The association between cagL and cagA, vacAs-m, babA genes in patients with gastric cancer, duodenal ulcer, and non-ulcer dyspepsia related to Helicobacter pylori

Acta Gastroenterol Belg. 2020 Jul-Sep;83(3):385-392.

Abstract

Introduction: As a component of the cag T4SS, the cagL gene is involved in the translocation of CagA into host cells and is essential for the formation of cag PAI-associated pili between H. pylori and gastric epithelial cells.

Aim: We aimed to investigate the clinical association of the cagL gene with other virulence factors (VacA, CagA, EPIYA-C, and BabA protein) of H. pylori strains isolated from GC, duodenal ulcer (DU), and non-ulcer dyspepsia (NUD) cases.

Methods: The patient group (PG), including 47 patients (22 GC and 25 DU) and a 25 control group (CG= NUD) were included. Amplification of the H. pylori cagL, cagA, vacA, and babA2 genes and typing of EPIYA motifs were performed by PCR methods.

Results: Sixty-one (84.7%) H. pylori strains were detected with cagL (93.6% in SG, 68% in CG). We detected a significant difference between SG and CG for the presence of cagL (p=0.012) but no statistical comparison was done for (≥2) EPIYA-C repeats In the comparison of H. pylori strains with cagA/vacAs1m1 and cagA/ vacAs1m2 and babA2 for the presence of cagL, we could not detect a significant difference (p=1).

Conclusion: We detected a significant difference between groups for the presence of cagL genotype (p=0.012). The vacAs1m1 (OR: 2.829), genotypes increased the GC and DU risk by 2.8 times, while multiple (≥2) EPIYA-C repeats incresed the GC and DU risk by 3.524 times. Gender (to be female) (OR: 0.454) decreased the GC and DU risk by inversly decreased in the multivariate analysis.

Keywords: Helicobacter pylori; cytotoxin-associated gene A (cagA); cytotoxin-associated gene L (cagL); vacuolating cytotoxin A (vacA).

MeSH terms

  • Antigens, Bacterial / genetics
  • Bacterial Proteins / genetics
  • Duodenal Neoplasms* / genetics
  • Duodenal Neoplasms* / microbiology
  • Duodenal Ulcer* / genetics
  • Duodenal Ulcer* / microbiology
  • Dyspepsia* / genetics
  • Dyspepsia* / microbiology
  • Female
  • Helicobacter Infections* / complications
  • Helicobacter Infections* / diagnosis
  • Helicobacter Infections* / epidemiology
  • Helicobacter pylori* / genetics
  • Humans
  • Male
  • Ulcer

Substances

  • Antigens, Bacterial
  • Bacterial Proteins