title: Association of polymorphisms in virulence factor of Helicobacter pylori and gastroduodenal diseases in South Korea.
abstract: OBJECTIVE
  Clinical outcomes of Helicobacter pylori (HP) infection have been shown to be dependent on the variability of virulence factors. The aim of this study was to evaluate the prevalence of each virulence factor and the association between polymorphisms of the virulence factors of HP, and the clinical outcome of gastroduodenal diseases in South Korea.
  
  
  METHODS
  Four hundred one HP colonies were analyzed (75 colonies from 45 controls; 71 colonies from 39 benign gastric ulcer [BGU] patients; 102 colonies from 54 duodenal ulcer [DU] patients; 121 colonies from 77 stomach cancer patients; and 32 colonies from 25 dysplasia patients). Polymerase chain reaction amplifications for vacA, cagA, iceA, oipA, and dupA were performed using DNA extract from HP isolates cultured from mucosal biopsy specimens. dupA was regarded as positive when all of jph0718, jph0719, and dupA were positive.
  
  
  RESULTS
  Most colonies were composed of vacA s1 (100.0%), i1 (100.0%) and m1 (92.9%), cagA-positive (87.2%), iceA1 (95.8%), oipA-positive (91.2%), and dupA-negative (52.0%) genotypes. dupA was more frequently expressed in BGU (81.3%), DU (74.7%), and dysplasia (41.7%) than control (16.7%) (P < 0.001). Infection by dupA-positive HP showed an increased risk of BGU (odds ratio 33.06, 95% confidence interval 11.91-91.79) and DU (odds ratio 15.60, 95% confidence interval 6.49-37.49).
  
  
  CONCLUSIONS
  HP infection in South Koreans appears to be closely related to highly virulent strains (vacA s1/i1/m1, cagA(+), iceA1(+), and oipA(+)), except dupA. dupA has an intimate association with the development of peptic ulcer diseases.
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do; Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine.
authors.forename: Ji Yeon
authors.initials: JY
authors.lastname: Kim
authors.forename: Nayoung
authors.initials: N
authors.lastname: Kim
authors.forename: Ryoung Hee
authors.initials: RH
authors.lastname: Nam
authors.forename: Ji Hyung
authors.initials: JH
authors.lastname: Suh
authors.forename: Hyun
authors.initials: H
authors.lastname: Chang
authors.forename: Jung Won
authors.initials: JW
authors.lastname: Lee
authors.forename: Young Sun
authors.initials: YS
authors.lastname: Kim
authors.forename: Jung Mogg
authors.initials: JM
authors.lastname: Kim
authors.forename: Jae Won
authors.initials: JW
authors.lastname: Choi
authors.forename: Jung Geun
authors.initials: JG
authors.lastname: Park
authors.forename: Yeon Suk
authors.initials: YS
authors.lastname: Lee
authors.forename: Dong Ho
authors.initials: DH
authors.lastname: Lee
authors.forename: Hyun Chae
authors.initials: HC
authors.lastname: Jung
mesh_terms: D000328:Adult; D000368:Aged; D000942:Antigens, Bacterial / Q000235:genetics / Q000302:isolation & purification; D001425:Bacterial Outer Membrane Proteins / Q000235:genetics / Q000302:isolation & purification; D001426:Bacterial Proteins / Q000235:genetics / Q000302:isolation & purification; D001483:Base Sequence; D004381:Duodenal Ulcer / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology*; D005260:Female; D005756:Gastritis / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology*; D016481:Helicobacter Infections / Q000150:complications / Q000382:microbiology*; D016480:Helicobacter pylori / Q000235:genetics* / Q000472:pathogenicity*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction; D011110:Polymorphism, Genetic / Q000235:genetics*; D056910:Republic of Korea / Q000453:epidemiology; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology*; D013276:Stomach Ulcer / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology*; D037521:Virulence Factors / Q000235:genetics*
chemical_list: D000942:Antigens, Bacterial; D001425:Bacterial Outer Membrane Proteins; D001426:Bacterial Proteins; C526444:OipA protein, Helicobacter pylori; C074689:VacA protein, Helicobacter pylori; D037521:Virulence Factors; C080866:cagA protein, Helicobacter pylori; C063113:ice nucleation protein
keywords: Helicobacter pylori; dupA; gastrointestinal disease; polymorphism; virulence factors