CagA in Barrett's oesophagus in Colombia, a country with a high prevalence of gastric cancer.
BACKGROUND
In the USA, atrophic gastritis and gastric cancer are rare, whereas gastro-oesophageal reflux disease (GERD) is common. Infection with Helicobacter pylori, especially a CagA positive strain, is unusual in patients with GERD/Barrett's oesophagus in the USA.


OBJECTIVE
To examine the relation between Barrett's oesophagus and CagA positive H pylori in Colombia, a country with a high prevalence of CagA positive H pylori associated atrophic gastritis and gastric cancer.


METHODS
Helicobacter pylori and CagA status was determined among Colombian patients with long segment Barrett's oesophagus and a control group with simple H pylori gastritis. Helicobacter pylori status was determined using a triple stain and CagA status was determined by immunohistochemistry using a specific rabbit anti-CagA serum.


RESULTS
Gastric and oesophageal mucosal biopsies were obtained from 51 patients--39 men (mean age, 57.8 years; SD, 13.1) and 12 women (mean age, 51.8 years; SD, 14.4)--with documented long segment Barrett's oesophagus. The results were compared with 24 Colombian patients with H pylori gastritis without oesophageal disease. Thirty two patients with Barrett's oesophagus had active H pylori infection. CagA status was evaluated in a subset of 23 H pylori infected patients with Barrett's oesophagus, and was positive in eight of these patients compared with 19 of 24 controls (p = 0.01).


CONCLUSIONS
Although most Colombian patients with Barrett's oesophagus had H pylori infection, CagA positive infections were unusual. These data illustrate how consistent corpus inflammation reduces acid secretion, which prevents Barrett's oesophagus among those with abnormal gastro-oesophageal reflux barriers.
Kudo
M
M
Michael E DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, TX 77030, USA.
Gutierrez
O
O
El-Zimaity
H M T
HM
Cardona
H
H
Nurgalieva
Z Z
ZZ
Wu
J
J
Graham
D Y
DY
D000328:Adult; D000368:Aged; D000818:Animals; D000942:Antigens, Bacterial / Q000032:analysis*; D001426:Bacterial Proteins / Q000032:analysis*; D001471:Barrett Esophagus / Q000208:ethnology / Q000382:microbiology* / Q000473:pathology; D003105:Colombia / Q000453:epidemiology; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology; D005756:Gastritis / Q000382:microbiology; D016481:Helicobacter Infections / Q000150:complications* / Q000382:microbiology; D016480:Helicobacter pylori / Q000737:chemistry* / Q000145:classification; D006801:Humans; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D011230:Precancerous Conditions / Q000208:ethnology / Q000382:microbiology / Q000473:pathology; D015995:Prevalence; D011817:Rabbits; D013274:Stomach Neoplasms / Q000208:ethnology / Q000382:microbiology* / Q000473:pathology
D000942:Antigens, Bacterial; D001426:Bacterial Proteins; C080866:cagA protein, Helicobacter pylori
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