Abstract
Background and AimSeveral biological and epidemiological studies support a relationship between smoking and Helicobacter pylori (H. pylori) to increase the risk of pathology. However, there have been few studies on the potential synergistic association between specific cagA and vacA virulence factors and smoking in patients infected by Helicobacter pylori. We studied the relationship between smoking and cagA, vacA i1 virulence factors and bacterial load in H. pylori infected patients.MethodsBiopsies of the gastric corpus and antrum from 155 consecutive patients in whom there was clinical suspicion of infection by H. pylori were processed. In 106 patients H. pylori infection was detected. Molecular methods were used to quantify the number of microorganisms and presence of cagA and vacA i1 genes. A standardized questionnaire was used to obtain patients’ clinical data and lifestyle variables, including tobacco and alcohol consumption. Adjusted Odds Ratios (ORadjusted) were estimated by unconditional logistic regression.Results cagA was significantly associated with active-smoking at endoscope: ORadjusted 4.52. Evidence of association was found for vacA i1 (ORadjusted 3.15). Bacterial load was higher in active-smokers, although these differences did not yield statistical significance (median of 262.2 versus 79.4 copies of H. pylori per cell).ConclusionsThe association between smoking and a higher risk of being infected by a virulent bacterial population and with higher bacterial load, support a complex interaction between H. pylori infection and environmental factors.
Highlights
Interaction between Helicobacter pylori (H. pylori) and gastric mucosa is a complex phenomenon and as yet little understood
Bacterial load was higher in active-smokers, these differences did not yield statistical significance
Smoking and High Virulence H. pylori participants' privacy, since the dataset is derived from clinical studies involving human participants
Summary
Interaction between Helicobacter pylori (H. pylori) and gastric mucosa is a complex phenomenon and as yet little understood. Though in most cases this microorganism does not cause any symptomatic pathology, in some cases it causes serious lesions in the mucosa, being the main risk factor for gastric cancer. This different patterns of evolution may be related to the host’s characteristics (genetic, immunological), environmental exposures (socio-sanitary and lifestyle factors), and to certain characteristics of the microorganism [1]. There have been few studies on the potential synergistic association between specific cagA and vacA virulence factors and smoking in patients infected by Helicobacter pylori. We studied the relationship between smoking and cagA, vacA i1 virulence factors and bacterial load in H. pylori infected patients
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