title: The interrelationship between cytotoxin-associated gene A, vacuolating cytotoxin, and Helicobacter pylori-related diseases.
abstract: The interrelationship between cytotoxin-associated gene A (CagA), vacuolating cytotoxin (VacA), and Helicobacter pylori-related diseases was investigated in 155 H. pylori-infected patients. Four (7%) of 60 subjects had mixed cagA+ and cagA- H. pylori infections. The H. pylori isolates from 98.3% of 121 patients with anti-CagA antibodies were cagA+. The occurrence of cagA+ H. pylori among 76 patients with peptic ulcer disease (PUD) was higher (93.4%) than among 79 patients with functional dyspepsia (FD; 64.6%) (odds ratio [OR] = 7.80; P < .001). VacA+ isolates were isolated from 56.6% of the PUD patients and 35.4% of the FD patients (OR = 2.37; P = .0132). For type I (cagA+VacA+) isolates, these numbers were 56.6% and 31.6%, respectively (P = .003). Only 4% of the 71 VacA+ isolates were cagA-. In addition, 37% of the patients with PUD were infected with cagA+VacA- H. pylori. Chi 2 results did not improve when VacA was entered into the model in the presence of cagA, indicating that only cagA is associated with PUD.
authors.affiliation: University of Amsterdam, Department of Medical Microbiology, Netherlands.
authors.forename: J F
authors.initials: JF
authors.lastname: Weel
authors.forename: R W
authors.initials: RW
authors.lastname: van der Hulst
authors.forename: Y
authors.initials: Y
authors.lastname: Gerrits
authors.forename: P
authors.initials: P
authors.lastname: Roorda
authors.forename: M
authors.initials: M
authors.lastname: Feller
authors.forename: J
authors.initials: J
authors.lastname: Dankert
authors.forename: G N
authors.initials: GN
authors.lastname: Tytgat
authors.forename: A
authors.initials: A
authors.lastname: van der Ende
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood; D000942:Antigens, Bacterial; D001426:Bacterial Proteins / Q000032:analysis* / Q000235:genetics*; D001483:Base Sequence; D002460:Cell Line; D015331:Cohort Studies; D003603:Cytotoxins / Q000032:analysis*; D004415:Dyspepsia / Q000382:microbiology; D004847:Epithelial Cells; D005753:Gastric Mucosa / Q000382:microbiology; D005798:Genes, Bacterial / Q000235:genetics; D016481:Helicobacter Infections / Q000382:microbiology*; D016480:Helicobacter pylori / Q000235:genetics / Q000276:immunology / Q000472:pathogenicity*; D006801:Humans; D008969:Molecular Sequence Data; D010437:Peptic Ulcer / Q000382:microbiology; D016133:Polymerase Chain Reaction / Q000379:methods; D014617:Vacuoles
chemical_list: D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D003603:Cytotoxins; C074689:VacA protein, Helicobacter pylori; C080866:cagA protein, Helicobacter pylori