Khan Adnan, Farooqui Amber, Raza Yasir, Rasheed Faisal, Manzoor Hamid, Akhtar Syed Shakeel, Quraishy Muhammad Saeed, Rubino Salvatore, Kazmi Shahana U, Paglietti Bianca
Immunology and Infectious Diseases Research Laboratory, Department of Microbiology, University of Karachi, Pakistan.
J Infect Dev Ctries. 2013 Mar 14;7(3):220-8. doi: 10.3855/jidc.2942.
The etiological association of Helicobacter pylori with gastric ulcer (GU), gastric cancer (GC), and duodenal ulcer (DU) is well-known. Understanding the epidemiology of H. pylori facilitates the estimation of disease burden in a certain population. This study presents the diversity of H. pylori genotypes and their association with different clinical outcomes among dyspeptic patients in Pakistan over a period of four years.
Gastric biopsy samples from a total of 450 dyspeptic individualswere subjected to PCR, genotypingand histology.
A total of 201 (45%) cases were found positive for H. pylori. The detection rate was high in GU (91%), DU (86%) and GC (83%) cases compared with those cases who had intact gastric mucosa (18%). Histology revealed the presence of infection in 68% of cases of mild/chronic nonspecific gastritis with others belonging to the GU sequel. cagA gene carriage was observed in 104 (51%) cases or mostly from DU, GU and GC groups, of which 97 were Western type strains while 3 were East-Asian type strains that are rarely observed in South Asia. vacA allelic variant s1am1 was most commonly observed, followed by s1am2, and s1bm1, with direct correlation in diseased cases (gastritis, GU, DU and GC). Prevalent genotypic combinations were s1am1/cagA- in gastritis and s1am1/cagA+ in DU, GU, and GC.
Our study indicates the predominant circulation of Western type cagA and vacAs1am1 type H. pylori strains in Pakistan.
幽门螺杆菌与胃溃疡（GU）、胃癌（GC）和十二指肠溃疡（DU）之间的病因学关联已广为人知。了解幽门螺杆菌的流行病学有助于估计特定人群中的疾病负担。本研究呈现了四年期间巴基斯坦消化不良患者中幽门螺杆菌基因型的多样性及其与不同临床结局的关联。
对总共450名消化不良个体的胃活检样本进行聚合酶链反应（PCR）、基因分型和组织学检查。
总共201例（45%）幽门螺杆菌检测呈阳性。与胃黏膜完整的患者（18%）相比，GU（91%）、DU（86%）和GC（83%）患者的检测率较高。组织学检查显示，68%的轻度/慢性非特异性胃炎病例存在感染，其他病例属于GU后遗症。在104例（51%）病例中观察到cagA基因携带，主要来自DU、GU和GC组，其中97株为西方型菌株，3株为东亚型菌株，在南亚很少见。vacA等位基因变体s1am1最常见，其次是s1am2和s1bm1，在患病病例（胃炎、GU、DU和GC）中呈直接相关。常见的基因型组合在胃炎中为s1am1/cagA -，在DU、GU和GC中为s1am1/cagA +。
我们的研究表明，西方型cagA和vacAs1am1型幽门螺杆菌菌株在巴基斯坦占主导地位。
