Evaluating the Genetic Diversity of Helicobacter pylori Isolates in Patients Suffering from Gastritis

Document Type : Original Research

Authors
S. Mami 1
S. Khaleghnezhad 2
M. Mami 3
M. dadashi 4
M. Goudarzi 2
H. Ghahremanpour 2
B. Hajikhani 5
1 Department of Immunology, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran
2 Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Ilam university of Medical Sciences, Ilam, Iran
4 Department of Microbiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
5 Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
10.52547/iem.8.4.297
Abstract
Backgrounds: Helicobacter pylori infections vary in severity and virulence in different populations for various reasons. There are different H. pylori strains with varying degrees of virulence. The genetic diversity of H. pylori strains in gastritis patients in different areas has not been well understood. This study aimed to evaluate the prevalence rate and different genotypes of H. pylori strains in clinical specimens of patients with gastritis in Ilam, Iran.

Materials & Methods: Saliva and gastric biopsy samples were collected from 81 patients (55 males and 26 females in the age range of 20 to 90 years) referring to Ilam medical centers. After DNA extraction, the prevalence of H. pylori as well as vacA, cagA, and ureC genes was evaluated using PCR, and then each vacA-positive sample was further evaluated for m1m2 and s1s2 variants.

Findings: The cagA and vacA genes were found in 27 (71%) and 36 (94.7%) H. pylori-positive samples, respectively. The cagA gene was detected in patients with gastric pain (44.4%) and anorexia (18.51%). Also, the results showed that the vacA s2m2 genotype and m2 allele were present in 32.9% of H. pylori isolates. Moreover, s2m2 and s1m2 genotypes were detected in 42.1 and 26.3% of vacA-positive samples, respectively. The lowest frequency was related to the m1 allele (17.18%).

Conclusion: This study results indicate a plausible relationship between the presence of some genotypes of H. pylori and the progression of gastritis, suggesting these markers as promising biomarkers to predict the disease severity.

Keywords

Subjects

1. Blaser MJ. Ecology of Helicobacter pylori in the human stomach. The Journal of clinical investigation. 1997;100(4):759-62.
2. Archampong TN, Asmah RH, Aidoo EK, Wiredu EK, Gyasi RK, Adjei DN, et al. Helicobacter pylori cagA and vacA genes in dyspeptic Ghanaian patients. BMC Research Notes. 2017 2017/06/27;10(1):231.
3. Thung I, Aramin H, Vavinskaya V, Gupta S, Park JY, Crowe SE, et al. Review article: the global emergence of Helicobacter pylori antibiotic resistance. Alimentary pharmacology & therapeutics. 2016;43(4):514-33.
4. Chirani AS, Ghazi M, Goudarzi M, Peerayeh SN, Soleimanjahi H, Dadashi M, et al. A survey on chimeric UreB229-561-HpaA protein targeting Helicobacter pylori: Computational and in vitro urease activity valuation. Computational biology and chemistry. 2018;76:42-52.
5. Breurec S, Michel R, Seck A, Brisse S, Come D, Dieye F, et al. Clinical relevance of cagA and vacA gene polymorphisms in Helicobacter pylori isolates from Senegalese patients. Clinical microbiology and infection. 2012;18(2):153-9.
6. Yong X, Tang B, Li B-S, Xie R, Hu C-J, Luo G, et al. Helicobacter pylori virulence factor CagA promotes tumorigenesis of gastric cancer via multiple signaling pathways. Cell communication and signaling. 2015;13(1):30.
7. Shiota S, Suzuki R, Yamaoka Y. The significance of virulence factors in Helicobacter pylori. Journal of digestive diseases. 2013;14(7):341-9.
8. 7. Basso D, Zambon CF, Letley DP, Stranges A, Marchet A, Rhead JL, et al. Clinical relevance of Helicobacter pylori cagA and vacA gene polymorphisms. Gastroenterology. 2008;135(1):91-9.
9. 8. Bibi F, Alvi SA, Sawan SA, Yasir M, Sawan A, Jiman-Fatani AA, et al. Detection and genotyping of Helicobacter pylori among gastric ulcer and cancer patients from Saudi Arabia. Pakistan journal of medical sciences. 2017;33(2):320.
10. Smith SI, Fowora MA, Lesi OA, Agbebaku E, Odeigah P, Abdulkareem FB, et al. Application of stool-PCR for the diagnosis of Helicobacter pylori from stool in Nigeria- a pilot study. SpringerPlus. 2012 2012/12/22;1(1):78.
11. Veiga N, Pereira C, Resende C, Amaral O, Ferreira M, Nelas P, et al. Oral and gastric Helicobacter pylori: effects and associations. PloS one. 2015;10(5):e0126923.
12. Tavakolian S, Goudarzi H, Faghihloo E. E-cadherin, Snail, ZEB-1, DNMT1, DNMT3A and DNMT3B expression in normal and breast cancer tissues. Acta Biochim Pol. 2019 Dec 1;66(4):409-414.
13. Tavakolian S, Goudarzi H, Faghihloo E. Evaluating the expression level of HERV-K env, np9, rec and gag in breast tissue. Infect Agent Cancer. 2019 Nov 29;14:42.
14. Tavakolian S, Goudarzi H, Torfi F, Faghihloo E. Evaluation of microRNA-9 and -192 expression levels as biomarkers in patients suffering from breast cancer. Biomed Rep. 2020 Jan;12(1):30-34.
15. Xue F-B, Xu Y-Y, Wan Y, Pan B-R, Ren J, Fan D-M. Association of H. pylori infection with gastric carcinoma: a Meta analysis. World journal of gastroenterology. 2001;7(6):801.
16. Cittelly D, Huertas M, Martinez J, Oliveros R, Posso H, Bravo M, et al. Helicobacter pylori genotypes in non atrophic gastritis are different of the found in peptic ulcer, premalignant lesions and gastric cancer in Colombia. Revista medica de Chile. 2002;130(2):143-51.
17. Qiao W, Hu J-L, Xiao B, Wu K-C, Peng D-R, Atherton JC, et al. cagA and vacA genotype of Helicobacter pylori associated with gastric diseases in Xi’an area. World Journal of Gastroenterology: WJG. 2003;9(8):1762.
18. Tan HJ, Rizal AM, Rosmadi MY, Goh KL. Distribution of Helicobacter pylori cagA, cagE and vacA in different ethnic groups in Kuala Lumpur, Malaysia. J Gastroenterol Hepatol. 2005 Apr;20(4):589-94.
19. Kazemian H, Shavalipour A, Mohebi R, Ghafurian S, Aslani S, Maleki A, et al. Estimation of the parasitic infection prevalence in children with Helicobacter pylori infection in Ilam city (2012-2013). Archives of Pediatric Infectious Diseases. 2014;2(3).
20. Kazemian H, Heidari H, Kardan Yamchi J, Shavalipour A, Ghafourian S, Mohebi R, et al. Relationship between Helicobacter pylori infection and parasitic infection in patients in Ilam. Infection Epidemiology and Microbiology. 2016;2(2):15-7.
21. Miernyk K, Morris J, Bruden D, McMahon B, Hurlburt D, Sacco F, et al. Characterization of Helicobacter pylori cagA and vacA genotypes among Alaskans and their correlation with clinical disease. Journal of clinical microbiology. 2011;49(9):3114-21.
22. Torres LE, Melián K, Moreno A, Alonso J, Sabatier CA, Hernández M, et al. Prevalence of vacA, cagA and babA2 genes in Cuban Helicobacter pylori isolates. World journal of gastroenterology: WJG. 2009;15(2):204.
23. van Doorn LJ, Figueiredo C, Sanna R, Plaisier A, Schneeberger P, de Boer W, et al. Clinical relevance of the cagA, vacA, and iceA status of Helicobacter pylori. Gastroenterology. 1998;115(1):58-66.
24. Paniagua GL1, Monroy E, Rodríguez R, Arroniz S, Rodríguez C, et al. Frequency of vacA, cagA and babA2 virulence markers in Helicobacter pylori strains isolated from Mexican patients with chronic gastritis. Ann Clin Microbiol Antimicrob. 2009 Apr 30;8:14.
25. Jafari F, Shokrzadeh L, Dabiri H, Baghaei K, Yamaoka Y, Zojaji H, et al. vacA genotypes of Helicobacter pylori in relation to cagA status and clinical outcomes in Iranian populations. Japanese journal of infectious diseases. 2008;61(4):290.
26. Wong BCY, Yin Y, Berg DE, Xia HHX, Zhang JZ, Wang WH, et al. Distribution of distinct vacA, cagA and iceA alleles in Helicobacter pylori in Hong Kong. Helicobacter. 2001;6(4):317-24.
27. Amin M, Shayesteh AA, Serajian A. Concurrent detection of cagA, vacA, sodB and hsp60 virulence genes and their relationship with clinical outcomes of disease in Helicobacter pylori isolated strains of southwest of Iran. Iran J Microbiol. 2019 Jun;11(3):198-205.
28. Roldán IJ, Castaño R, Navas MC. Mutations in the Helicobacter pylori 23S rRNA gene associated with clarithromycin resistance in patients at an endoscopy unit in Medellín, Colombia. Biomedica. 2019 Aug 1;39(Supl. 2):117-129.
29. Suriani R, Colozza M, Cardesi E, Mazzucco D, Marino M, Grosso S, et al. CagA and VacA Helicobacter pylori antibodies in gastric cancer. Can J Gastroenterol. 2008 Mar;22(3):255-8.
30. 29. Domilgo D, Alarcon T, Lopez- Brea M. Virulence factors of Spanish Helicobacter pylori isolates and correlation with gastritis or ulcer production. Clin Microbiol Infect 1999; 5: 668-671.
31. Van Doorn LJ, Figueiredo C, Mégraud F, Pena S, Midolo P, Queiroz DMDM, et al. Geographic distribution of vacA allelic types of Helicobacter pylori. Gastroenterology. 1999;116(4):823-30.
32. Mansour KB, Fendri C, Zribi M, Masmoudi A, Labbene M, Fillali A, et al. Prevalence of Helicobacter pylori vacA, cagA, iceA and oipA genotypes in Tunisian patients. Annals of Clinical Microbiology and Antimicrobials. 2010;9(1):10.
33. Al Qabandi A, Mustafa A, Siddique I, Khajah A, Madda J, Junaid T. Distribution of vacA and cagA genotypes of Helicobacter pylori in Kuwait. Acta tropica. 2005;93(3):283-8.
34. Cover TL, Blaser MJ. Helicobacter pylori in health and disease. Gastroenterology. 2009;136(6):1863-73.
35. Erzin Y, Koksal V, Altun S, Dobrucali A, Aslan M, Erdamar S, et al. Prevalence of Helicobacter pylori vacA, cagA, cagE, iceA, babA2 genotypes and correlation with clinical outcome in Turkish patients with dyspepsia. Helicobacter. 2006;11(6):574-80.
36. Atherton JC, Cao P, Peek RM, Tummuru MK, Blaser MJ, Cover TL. Mosaicism in vacuolating cytotoxin alleles of Helicobacter pylori association of specific vacA types with cytotoxin production and peptic ulceration. Journal of Biological Chemistry. 1995;270(30):17771-7.
37. Kamali-Sarvestani E, Bazargani A, Masoudian M, Lankarani K, Taghavi A-R, Saberifiroozi M. Association of H pylori cagA and vacA genotypes and IL-8 gene polymorphisms with clinical outcome of infection in Iranian patients with gastrointestinal diseases. World journal of gastroenterology: WJG. 2006;12(32):5205.
38. Siavoshi F, Malekzadeh R, Daneshmand M, Smoot DT, Ashktorab H. Association between Helicobacter pylori infection in gastric cancer, ulcers and gastritis in Iranian patients. Helicobacter. 2004;9(5):470.
Infection Epidemiology and Microbiology
Volume 8, Issue 4
December 2022
Pages 297-305