The cagA EPIYA Motifs and vacA Genotypes in Upper Gastrointestinal Diseases

Abstract

Background: Helicobacter pylori (H. pylori) is the causative agent for upper gastrointestinal diseases. The presence of the cagA, at least with one repeat of EPIYA-C, and the vacA with s1-i1 polymorphisms are likely to be associated with increased gastric cancer risk. Aim: The aim of study was to determine the genotype of cagA and vacA and their usefulness as a predictive factor in upper gastrointestinal patients in Ilam, Iran. Methods: In this study, out of 168 biopsies, 109 H. pylori were isolated from different upper gastrointestinal patients and confirmed with molecular and biochemical tests. Chromosomal DNA bacteria was extracted and used as PCR templete to determine both the cagA EPIYA motifs and vacA polymorphism (s, i and m). Results: Our data showed that the prevalence of cagA gene is high in patients with gastrointestinal diseases (76.1%). The prevalence of vacA s1 was the highest with the percentage frequency of 85.3%, followed by i (71.5%) and m (68.8%). We demonstrated that the percentage of A, B, AB, AC, ABC and ABCC were 28.9% (24/83), 3.6% (3/83), 28.9% (24/83), 12.04% (10/83), 16.8% (14/83) and 9.6% (8/83), respectively. Interestingly, there was an important difference of the presence of EPIYA-C motif between PUD and gastritis groups (P < 0.001). There was a significant relationship between the presence of vacA i and EPIYA-C, at least with one repeat (P = 0.002). Conclusions: We performed the first cagA-EPIYA and vacA genotyping of H. pylori from Western Iran in relation to gasteroduodenal diseases. The present study showed that the presence of vacA i1 with cagA-EPIYA-C could be assumed as a predictive factor for PUD in our area.