title: Role of deletion located between the intermediate and middle regions of the Helicobacter pylori vacA gene in cases of gastroduodenal diseases.
abstract: The vacuolating cytotoxin gene of Helicobacter pylori, vacA, induces cytoplasmic vacuolation in gastric epithelial cells. Recently, the vacA intermediate (i) region, which is located between the signal (s) and middle (m) regions, was identified as a third polymorphic determinant of vacA activity. In vacA, there are approximately 81-bp deletions between the vacA i and m regions (denoted the d region). The aim was to clarify the roles of the vacA d region in relation to H. pylori-related diseases and histopathological gastric mucosal changes. We assessed the vacA signal s-, m-, i-, and d-region genotypes and cagA status in H. pylori isolates recovered from Western countries (n = 266) and East Asian countries (n = 244) by PCR. In East Asian countries, there were no relationships between the vacA genotypes and the clinical outcomes and histopathological changes. In Western countries, strains with the vacA s1, m1, i1, or d1 (no deletion) genotype significantly increased the risk for the development of gastric cancer compared with the risk from strains with the s2, m2, i2, or d2 genotype (adjusted odd ratios, 3.17 [95% confidence interval {CI}, 1.07 to 9.45] for s1, 10.65 [95% CI, 3.36 to 31.35] for m1, 8.57 [95% CI, 2.85 to 25.81] for i1, and 8.04 [95% CI, 2.67 to 24.16] for d1). The highly virulent vacA genotypes significantly enhanced neutrophil infiltration and gastric atrophy in univariant analysis, whereas only the vacA d-region genotype was significantly associated with neutrophil infiltration and gastric atrophy in both the antrum and the corpus by multiple linear regression analysis. The presence of the vacA d1 genotype in H. pylori strains could be an improved predictor of histological inflammation and the potential for atrophy compared with the presence of the vacA s-, m-, and i-region genotypes in Western countries.
authors.affiliation: Department of Medicine-Gastroenterology, Michael E. DeBakey Veterans Affairs Medical Center (111D), Rm. 3A-320, 2002 Holcombe Blvd., Houston, TX 77030, USA.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ogiwara
authors.forename: Mitsushige
authors.initials: M
authors.lastname: Sugimoto
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Ohno
authors.forename: Ratha-Korn
authors.initials: RK
authors.lastname: Vilaichone
authors.forename: Varocha
authors.initials: V
authors.lastname: Mahachai
authors.forename: David Y
authors.initials: DY
authors.lastname: Graham
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Yamaoka
mesh_terms: D001426:Bacterial Proteins / Q000235:genetics*; D001483:Base Sequence; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology; D005838:Genotype; D016481:Helicobacter Infections / Q000382:microbiology* / Q000473:pathology*; D016480:Helicobacter pylori / Q000235:genetics* / Q000302:isolation & purification / Q000821:virology*; D006651:Histocytochemistry; D006801:Humans; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D009504:Neutrophils / Q000276:immunology; D010437:Peptic Ulcer / Q000382:microbiology* / Q000473:pathology*; D016415:Sequence Alignment; D017384:Sequence Deletion; D037521:Virulence Factors / Q000235:genetics*
chemical_list: D001426:Bacterial Proteins; C074689:VacA protein, Helicobacter pylori; D037521:Virulence Factors