Brief Article
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World J Gastroenterol. Sep 21, 2010; 16(35): 4443-4447
Published online Sep 21, 2010. doi: 10.3748/wjg.v16.i35.4443
Clinical significance of Helicobacter pylori cagA and iceA genotype status
Nasser Amjad, Hussain Ali Osman, Najibah Abdul Razak, Junaini Kassian, Jeffri Din, Nasuruddin bin Abdullah
Nasser Amjad, Najibah Abdul Razak, Junaini Kassian, Department of Surgery, International Islamic University Malaysia, Kuantan 25710, Pahang, Malaysia
Hussain Ali Osman, Nasuruddin bin Abdullah, Department of Basic Medical Sciences, International Islamic University Malaysia, Kuantan 25710, Pahang, Malaysia
Jeffri Din, Department of Surgery, Hospital Tengku Ampuan Afzan, Kuantan 25710, Pahang, Malaysia
Author contributions: Amjad N, Osman HA and Razak NA contributed equally to this work; Kassian J and Din J provided some of the patients; bin Abdullah N provided laboratory support.
Supported by The Research Management Centre, International Islamic University Malaysia
Correspondence to: Nasser Amjad, MS, FRCS, Department of Surgery, International Islamic University Malaysia, Kuantan 25710, Pahang, Malaysia.
Telephone: +60-9-5716406 Fax: +60-9-5146090
Received: April 8, 2010
Revised: May 19, 2010
Accepted: May 26, 2010
Published online: September 21, 2010

AIM: To study the presence of Helicobacter pylori (H. pylori) virulence factors and clinical outcome in H. pylori infected patients.

METHODS: A prospective analysis of ninety nine H. pylori-positive patients who underwent endoscopy in our Endoscopy suite were included in this study. DNA was isolated from antral biopsy samples and the presence of cagA, iceA, and iceA2 genotypes were determined by polymerase chain reaction and a reverse hybridization technique. Screening for H. pylori infection was performed in all patients using the rapid urease test (CLO-Test).

RESULTS: From a total of 326 patients who underwent endoscopy for upper gastrointestinal symptoms, 99 patients were determined to be H. pylori-positive. Peptic ulceration was seen in 33 patients (33%). The main virulence strain observed in this cohort was the cagA gene isolated in 43 patients. cagA was associated with peptic ulcer pathology in 39.5% (17/43) and in 28% (16/56) of non-ulcer patients. IceA1 was present in 29 patients (29%) and iceA2 in 15 patients (15%). Ulcer pathology was seen in 39% (11/29) of patients with iceA1, while 31% (22/70) had normal findings. The corresponding values for iceA2 were 33% (5/15) and 33% (28/84), respectively.

CONCLUSION: Virulence factors were not common in our cohort. The incidence of factors cagA, iceA1 and iceA2 were very low although variations were noted in different ethnic groups.

Keywords: Ethnicity, Helicobacter pylori, Peptic ulcer disease, Virulence factors