were infected with two or more strains of different cagA, vacA, iceA and oipA genotypes and the discordance was respectively in 9.6%, 4.6%, 8.9% and 8.5% of strains.
CONCLUSION
Our results showed that in 46% (131 strains among 281), the H. pylori strains were highly virulent in relation of the three or four virulent factors they could carry. These finding were described before in the literature. Tunisian patients were colonized by one or multiple strains of H. pylori in the same time in relation of presence of vacA m1/m2 and iceA1/iceA2 in the same biopsy. The discordance between strains isolated from antrum and fundus was high, and it is in favour of multicolonization.
背景
幽门螺杆菌具有不同的毒力因子，包括空泡细胞毒素（vacA）、细胞毒素相关基因（cagA）、上皮接触诱导因子抗原（iceA 基因）和外膜蛋白 oipA。在突尼斯，尚未有关于幽门螺杆菌基因型模式的相关数据。因此，本项前瞻性、多中心研究在突尼斯首次进行，旨在调查空泡细胞毒素（vacA）、细胞毒素相关基因（cagA）、上皮接触诱导因子抗原（iceA 基因）和外膜蛋白 oipA 基因型在突尼斯消化性溃疡、胃癌、黏膜相关淋巴组织淋巴瘤和胃炎患者中幽门螺杆菌分离株的流行情况。
方法
从 281 例突尼斯患者的内镜活检中培养幽门螺杆菌。通过 PCR 确定 vacA 等位基因、cagA、iceA 和 oipA 基因型。
结果
分别在 10.7%、12.5%和 45.6%的菌株中发现 vacA s1m1、s1m2 和 s2m2。在本研究中未检测到 s2m1 基因型。61.6%的分离株存在 cagA。iceA1 和 iceA2 基因型分别在 60.2%和 16%的菌株中分离。90.8%的菌株检测到 oipA 基因型。考虑到 vacA 和 iceA 基因型，在 31.4%和 23.8%的单个活检标本中发现了单一菌株中存在多种幽门螺杆菌。在胃窦和胃底分离的菌株之间进行比较，发现突尼斯患者感染了两种或更多具有不同 cagA、vacA、iceA 和 oipA 基因型的菌株，其不一致性分别为 9.6%、4.6%、8.9%和 8.5%的菌株。
结论
我们的结果表明，在 46%（281 例中有 131 例）的情况下，幽门螺杆菌菌株携带三种或四种毒力因子，具有高度的毒力。这些发现之前在文献中已经描述过。在同一活检中，由于 vacA m1/m2 和 iceA1/iceA2 的存在，同时存在一种或多种幽门螺杆菌菌株，在突尼斯患者中同时定植。胃窦和胃底分离的菌株之间的不一致性很高，这有利于多定植。
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