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. 2019 Jan 25;19(1):16.
doi: 10.1186/s12876-019-0934-z.

Helicobacter pylori vacA, cagA and iceA genotypes in dyspeptic patients from southwestern region, Saudi Arabia: distribution and association with clinical outcomes and histopathological changes

Mohammed Akeel  1 , Atef Shehata  2   3 , Ahmed Elhafey  4   5 , Erwa Elmakki  6 , Thanaa Aboshouk  7 , Hussein Ageely  6 , Mohammed Mahfouz  8
Affiliations

Helicobacter pylori vacA, cagA and iceA genotypes in dyspeptic patients from southwestern region, Saudi Arabia: distribution and association with clinical outcomes and histopathological changes

Mohammed Akeel et al. BMC Gastroenterol. .

Abstract

Background: The aim of this study was to identify the common H. pylori virulence genes among dyspeptic Southwestern Saudi patients and their association with clinical outcomes and histopathological findings to help practitioners and researchers in the region for better management of infections caused by such bacteria.

Methods: Four hundred two gastric biopsy specimens were analyzed using histopathological examination and real time-PCR. The positive 187 specimens by RT-PCR were genotyped using PCR targeting cagA, vacA and iceA genes.

Results: One hundred twenty-eight gastric biopsy specimens were positive in genotyping PCRs. The cagA, vacA, iceA1 and iceA2 genes were detected in rates of 49.2% (63/128), 100%(128/128), 42.2% (54/128), 32.8% (42/128), respectively. The vacA s1as1bm2 subtype was the highest 23.4% (30/128), followed by m2 and s1a1b subtypes which were equally detected [16.4% (21/128) for each]. The iceA genes were significantly associated with gastritis and gastric ulcer. Overall, vacA genotypes were significantly associated with gastritis, gastric and duodenal ulcers. The vacA subtypes: s1as1bm2, s1a1b and s2 m2 showed chronic active gastritis in percentages of 90.0, 81, and 84.2%, respectively. All vacA mixed genotypes showed chronic active gastritis.

Conclusions: H. pylori virulence genes are highly prevalent and diverse among patients with dyspepsia in Southwestern region of Saudi Arabia. The iceA genes and the different vacA subtypes are significantly associated with the clinical outcomes and histopathological changes especially chronic active gastritis.

Keywords: Gastric ulcer; Gastritis; Genotype; H. pylori; PCR; Virulence genes.

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Conflict of interest statement

Ethics approval and consent to participate

Informed written consent was obtained from all enrolled patients, per the ethics guidelines in Saudi Arabia. Ethical approval for the current study was obtained from the Ethics Committee of the Faculty of Medicine, Jazan University (FMRERC).

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Agarose gel electrophoresis of the PCR-based genotyping amplified products of (a) cagA gene (349 bp). Lanes; M; 100 bp DNA ladder (Solis Biodyne). Lanes 1, 2, 3, 5, 7, 9, 11, and 15 are cagA positive while remaining lanes are negative for this gene. b cag empty site (550 bp). Lanes; M; 100 bp molecular DNA marker (Cleaver Scientific Ltd.). Lanes 1, 2, 4, 5, 7, 8 are cagA empty site positive while the remaining lanes are negative for this site. c iceA1 gene (247 bp). Lanes; M; 100 bp molecular DNA marker (Cleaver Scientific Ltd.). Lanes 1, 2, 3, 4, 5, 7, 8, 9, 11, 13, 14 and 15 are iceA1 positive while remaining lanes are negative for this gene. Note that PCR bands in lanes 4 and 11 are faint. d iceA2 gene (229 or 334 bp). Lanes; M; 100 bp molecular DNA marker (Cleaver Scientific Ltd.). Lanes 1, 4, 6, 10, 11, and 12 are iceA2 positive while lanes 2, 3, 5, 7–9, 13–15 are negative for this gene. Note that PCR products in lanes 1, 6 and 12 are of 334 bp size, while lanes 4, 10 and 11 have 229 bp PCR products
Fig. 2
Fig. 2
Agarose gel electrophoresis of the PCR-based genotyping amplified products of vacA gene. a PCR products of vacA s1a gene (212 bp). Lanes; M; 100 bp molecular DNA marker (Cleaver Scientific Ltd.). Lanes 4, 5, 8, 9, and 10 are positive while lanes 1, 2, 3, 6, 7 and 9 are negative. b PCR products of vacA s1b gene (187 bp). Lanes; M; 100 bp molecular DNA marker (Cleaver Scientific Ltd.). Lanes 2, 5, 7, 8 and 9, while lanes 10 are positive while lanes 1, 3, 4 and 10 are negative. c products of vacA s2 gene (199 bp). a) Positive photo. b) Negative photo. Lanes; M; 100 bp molecular DNA marker (Cleaver Scientific Ltd.). Lanes 7 and 9 are positive while lanes 1, 2, 3, 4, 5, 6 and 8 are negative for this gene. d amplified products of vacA m1 gene (290 bp). a Positive photo. b Negative photo. Lanes; M; 100 bp molecular DNA marker (Cleaver Scientific Ltd.). Lanes 4 and 8 are positive while lanes 1, 2, 3, 5, 6, 7 and 9 are negative for this gene. e products of vacA m2 gene (352 bp). Lanes; M; 100 bp molecular DNA marker (Cleaver Scientific Ltd.). Lanes 1, 2, 3, 5, 6, 7 and 10 are positive while lanes 4, 8 and 9 are negative for this gene
Fig. 3
Fig. 3
The relationship of vacA with: a clinical outcomes (as detected by endoscopic findings) and b histopathological changes
See this image and copyright information in PMC

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