Prevalence of Helicobacter pylori vacA, cagA, cagE, iceA, babA2, and oipA genotypes in patients with upper gastrointestinal diseases

Background and Objectives: Helicobacter pylori has been strongly associated with peptic ulcer diseases, chronic gastritis, ulcers, and reported as a risk factor for gastric cancer, too. The vaculating cytotoxin (vacA), the cytotoxin associated genes (cagA), the induced by contact with epithelium factor antigen (iceA gene), blood adhesion binding antigen (babA2), and outer membrane protein oipA have been described as different virulence factors of H. pylori. The aim of this study was to investigate the prevalence of the vacA, cagA, cagE, iceA, babA2 and oipA genotypes of H. pylori isolates from patients with upper gasterointestinal problem or dyspepsia. Material and Methods: H. pylori isolated from endoscopic biopsies obtained from 222 studied patients. PCR was done only on cultured positive samples. The vacA alleles, cagA, cagE, iceA, babA2 and oipA genotypes were determined by PCR. Results: The isolation rate of H. pylori strains from culture of gastric biopsies was 16.7%. The vacA alleles s1, s2, m1 and m2 were detected in 20 (54.1%), 14 (37.8%), 9 (24.3%) and 23 (62.2%) isolates, respectively. VacA s1c genotype was detected in 70.3% of isolates. s1m2 was the most frequent vacA allelic combination in the examined H. pylori strains. The cagA gene was detected in 62.2%, cagE in 40.5%, iceA1 in 48.6%, iceA2 in 16.2%, oipA in 81.1% (95% CI: 0.0902-0.1798) and babA2 in 94.6% (95% CI: 0.113- 0.207). A significant correlation was observed between vacAs1 and cagA genotypes (P < 0.008), vacAs1/cagE (P = 0.001), vacAs2/cagA (P < 0.047), and vacAs2/cagE (P = 0.016) with Non-ulcer dyspepsia; but there were not observed any correlation between other virulence markers. Conclusion: No significant correlation was found between the existence of vacA, cagA, cagE, iceA, babA2, and oipA genes with peptic ulcer diseases and non-ulcer dyspepsia groups of studied patients.