Relation of atrophic gastritis with Helicobacter pylori-CagA(+) and interleukin-1 gene polymorphisms.
OBJECTIVE
To determine the association of Helicobacter pylori (H pylori) CagA(+) infection and pro-inflammatory polymorphisms of the genes interleukin (IL)-1RN and IL-1B with the risk of gastric atrophy and peptic ulcers in a dyspeptic population in Costa Rica, a country with high incidence and mortality of gastric cancer.


METHODS
Seven biopsy specimens, a fasting blood sample and a questionnaire concerning nutritional and sociodemographic factors were obtained from 501 consecutive patients who had undergone endoscopy for dyspeptic symptoms. A histopathological diagnosis was made. Pepsinogen concentrations were analyzed by enzyme linked immunosorbent assay (ELISA). Infection with H pylori CagA(+) was determined by serology and polymerase chain reaction (PCR). IL-1B and IL-1RN polymorphisms genotyping was performed by PCR-restriction fragment length polymorphism (PCR-RFLP) and PCR respectively.


RESULTS
In this dyspeptic population, 86% were H pylori positive and of these, 67.8% were positive for CagA. Atrophic antral gastritis (AAG) was associated with CagA(+) status [odd ratio (OR) = 4.1; P < 0.000] and fruit consumption (OR = 0.3; P < 0.00). Atrophic body gastritis (ABG) was associated with pepsinogen PGI/PGII < 3.4 (OR = 4.9; P < 0.04) and alcohol consumption (OR = 7.3; P < 0.02). Duodenal ulcer was associated with CagA(+) (OR = 2.9; P < 0.04) and smoking (OR = 2.4; P < 0.04). PGI < 60 microg/L as well as PGI/PGII < 3.4 were associated with CagA(+).


CONCLUSIONS
In a dyspeptic population in Costa Rica, H pylori CagA(+) is not associated with ABG, but it is a risk factor for AAG. The pro-inflammatory cytokine polymorphisms IL-1B + 3945 and IL-1RN are not associated with the atrophic lesions of this dyspeptic population.
Sierra
Rafaela
R
Institute of Health Research, University of Costa Rica, San Jose 2060, Costa Rica.
Une
Clas
C
Ramirez
Vanessa
V
Alpizar-Alpizar
Warner
W
Gonzalez
Maria-I
MI
Ramirez
Jose-A
JA
De Mascarel
Antoine
A
Cuenca
Patricia
P
Perez-Perez
Guillermo
G
Megraud
Francis
F
D000428:Alcohol Drinking / Q000009:adverse effects; D000942:Antigens, Bacterial / Q000235:genetics*; D001284:Atrophy; D001426:Bacterial Proteins / Q000235:genetics*; D001706:Biopsy; D003364:Costa Rica; D004032:Diet / Q000009:adverse effects; D004415:Dyspepsia / Q000235:genetics / Q000276:immunology / Q000382:microbiology; D005260:Female; D005756:Gastritis / Q000235:genetics* / Q000276:immunology / Q000382:microbiology / Q000473:pathology; D005773:Gastroscopy; D020022:Genetic Predisposition to Disease; D016481:Helicobacter Infections / Q000150:complications / Q000235:genetics* / Q000276:immunology / Q000382:microbiology; D016480:Helicobacter pylori / Q000235:genetics*; D006801:Humans; D053590:Interleukin 1 Receptor Antagonist Protein / Q000235:genetics*; D053583:Interleukin-1beta / Q000235:genetics*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D020116:Pepsinogen A / Q000097:blood; D020115:Pepsinogen C / Q000097:blood; D010437:Peptic Ulcer / Q000235:genetics / Q000276:immunology / Q000382:microbiology; D011110:Polymorphism, Genetic; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D011795:Surveys and Questionnaires
D000942:Antigens, Bacterial; D001426:Bacterial Proteins; C507763:IL1RN protein, human; D053590:Interleukin 1 Receptor Antagonist Protein; D053583:Interleukin-1beta; C080866:cagA protein, Helicobacter pylori; D020115:Pepsinogen C; D020116:Pepsinogen A