title: The distribution of cagA and dupA genes in Helicobacter pylori strains in Kurdistan region, northern Iraq.
abstract: OBJECTIVE
  Helicobacter pylori is a Gram negative bacteria that causes peptic ulceration and gastric adenocarcinoma. H pylori virulence factors, such as cagA and dupA, are important to study in populations as they contribute to disease risk. This study aimed to look at the distribution of the cagA and dupA genes in H pylori strains isolated from patients suffering from gastroduodenal diseases in Kurdistan region, Iraq.
  
  
  METHODS
  A cross-sectional study conducted between June 2011 and January 2012. Biopsies were collected from the Endoscopy Department in Duhok and Sulaimania hospitals, Kurdistan region, northern Iraq.
  
  
  METHODS
  Upper gastrointestinal (GI) endoscopy examination was performed and 4 gastric biopsies (2 from the antrum and 2 from the corpus) were obtained from 204 patients. H pylori positivity was examined by CLO test; then the association between disease status and virulence factors was assessed by polymerase chain reaction.
  
  
  RESULTS
  154 (75%) of our samples were found to be H pylori + by CLO test. Endoscopic diagnoses for those who were positive were as follows: peptic ulcer disease (PUD) including duodenal ulcer, 45; gastric ulcer, 23; and no ulcer (NPUD), 86. The overall prevalence rates of cagA and dupA were 72.7% and 18.8%, respectively. While a significant association between cagA and PUD was observed (P. ≤.017; OR=0.4; CI=0.18–0.85), no relationship between dupA and PUD could be seen.
  
  
  CONCLUSIONS
  These data suggested that the presence of cagA may be a predictor of clinical outcome in Kurdistan region, northern Iraq.
authors.affiliation: School of Medical Science, University of Duhok, Iraq. nawfal.hussein@yahoo.com
authors.forename: Azad M
authors.initials: AM
authors.lastname: Salih
authors.forename: Amer
authors.initials: A
authors.lastname: Goreal
authors.forename: Nawfal R
authors.initials: NR
authors.lastname: Hussein
authors.forename: Shahla M
authors.initials: SM
authors.lastname: Abdullah
authors.forename: Khidir
authors.initials: K
authors.lastname: Hawrami
authors.forename: Mahde
authors.initials: M
authors.lastname: Assafi
mesh_terms: D000328:Adult; D000942:Antigens, Bacterial / Q000235:genetics*; D001426:Bacterial Proteins / Q000235:genetics*; D003430:Cross-Sectional Studies; D004381:Duodenal Ulcer / Q000382:microbiology; D016099:Endoscopy, Gastrointestinal; D016481:Helicobacter Infections / Q000382:microbiology* / Q000473:pathology; D016480:Helicobacter pylori / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D007493:Iraq; D008875:Middle Aged; D010437:Peptic Ulcer / Q000382:microbiology; D016133:Polymerase Chain Reaction; D015995:Prevalence; D013276:Stomach Ulcer / Q000382:microbiology; D037521:Virulence Factors / Q000235:genetics*; D055815:Young Adult
chemical_list: D000942:Antigens, Bacterial; D001426:Bacterial Proteins; C528428:DupA protein, Helicobacter pylori; D037521:Virulence Factors; C080866:cagA protein, Helicobacter pylori