Helicobacter pylori Western cagA genotype in Egyptian patients with upper gastrointestinal disease

Background: Infection with Helicobacter pylori (H. pylori) causes persistent gastritis that may progress to fatal gastric cancer. The cytotoxin-associated gene A protein (CagA), encoded by the cytotoxin-associated gene A (cagA) is the main virulence factor associated with more severe clinical outcom...

Full description

Bibliographic Details
Main Authors: Manal Diab, Mohamed Shemis, Doaa Gamal, Ahmed El-Shenawy, Maged El-Ghannam, Effat El-Sherbini, Mohamed Saber
Format: Article
Language:English
Published: SpringerOpen 2018-10-01
Series:Egyptian Journal of Medical Human Genetics
Online Access:http://www.sciencedirect.com/science/article/pii/S1110863018300703
_version_ 1819172970958946304
author Manal Diab
Mohamed Shemis
Doaa Gamal
Ahmed El-Shenawy
Maged El-Ghannam
Effat El-Sherbini
Mohamed Saber
author_facet Manal Diab
Mohamed Shemis
Doaa Gamal
Ahmed El-Shenawy
Maged El-Ghannam
Effat El-Sherbini
Mohamed Saber
author_sort Manal Diab
collection DOAJ
description Background: Infection with Helicobacter pylori (H. pylori) causes persistent gastritis that may progress to fatal gastric cancer. The cytotoxin-associated gene A protein (CagA), encoded by the cytotoxin-associated gene A (cagA) is the main virulence factor associated with more severe clinical outcomes. It is further divided into Western-type CagA and East Asian-type CagA. The East Asian-type CagA induces more cytoskeleton changes and is more likely to be associated with gastric cancer. Aim of the study: In the current study we aimed to identify the most prevalent H. pylori cagA genotype among Egyptian patients suffering from dyspepsia and to examine its possible correlation with the associated clinical condition. Patients and methods: Four biopsies were obtained from the antrum and angularis from each of 113 adult patients, who underwent upper endoscopy at the Endoscopy Unit, Theodor Bilharz Research Institute (TBRI) Hospital for the analysis of H. pylori by rapid urease test and detection of 16S rRNA. Nested PCR assay was used to determine cagA genotype. Results: Sixty (53.1%) dyspeptic patients were found infected with H. pylori. Although Egypt has a high prevalence of H. pylori infection, low prevalence of cagA was detected (26.5%). Western type cagA is the predominant type (62.5%) while East Asian type was not detected and others (37.5%) remain uncharacterized. Western-genotype cagA genotype was found in 80% of patients with peptic ulcer disease and 40% of patients with gastritis. Conclusion: Absence of the more virulent East Asian cagA genotype, which is the strongest risk factor for gastric carcinogenesis, may explain the very low gastric cancer rate among Egyptian population compared to other parts of the world. This finding demands further molecular studies using whole genome sequencing and more samples to determine the exact uncharacterized cagA genotype to identify the actual risk in developing gastroduodenal diseases in Egypt. Keywords: Helicobacter pylori, Endoscopic findings, Western type cagA, East-Asian cagA, Peptic ulcer, Gastritis
first_indexed 2024-12-22T20:15:39Z
format Article
id doaj.art-d15a62f8bf774babb1be2a156d20cfd0
institution Directory Open Access Journal
issn 1110-8630
language English
last_indexed 2024-12-22T20:15:39Z
publishDate 2018-10-01
publisher SpringerOpen
record_format Article
series Egyptian Journal of Medical Human Genetics
spelling doaj.art-d15a62f8bf774babb1be2a156d20cfd02022-12-21T18:13:58ZengSpringerOpenEgyptian Journal of Medical Human Genetics1110-86302018-10-01194297300Helicobacter pylori Western cagA genotype in Egyptian patients with upper gastrointestinal diseaseManal Diab0Mohamed Shemis1Doaa Gamal2Ahmed El-Shenawy3Maged El-Ghannam4Effat El-Sherbini5Mohamed Saber6Department of Microbiology, Theodor Bilharz Research Institute (TBRI), Giza, EgyptDepartment of Biochemistry, Theodor Bilharz Research Institute (TBRI), Giza, EgyptDepartment of Microbiology, Theodor Bilharz Research Institute (TBRI), Giza, Egypt; Corresponding author at: Theodor Bilharz Research Institute (TBRI), El Nile Street, PO Box: 30, Imbaba, 12411 Giza, Egypt.Department of Microbiology, Theodor Bilharz Research Institute (TBRI), Giza, EgyptDepartment of Gastroentrology and Hepatology, Theodor Bilharz Research Institute (TBRI), Giza, EgyptDepartment of Microbiology, Theodor Bilharz Research Institute (TBRI), Giza, EgyptDepartment of Biochemistry, Theodor Bilharz Research Institute (TBRI), Giza, EgyptBackground: Infection with Helicobacter pylori (H. pylori) causes persistent gastritis that may progress to fatal gastric cancer. The cytotoxin-associated gene A protein (CagA), encoded by the cytotoxin-associated gene A (cagA) is the main virulence factor associated with more severe clinical outcomes. It is further divided into Western-type CagA and East Asian-type CagA. The East Asian-type CagA induces more cytoskeleton changes and is more likely to be associated with gastric cancer. Aim of the study: In the current study we aimed to identify the most prevalent H. pylori cagA genotype among Egyptian patients suffering from dyspepsia and to examine its possible correlation with the associated clinical condition. Patients and methods: Four biopsies were obtained from the antrum and angularis from each of 113 adult patients, who underwent upper endoscopy at the Endoscopy Unit, Theodor Bilharz Research Institute (TBRI) Hospital for the analysis of H. pylori by rapid urease test and detection of 16S rRNA. Nested PCR assay was used to determine cagA genotype. Results: Sixty (53.1%) dyspeptic patients were found infected with H. pylori. Although Egypt has a high prevalence of H. pylori infection, low prevalence of cagA was detected (26.5%). Western type cagA is the predominant type (62.5%) while East Asian type was not detected and others (37.5%) remain uncharacterized. Western-genotype cagA genotype was found in 80% of patients with peptic ulcer disease and 40% of patients with gastritis. Conclusion: Absence of the more virulent East Asian cagA genotype, which is the strongest risk factor for gastric carcinogenesis, may explain the very low gastric cancer rate among Egyptian population compared to other parts of the world. This finding demands further molecular studies using whole genome sequencing and more samples to determine the exact uncharacterized cagA genotype to identify the actual risk in developing gastroduodenal diseases in Egypt. Keywords: Helicobacter pylori, Endoscopic findings, Western type cagA, East-Asian cagA, Peptic ulcer, Gastritishttp://www.sciencedirect.com/science/article/pii/S1110863018300703
spellingShingle Manal Diab
Mohamed Shemis
Doaa Gamal
Ahmed El-Shenawy
Maged El-Ghannam
Effat El-Sherbini
Mohamed Saber
Helicobacter pylori Western cagA genotype in Egyptian patients with upper gastrointestinal disease
Egyptian Journal of Medical Human Genetics
title Helicobacter pylori Western cagA genotype in Egyptian patients with upper gastrointestinal disease
title_full Helicobacter pylori Western cagA genotype in Egyptian patients with upper gastrointestinal disease
title_fullStr Helicobacter pylori Western cagA genotype in Egyptian patients with upper gastrointestinal disease
title_full_unstemmed Helicobacter pylori Western cagA genotype in Egyptian patients with upper gastrointestinal disease
title_short Helicobacter pylori Western cagA genotype in Egyptian patients with upper gastrointestinal disease
title_sort helicobacter pylori western caga genotype in egyptian patients with upper gastrointestinal disease
url http://www.sciencedirect.com/science/article/pii/S1110863018300703
work_keys_str_mv AT manaldiab helicobacterpyloriwesterncagagenotypeinegyptianpatientswithuppergastrointestinaldisease
AT mohamedshemis helicobacterpyloriwesterncagagenotypeinegyptianpatientswithuppergastrointestinaldisease
AT doaagamal helicobacterpyloriwesterncagagenotypeinegyptianpatientswithuppergastrointestinaldisease
AT ahmedelshenawy helicobacterpyloriwesterncagagenotypeinegyptianpatientswithuppergastrointestinaldisease
AT magedelghannam helicobacterpyloriwesterncagagenotypeinegyptianpatientswithuppergastrointestinaldisease
AT effatelsherbini helicobacterpyloriwesterncagagenotypeinegyptianpatientswithuppergastrointestinaldisease
AT mohamedsaber helicobacterpyloriwesterncagagenotypeinegyptianpatientswithuppergastrointestinaldisease