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DNA sequence analysis of cagA 3' motifs of Helicobacter pylori strains from patients with peptic ulcer diseases

¹ Fatih University;

² Istanbul Teaching Hospital

³ E-mail: basalih{at}fatih.edu.tr

Received July 31, 2009
Accepted October 21, 2009

The H. pylori cagA gene is a major virulence factor that plays an important role in gastric pathologies. DNA sequence data of the cagA 3' region of Western isolates differs markedly in their EPIYA motifs from those of East Asian isolates. An increase in the number of these motifs is known to be associated with gastric cancer. Whether such association is also the case for peptic ulceration was investigated in this study. Gastric biopsies were collected from 96 patients with duodenal ulcer (DU), gastric ulcer (GU) and gastritis. The type of the EPIYA motifs detected by PCR among 28 DU strains were 13 ABC, 8 ABCC, 6 ABCCC, and in one patient with mixed infection of ABC and ABCCCCC; among the 9 GU strains were 2 ABC, 5 ABCC, and 2 ABCCC; and in 40 gastritis strains were 35 ABC, and 5 ABCC. DNA sequencing was done to confirm the detection of the EPIYA motifs type and to analyze their peptide sequences. A significant association was found between the number of the EPIYA-C motifs (>/2) and peptic ulceration (P = 0.00001) as compared to gastritis. In conclusion, this study shows that our patients harbor cagA positive H. pylori strains with EPIYA motifs of the Western type and the increase in the number of EPIYA-C motifs was significantly associated with DU and GU than with gastritis indicating predictive association with the severity of the disease.