Oral cavity is not a reservoir for Helicobacter pylori in infected patients with functional dyspepsia.
BACKGROUND
Helicobacter pylori infection is very prevalent in Brazil, infecting almost 65% of the population. The aim of this study was to evaluate the presence of this bacterium in the oral cavity of patients with functional dyspepsia (epigastric pain syndrome), establish the main sites of infection in the mouth, and assess the frequency of cagA and vacA genotypes of oral H. pylori.


METHODS
All 43 outpatients with epigastric pain syndrome, who entered the study, were submitted to upper gastrointestinal endoscopy to rule out organic diseases. Helicobacter pylori infection in the stomach was confirmed by a rapid urease test and urea breath tests. Samples of saliva, the tongue dorsum and supragingival dental plaque were collected from the oral cavity of each subject and subgingival dental plaque samples were collected from the patients with periodontitis; H. pylori infection was verified by polymerase chain reaction using primers that amplify the DNA sequence of a species-specific antigen present in all H. pylori strains; primers that amplify a region of urease gene, and primers for cagA and vacA (m1, m2, s1a, s1b, s2) genotyping.


RESULTS
Thirty patients harbored H. pylori in the stomach, but it was not possible to detect H. pylori in any oral samples using P1/P2 and Urease A/B. The genotype cagA was also negative in all samples and vacA genotype could not be characterized (s-m-).


CONCLUSIONS
The oral cavity may not be a reservoir for H. pylori in patients with epigastric pain syndrome, the bacterium being detected exclusively in the stomach.
Clinical Gastroenterology Division, Department of Gastroenterology, University of São Paulo School of Medicine, São Paulo, Brazil. fopvan@yahoo.com
V P
VP
Silva Rossi-Aguiar
T
T
Navarro-Rodriguez
R
R
Mattar
M P
MP
Siqueira de Melo Peres
R
R
Correa Barbuti
F M
FM
Silva
F J
FJ
Carrilho
J N
JN
Eisig
D000942:Antigens, Bacterial / Q000032:analysis; D001426:Bacterial Proteins / Q000032:analysis; D002352:Carrier Proteins / Q000032:analysis; D003603:Cytotoxins / Q000032:analysis; D004269:DNA, Bacterial / Q000032:analysis; D003773:Dental Plaque / Q000382:microbiology; D004415:Dyspepsia / Q000382:microbiology*; D005260:Female; D005773:Gastroscopy; D005838:Genotype; D016481:Helicobacter Infections / Q000382:microbiology*; D016480:Helicobacter pylori / Q000145:classification / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000382:microbiology*; D010518:Periodontitis / Q000382:microbiology; D016133:Polymerase Chain Reaction; D012463:Saliva / Q000382:microbiology; D013272:Stomach Diseases / Q000382:microbiology; D014059:Tongue / Q000382:microbiology; D014510:Urease / Q000032:analysis
D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D002352:Carrier Proteins; D003603:Cytotoxins; D004269:DNA, Bacterial; C074689:VacA protein, Helicobacter pylori; C080866:cagA protein, Helicobacter pylori; D014510:Urease