Abstract
BackgroundHelicobacter pylori is accounted as the most etiologic agent for digestive disorders, in particular, the most important of them i.e. peptic ulcer and gastric cancer. In the recent years, association of vacA genotypes and gastrointestinal disorders has attracted a lot of attention. In present study, we assessed the correlation between vacA genotypes (s1, s2, m1, m2, s1m1, s1m2, s2m1 and s2m2) and development to peptic ulcer in Iranian population.MethodsIn our study, first, 24 original articles containing of information of 3328 patients were evaluated. Statistical analysis was done by Comprehensive Meta-Analysis version 2.0 software (Biostat, Englewood, NJ, USA). In this regards, we used from fixed-effects model for analysis of data with low heterogeneity, while for analysis of data with high heterogeneity (I2 statistic index > 25%, Cochrane Q statistic p value < 0.05), random-effects model was used.ResultsAbundance of each of s1, s2, m1, m2, s1m1, s1m2, s2m1, and s2m2 was estimated 36.24, 28.32, 42.90 29.86, 27.88, 32.34, 15.70, and 25.94%, respectively. According to the results, the m1, s1, and s1m2 genotypes were among the most prevalent genotypes among the Iranian patients, whereas, s2m1 genotype had the lowest frequency.ConclusionsOverall, 24 articles (total participants = 3328) were included in this comprehensive analysis. H. pylori infection rate were 90.26% in these cases, so that 33.65% of whom had peptic ulcer. Moreover, the abundance of each vacA genotypes including s1, s2, m1, m2, s1m1, s1m2, s2m1, and s2m2 was estimated as 36.24, 28.32, 42.90 29.86, 27.88, 32.34, 15.70, and 25.94% respectively. We demonstrated that there is a significant relationship between infection of stomach with m1, s1m1, and s2m1 genotypes and development to peptic ulcer disease.
Highlights
Helicobacter pylori is accounted as the most etiologic agent for digestive disorders, in particular, the most important of them i.e. peptic ulcer and gastric cancer
It was demonstrated that vacA genotypes such as m1, s1, and s1m2 were the most prevalent vacA alleles among the Iranian patients with peptic ulcer
We found a meaningful relationship between infection with vacA and cagA positive strains of H. pylori and development to peptic ulcer (OR: 1.63, 1.39–1.91; Q-value: 12.15; I2: 0.00; p value: 0.00 and Egger’s regression: 0.53) (Fig. 5)
Summary
Helicobacter pylori is accounted as the most etiologic agent for digestive disorders, in particular, the most important of them i.e. peptic ulcer and gastric cancer. The International Agency for Research on Cancer (IARC) introduced this bacterium as the main causing enemy of gastric cancer [16, 17] This bacterium is accounted for some diseases such as primary gastric non-Hodgkin’s lymphoma, mucosa-associated lymphoid tissue lymphoma (MALT), gastritis, and peptic ulcer [18]. Whilst the cytotoxicity power of all genotypes differs from each other, in addition, two s1 and m1 regions in turn comprise several subtypes including s1a, s1b, s1c, m1a, m1b and m1c [14, 19,20,21] This antigen through induction of cytoplasmic vacuolation and apoptosis in infected cells can lead to the death of host gastric epithelial cells [14, 22]. The main goal of this study was the determination of frequency of vacA (s1, s2, m1, m2, s1m1, s1m2, s2m1 and s2m2) alleles and their relationship with creation of peptic ulcer in Iranian population
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