沙特阿拉伯西南部消化不良患者中幽门螺杆菌vacA、cagA和iceA基因型：分布及其与临床结局和组织病理学变化的关联

Helicobacter pylori vacA, cagA and iceA genotypes in dyspeptic patients from southwestern region, Saudi Arabia: distribution and association with clinical outcomes and histopathological changes.

作者信息

Akeel Mohammed, Shehata Atef, Elhafey Ahmed, Elmakki Erwa, Aboshouk Thanaa, Ageely Hussein, Mahfouz Mohammed

机构信息

Department of Anatomy, Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia.

Department of Microbiology and Immunology, Faculty of Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia.

出版信息

BMC Gastroenterol. 2019 Jan 25;19(1):16. doi: 10.1186/s12876-019-0934-z.

DOI:10.1186/s12876-019-0934-z

PMID:30683054

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6346553/

Abstract

BACKGROUND

The aim of this study was to identify the common H. pylori virulence genes among dyspeptic Southwestern Saudi patients and their association with clinical outcomes and histopathological findings to help practitioners and researchers in the region for better management of infections caused by such bacteria.

METHODS

Four hundred two gastric biopsy specimens were analyzed using histopathological examination and real time-PCR. The positive 187 specimens by RT-PCR were genotyped using PCR targeting cagA, vacA and iceA genes.

RESULTS

One hundred twenty-eight gastric biopsy specimens were positive in genotyping PCRs. The cagA, vacA, iceA1 and iceA2 genes were detected in rates of 49.2% (63/128), 100%(128/128), 42.2% (54/128), 32.8% (42/128), respectively. The vacA s1as1bm2 subtype was the highest 23.4% (30/128), followed by m2 and s1a1b subtypes which were equally detected [16.4% (21/128) for each]. The iceA genes were significantly associated with gastritis and gastric ulcer. Overall, vacA genotypes were significantly associated with gastritis, gastric and duodenal ulcers. The vacA subtypes: s1as1bm2, s1a1b and s2 m2 showed chronic active gastritis in percentages of 90.0, 81, and 84.2%, respectively. All vacA mixed genotypes showed chronic active gastritis.

CONCLUSIONS

H. pylori virulence genes are highly prevalent and diverse among patients with dyspepsia in Southwestern region of Saudi Arabia. The iceA genes and the different vacA subtypes are significantly associated with the clinical outcomes and histopathological changes especially chronic active gastritis.

摘要

背景

本研究旨在确定沙特西南部消化不良患者中常见的幽门螺杆菌毒力基因，以及它们与临床结果和组织病理学发现之间的关联，以帮助该地区的从业者和研究人员更好地管理此类细菌引起的感染。

方法

使用组织病理学检查和实时聚合酶链反应（PCR）对402份胃活检标本进行分析。对187份实时PCR检测呈阳性的标本，采用针对细胞毒素相关基因A（cagA）、空泡毒素A（vacA）和冰结合蛋白A（iceA）基因的PCR进行基因分型。

结果

128份胃活检标本基因分型PCR呈阳性。cagA、vacA、iceA1和iceA2基因的检出率分别为49.2%（63/128）、100%（128/128）、42.2%（54/128）、32.8%（42/128）。vacA s1as1bm2亚型占比最高，为23.4%（30/128），其次是m2和s1a1b亚型，二者占比相同[均为16.4%（21/128）]。iceA基因与胃炎和胃溃疡显著相关。总体而言，vacA基因型与胃炎、胃溃疡和十二指肠溃疡显著相关。vacA亚型s1as1bm2、s1a1b和s2 m2的慢性活动性胃炎发生率分别为90.0%、81%和84.2%。所有vacA混合基因型均表现为慢性活动性胃炎。