Abstract
BackgroundThere are increasing studies examining the relationship between the status of H. pylori oipA gene and peptic ulcer disease (PUD) and gastric cancer (GC) but the results turn out to be controversial. We attempted to clarify whether oipA gene status is linked with PUD and/or GC risks.MethodsA systematically literature search was performed through four electronic databases. According to the specific inclusion and exclusion criteria, seven articles were ultimately available for the meta-analysis of oipA presence/absence with PUD and GC, and eleven articles were included for the meta-analysis of oipA on/off status with PUD and GC.ResultsFor the on/off functional status analysis of oipA gene, the “on” status showed significant associations with increased risks of PUD (OR = 3.97, 95% CI: 2.89, 5.45; P < 0.001) and GC (OR = 2.43, 95% CI: 1.45, 4.07; P = 0.001) compared with gastritis and functional dyspepsia controls. Results of the homogeneity test indicated different effects of oipA “on” status on PUD risk between children and adult subgroups and on GC risk between PCR-sequencing and immunoblot subgroups. For the presence/absence analysis of oipA gene, we found null association of the presence of oipA gene with the risks of PUD (OR = 1.93, 95% CI: 0.60, 6.25; P = 0.278) and GC (OR = 2.09, 95% CI: 0.51, 8.66; P = 0.308) compared with gastritis and functional dyspepsia controls.ConclusionsTo be concluded, when oipA exists, the functional “on” status of this gene showed association with increased risks for PUD and GC compared with gastritis and FD controls. However, merely investigating the presence/absence of oipA would overlook the importance of its functional on/off status and would not be reliable to predict risks of PUD and GC. Further large-scale and well-designed studies concerning on/off status of oipA are required to confirm our meta-analysis results.
Highlights
There are increasing studies examining the relationship between the status of H. pylori oipA gene and peptic ulcer disease (PUD) and gastric cancer (GC) but the results turn out to be controversial
Studies included in the present meta-analysis must meet the inclusion criteria as follows: observational studies concerning the association between the presence/ absence or on/off status of oipA gene and PUD or GC with control group of gastritis or functional dyspepsia (FD); studies published in English or Chinese; studies with H. pylori-positive cases and controls; studies with sufficient raw data for estimating odds ratios (OR) and their 95% confidence interval (CI)
By performing the current meta-analysis, we found that when oipA gene exists, the oipA “on” status was associated with increased risks of PUD and GC compared with gastritis and FD controls
Summary
There are increasing studies examining the relationship between the status of H. pylori oipA gene and peptic ulcer disease (PUD) and gastric cancer (GC) but the results turn out to be controversial. Helicobacter pylori (H. pylori) infection is the most important risk factor for the development of peptic ulcer disease (PUD) and gastric cancer (GC) [1]. Several well-described virulence factors of H. pylori including CagA (cytotoxin-associated gene A product) and VacA (vacuolating cytotoxin A) have been linked to severe gastroduodenal diseases such as PUD and GC [5]. A study reported by Yamaoka Y. et al in 2000 and subsequent studies provided evidence that OipA (outer inflammatory protein A) is another important virulence factor in relation to the risks of PUD and GC [6]. The status is “off”, which is nonfunctional oipA gene [7] This OipA protein appeared to be important in inducing interleukin 8 (IL-8) secretion and facilitating the bacteria’s colonization in stomach [1]
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