title: Infection with Helicobacter pylori strains carrying babA2 and cagA is associated with an increased risk of peptic ulcer disease development in Iraq.
abstract: OBJECTIVE
  Several genes of Helicobacter pylori, such as vacA, cagA, iceA and babA, have been reported to significantly increase the risk of gastrointestinal diseases. The aim of this study was to study the relationship between H. pylori virulence factors and clinical outcomes and identify the independent markers of peptic ulcer disease in Iraq.
  
  
  METHODS
  DNA was extracted from specimens taken from 154 unselected H. Pylori positive Iraqi patients. Genotyping was performed by the polymerase chain reaction (PCR), using specific primers for cagA, vacA (s, m), iceA and babA2 genes.
  
  
  RESULTS
  A total of 56 (82%) peptic ulcer disease (PUD) patients carried cagA+ strains, significantly more than the 56 (65%) non-ulcer disease (NUD) patients (p=0.017). The difference in the prevalence of babA2 positivity was significant between patients with NUD (33.7%) and PUD (58.8%) (p=0.002). In addition, babA2 was associated as an independent factor, with PUD (p=0.005; odds ratio (OR)=0.4; confidence interval (CI)=0.18-0.68) followed by cagA (p=0.05; OR=0.4; CI=0.18-0.85). Forty-five isolates (29%) were typed as 'triple positive' strains, and their presence was significantly associated with PUD (p=0.001).
  
  
  CONCLUSIONS
  The cagA and babA2 genotypes might be considered as useful markers for PUD patients. However, iceA1 and iceA2 seem not to be good markers for the disease. The presence of H. pylori strains with triple-positive status is of high clinical relevance to H. pylori-associated diseases.
authors: Genomic Centre, Koya University, Koya, Kurdistan Region, Iraq.
authors: Shahla M
authors: SM
authors: Abdullah
authors: Nawfal R
authors: NR
authors: Hussein
authors: Azad M
authors: AM
authors: Salih
authors: Muayad A
authors: MA
authors: Merza
authors: Amer A
authors: AA
authors: Goreal
authors: Odeesh Y
authors: OY
authors: Odeesh
authors: Halat S
authors: HS
authors: Majed
authors: Mahde A
authors: MA
authors: Assafi
authors: Khidir
authors: K
authors: Hawrami
mesh_terms: D018829:Adhesins, Bacterial / Q000235:genetics*; D000328:Adult; D000942:Antigens, Bacterial / Q000235:genetics*; D001426:Bacterial Proteins / Q000235:genetics*; D017931:DNA Primers / Q000737:chemistry; D005819:Genetic Markers; D005838:Genotype; D016481:Helicobacter Infections / Q000150:complications / Q000235:genetics* / Q000382:microbiology; D016480:Helicobacter pylori / Q000235:genetics*; D006801:Humans; D007493:Iraq / Q000453:epidemiology; D008875:Middle Aged; D010437:Peptic Ulcer / Q000453:epidemiology / Q000209:etiology / Q000235:genetics* / Q000382:microbiology; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012307:Risk Factors; D037521:Virulence Factors / Q000235:genetics
chemical_list: D018829:Adhesins, Bacterial; D000942:Antigens, Bacterial; C400429:BabA protein, Helicobacter pylori; D001426:Bacterial Proteins; D017931:DNA Primers; D005819:Genetic Markers; C074689:VacA protein, Helicobacter pylori; D037521:Virulence Factors; C080866:cagA protein, Helicobacter pylori