Abstract
BackgroundIn general, all virulence factors of Helicobacter pylori (H. pylori) are involved in its infections. However, recent studies have shown that the homB gene is one of the virulence genes that affects the severity of the clinical results of this bacterium.MethodsThe main purpose of this study was to investigate the relationship between the presence of homB gene in H. pylori and the progression of its infection to peptic ulcer and gastric cancer. In the present study, we conducted a systematic search to collect all articles related to the effect of homB-positive strains on clinical outcomes. Finally, 12 eligible studies according to our criteria were included in this meta-analysis and the effect of homB gene on gastric ulcer and gastric cancer diseases was evaluated by summary odds ratio (OR).ResultsCurrent results showed that the homB-positive strains significantly increase the risk of peptic ulcer (OR 1.36; 1.07–1.72 with 95% CIs), especially in western countries (OR 1.61; 1.20–2.14 with 95% CIs). Moreover, we observed a positive association between the homB gene and risk of gastric cancer (OR 2.16; 1.37–3.40 with 95% CIs). In addition, based on subgroup analysis, it was found that the presence of this gene in H. pylori strains increases the risk of gastric cancer in the Asian population (OR 3.71; 1.85–7.45 with 95% CIs).ConclusionsOverall, in the present study we found that homB gene is responsible for the progressing of primary infection to severe complications, in particular peptic ulcer in western countries and gastric cancer in Asian countries.
Highlights
All virulence factors of Helicobacter pylori (H. pylori) are involved in its infections
Inclusion criteria In this step, we used the full-text of all published case– control studies examining the relationship between the homB and severe clinical outcomes
The inclusion criteria in adult populations included; (1) published researches on the presence of homB confirmed by polymerase chain reaction (PCR) or immunoblotting, (2) exploratory studies on the association between H. pylori homB gene and severe clinical outcomes, (3) articles published in English, and (4) articles about human adults
Summary
All virulence factors of Helicobacter pylori (H. pylori) are involved in its infections. The relationship between homB and severe clinical outcomes has attracted much attention; the product of homB, HomB is a virulence factor that contributes to several bacterial activities such as biofilm formation, antibiotic resistance, delivery of CagA from type 4 secretion system (T4SS), induction of IL-8 production, gastritis, corpus atrophy, and persistent colonization [17,18,19,20]. Oleastro et al first showed a significant association between the homb-positive strains and the progression of infection to PUD in Portuguese children [21]. In another study, they found that the ability of homB knockout mutant strains to bind to gastric epithelium was significantly reduced compared to homB-positive strains [22]. In the present meta-analysis, we evaluated the association between homB-positive strains of H. pylori and several clinical outcomes
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