Abstract
The aim of this study was to investigate the Lewis antigen expression in Helicobacter pylori gastric MALT lymphoma associated strains in comparison to chronic gastritis only strains. Forty MALT strains (19 cagPAI (−) and 21 cagPAI (+)) and 39 cagPAI frequency-matched gastritis strains (17 cagPAI (−) and 22 cagPAI (+)) were included in this study. The lipopolyssacharide for each strain was extracted using a hot phenol method and the expression of Lex and Ley were investigated using Western Blot. The data were analyzed according to the strains' cagPAI status and vacA genotype. Lex was identified in 21 (52.5%) MALT strains and 29 (74.3%) gastritis strains. Ley was identified in 30 (75%) MALT strains and 31 (79.5%) gastritis strains. There was an association between cagPAI positivity and Lex expression among MALT strains (p<0.0001), but not in gastritis strains (p = 0.64). Among cagPAI (−) strains, isolates expressing solely Ley were associated with MALT with an odds ratio of 64.2 (95% CI 4.9–841.0) when compared to strains expressing both Lex and Ley. vacA genotypes did not modify the association between Lewis antigen expression and disease status. In conclusion, cagPAI (−) MALT strains have a particular Lewis antigen profile which could represent an adaptive mechanism to the host response or participate in MALT lymphomagenesis.
Highlights
Helicobacter pylori was the first bacterium classified as a type I carcinogen [1]
Many research projects have focused on virulence factors or genetic markers but few studies have included H. pylori strains associated with gastric mucosa associated lymphoid tissue (MALT) lymphoma [2,3,4,5]
The 39 gastritis strains were classified according to the signal region as either s1 or s2 or according to the middle region as m1 or m2 of the vacuolating cytotoxin gene A (vacA) gene
Summary
Helicobacter pylori was the first bacterium classified as a type I carcinogen (maximum level) [1]. Gastric lymphoma is considered to be the classic lymphoma of MALT-type of the digestive tract [6]. It is a B lymphoma with a very unusual pathogenesis and evolution which evolves very progressively and stays localized in the stomach for a long time. The development of the lymphoma is directly linked to the H. pylori infection it is not known why this evolution occurs in only a very small number of infected subjects. A large number of molecular events participating in the lymphomagenesis of MALT lymphomas have already been described, in which a chronic antigenic stimulation plays a pivotal role. As the incidence of MALT lymphoma may correlate with different inflammatory cytokines and gene polymorphisms, the role of the host immune response has not been clearly defined yet [7]
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