幽门螺杆菌cagA、vacA和iceA状态的临床相关性。
Clinical relevance of the cagA, vacA, and iceA status of Helicobacter pylori.
作者信息
van Doorn L J, Figueiredo C, Sanna R, Plaisier A, Schneeberger P, de Boer W, Quint W
机构信息
Delft Diagnostic Laboratory, The Netherlands.
出版信息
Gastroenterology. 1998 Jul;115(1):58-66. doi: 10.1016/s0016-5085(98)70365-8.
BACKGROUND & AIMS: Clinical outcome of Helicobacter pylori infection may be associated with specific virulence-associated bacterial genotypes. The aim of this study was to assess the relationships between H. pylori cagA, vacA, and iceA status and severity of disease.
METHODS
Gastric biopsy specimens from 94 patients in The Netherlands were analyzed by polymerase chain reaction and reverse hybridization.
RESULTS
cagA was present in 63 (67%) of 94 cases and was associated with peptic ulcer disease (P = 0.0019). vacA geno-types s1a/m1, s1b/m2, s1b/m1, s1b/m2, and s2/m2 were found in 36.2%, 23.4%, 2.1%, 5.3%, and 20.2%, respectively. Ten isolates (10.6%) contained multiple vacA genotypes. The presence of peptic ulcers was associated with type s1 strains (P = 0.0006) but not with the m type (P = 0.2035). cagA and vacA s1 were strongly associated (P < 10(-5)). iceA1 was found in 53 (56.4%) and iceA2 in 25 (26.6%) of the 94 cases. In 14 isolates (14.9%), both iceA alleles were found, and 2 (2.1%) were negative for both iceA1 and iceA2. iceA1 was also associated with peptic ulcer disease (P = 0.0042). The iceA allelic type was independent of the cagA and vacA status.
CONCLUSIONS
vacA s1, cagA, and iceA1 are markers of H. pylori strains that are more likely to lead to ulcer disease.
背景与目的
幽门螺杆菌感染的临床结局可能与特定的毒力相关细菌基因型有关。本研究旨在评估幽门螺杆菌cagA、vacA和iceA状态与疾病严重程度之间的关系。
方法
对荷兰94例患者的胃活检标本进行聚合酶链反应和反向杂交分析。
结果
94例中有63例（67%）存在cagA，且与消化性溃疡病相关（P = 0.0019）。分别发现vacA基因型s1a/m1、s1b/m2、s1b/m1、s1b/m2和s2/m2的比例为36.2%、23.4%、2.1%、5.3%和20.2%。10株分离株（10.6%）含有多种vacA基因型。消化性溃疡的存在与s1型菌株相关（P = 0.0006），但与m型无关（P = 0.2035）。cagA和vacA s1密切相关（P < 10⁻⁵）。94例中有53例（56.4%）发现iceA1，25例（26.6%）发现iceA2。在14株分离株（14.9%）中同时发现了两种iceA等位基因，2株（2.1%）iceA1和iceA2均为阴性。iceA1也与消化性溃疡病相关（P = 0.0042）。iceA等位基因类型与cagA和vacA状态无关。
结论
vacA s1、cagA和iceA1是幽门螺杆菌菌株更易导致溃疡病的标志物。
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