title: Patterns of EPIYA motifs among cagA-positive Helicobacter pylori strains: a case-control study in a Turkish population with Eurasian geographical features.
abstract: Geographical variation in the frequency of various gastroduodenal pathologies was shown to be related to the geographical diversity of H. pylori CagA Glu-Pro-Ile-Tyr-Ala (EPIYA) patterns. We examined the EPIYA patterns of H. pylori and the association of EPIYA patterns with gastric cancer (GC) for the first time, to the best of our knowledge, in Turkey. The patient group (PG) contained 60 patients [38 GC and 22 duodenal ulcer (DU) patients]. The control group (CG) was 110 individuals [94 gastritis patients and 16 persons with a normal gastrointestinal system (NGIS)]. Specific primers were used for the detection of cagA including empty-site-positive and EPIYA-A, -B, -C, -D PCR. Bands of EPIYA-A, -B, -C were confirmed by DNA sequencing. One hundred and forty-two (83.5 %) strains [60 in the PG (38 GC, 22 DU), 82 in the CG (72 gastritis, 10 NGIS)] were positive for the cagA gene. EPIYA-C with multiple repeats was detected in 34 (23.9 %) strains, and 22 (64.7 %) were from GC patients. EPIYA-C with one repeat was detected in 89 (62.7 %) strains, and 54 (60.7 %) were from gastritis patients. EPIYT was detected in 10 strains, and EPIYA-D was not detected. The number of EPIYA-C with multiple repeats was significantly higher for the PG than for the CG (P < 0.0001). In GC patients, the number of EPIYA-C with multiple repeats was significantly higher than one repeat (P < 0.0001). In conclusion, our study showed that multiple EPIYA-C repeats increases the GC risk by 30.6-fold and the DU risk by 8.9-fold versus the CG. This indicates that Western-type H. pylori strains in Turkey have similar EPIYA motifs to those of neighbouring countries and Western populations.
authors.affiliation: 1​ Department of Medical Microbiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Bekir Sami
authors.initials: BS
authors.lastname: Kocazeybek
authors.affiliation: 1​ Department of Medical Microbiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Reyhan
authors.initials: R
authors.lastname: Caliskan
authors.affiliation: 2​ Department of Medical Pathology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Sibel
authors.initials: S
authors.lastname: Erdamar Cetin
authors.affiliation: 1​ Department of Medical Microbiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Sevgi
authors.initials: S
authors.lastname: Ergin
authors.affiliation: 1​ Department of Medical Microbiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Mert
authors.initials: M
authors.lastname: Kuskucu
authors.affiliation: 2​ Department of Medical Pathology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Nuray
authors.initials: N
authors.lastname: Kepil
authors.affiliation: 1​ Department of Medical Microbiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Harika
authors.initials: H
authors.lastname: Oyku Dinc
authors.affiliation: 3​ Department of Gastroenterology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Ziya Erzin
authors.affiliation: 1​ Department of Medical Microbiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Suat
authors.initials: S
authors.lastname: Saribas
authors.affiliation: 1​ Department of Medical Microbiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Hrisi
authors.initials: H
authors.lastname: Bahar Tokman
authors.affiliation: 1​ Department of Medical Microbiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Fatma
authors.initials: F
authors.lastname: Kalayci
authors.affiliation: 1​ Department of Medical Microbiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Ozer
authors.initials: O
authors.lastname: Akgul
authors.affiliation: 1​ Department of Medical Microbiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Pelin
authors.initials: P
authors.lastname: Yuksel
authors.affiliation: 1​ Department of Medical Microbiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Asiye
authors.initials: A
authors.lastname: Karakullukcu
authors.affiliation: 1​ Department of Medical Microbiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Tevhide
authors.initials: T
authors.lastname: Ziver
authors.affiliation: 1​ Department of Medical Microbiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Serhat
authors.initials: S
authors.lastname: Sirekbasan
authors.affiliation: 3​ Department of Gastroenterology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Erkan
authors.initials: E
authors.lastname: Caglar
authors.affiliation: 3​ Department of Gastroenterology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Kadir
authors.initials: K
authors.lastname: Bal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020816:Amino Acid Motifs; D000942:Antigens, Bacterial / Q000235:genetics*; D001426:Bacterial Proteins / Q000235:genetics*; D016022:Case-Control Studies; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D005260:Female; D005843:Geography; D016481:Helicobacter Infections / Q000150:complications / Q000453:epidemiology / Q000382:microbiology* / Q000473:pathology*; D016480:Helicobacter pylori / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D020449:Repetitive Sequences, Amino Acid; D018570:Risk Assessment; D017422:Sequence Analysis, DNA; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000382:microbiology* / Q000473:pathology*; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D004269:DNA, Bacterial; C080866:cagA protein, Helicobacter pylori