Departamento de Gastroenterología Clínica, Hospital General Docente de Calderón, Quito, Ecuador.
Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador.
BMC Gastroenterol. 2023 Jun 6;23(1):197. doi: 10.1186/s12876-023-02838-9.
The most prevalent stomach infection in the world is caused by Helicobacter pylori (H. pylori). Several pathogenicity genes, including cagA, vacA, babA2, dupA, iceA, and oipA, are associated with an increased risk of gastrointestinal disease such as peptic ulcer and stomach cancer. This research aims to determine the prevalence of different H. pylori genotypes and correlate their risk in the development of gastrointestinal diseases in the Ecuadorian population.
A cross-sectional research of 225 patients at the Calderón Hospital in Quito, Ecuador, was conducted. End point PCRs were run to determine the presence of 16S rRNA, cagA, vacA (m1), vacA (s1), babA2, dupA, iceA1, and oipA virulence genes. Chi-square test, odds ratios (OR) and 95% confidence intervals (CI) were utilized for the statistical analysis.
H. pylori infection was present in 62.7% of people. Peptic ulcers were seen in 22.2% and malignant lesions in 3.6% of patients. Genes oipA (93.6%), vacA (s1) (70.9%), and babA2 (70.2%) were the most prevalent. cagA/vacA (s1m1) and cagA/oipA (s1m1) combinations were found in 31.2% and 22.7% of the cases, respectively. Acute inflammation has a significant correlation with the genes cagA (OR = 4.96 95% CI: 1.1-22.41), babA2 (OR = 2.78 95% CI: 1.06-7.3), and the cagA/oipA combination (OR = 4.78, 95% CI: 1.06-21.62). Follicular hyperplasia was associated with iceA1 (OR = 3.13; 95% CI: 1.2-8.16), babA2 (OR = 2.56; 95% CI: 1.14-5.77), cagA (OR = 2.19; 95% CI: 1.06-4.52), and the cagA/oipA combination (OR = 2.32, 95% CI: 1.12-4.84). The vacA (m1) and vacA (s1m1) genes were associated with gastric intestinal metaplasia (OR = 2.71 95% CI: 1.17-6.29) (OR = 2.33 95% CI: 1.03-5.24). Finally, we showed that cagA/vacA (s1m1) gene combination increased the risk of duodenal ulcer development (OR = 2.89, 95% CI 1.10-7.58).
This study makes a significant contribution by offering genotypic information regarding H. pylori infection. The presence of several H. pylori genes was associated with the onset of gastrointestinal illness in the Ecuadorian population.
世界上最常见的胃部感染是由幽门螺杆菌（H. pylori）引起的。包括 cagA、vacA、babA2、dupA、iceA 和 oipA 在内的几种致病基因与胃肠道疾病（如消化性溃疡和胃癌）的风险增加有关。本研究旨在确定不同 H. pylori 基因型的流行情况，并探讨其在厄瓜多尔人群中胃肠道疾病发展中的风险。
在厄瓜多尔基多的卡尔德隆医院进行了一项 225 例患者的横断面研究。采用终点 PCR 检测 16S rRNA、cagA、vacA（m1）、vacA（s1）、babA2、dupA、iceA1 和 oipA 毒力基因的存在情况。采用卡方检验、比值比（OR）和 95%置信区间（CI）进行统计学分析。
62.7%的人存在 H. pylori 感染。22.2%的患者患有消化性溃疡，3.6%的患者患有恶性病变。oipA（93.6%）、vacA（s1）（70.9%）和 babA2（70.2%）是最常见的基因。cagA/vacA（s1m1）和 cagA/oipA（s1m1）组合分别在 31.2%和 22.7%的病例中发现。急性炎症与基因 cagA（OR=4.96，95%CI：1.1-22.41）、babA2（OR=2.78，95%CI：1.06-7.3）和 cagA/oipA 组合（OR=4.78，95%CI：1.06-21.62）显著相关。滤泡增生与 iceA1（OR=3.13，95%CI：1.2-8.16）、babA2（OR=2.56，95%CI：1.14-5.77）、cagA（OR=2.19，95%CI：1.06-4.52）和 cagA/oipA 组合（OR=2.32，95%CI：1.12-4.84）相关。vacA（m1）和 vacA（s1m1）基因与胃肠化生（OR=2.71，95%CI：1.17-6.29）（OR=2.33，95%CI：1.03-5.24）相关。最后，我们表明 cagA/vacA（s1m1）基因组合增加了十二指肠溃疡发展的风险（OR=2.89，95%CI 1.10-7.58）。
本研究提供了有关 H. pylori 感染的基因信息，具有重要意义。厄瓜多尔人群中存在几种 H. pylori 基因与胃肠道疾病的发生有关。
