Heterogeneity in the Helicobacter pylori vacA and cagA genes: association with gastroduodenal disease in South Africa?
Open accessAbstract
BACKGROUND: Helicobacter pylori infection is universally associated with gastritis, but only sometimes with clinically significant disease. Candidate virulence markers seem to be useful in identifying the pathogenic infections in some populations. AIMS: To investigate the association between putative virulence markers and disease in an African population. METHODS: Fifty nine H pylori strains isolated from dyspeptic patients (11 with peptic ulceration, eight with gastric adenocarcinoma, and 28 with no pathology other than gastritis) were studied for differences in the genes vacA and cagA . RESULTS: Forty seven (80%) of 59 strains had the vacA signal sequence genotype s1 (one s1a, 46 s1b) and 12 (20%) had subtype s2. vacA mid-region analysis revealed that 40 (68%) strains were vacA m1 and 19 (32%) were m2. All 14 strains from patients with peptic ulceration were vacA s1, in contrast to 23 (66%) of 35 strains from patients with gastritis alone (p<0.01). vacA s2 was found exclusively in patients with gastritis alone (p<0.01). All strains isolated from patients with gastric adenocarcinoma were s1b/m1 (p<0.005 versus gastritis alone). cagA was detectable in 56 (95%) of 59 isolates. Strains from patients with peptic ulceration (12/13 versus 19/30 with gastritis alone, p=0.05) had the shortest fragment length in the 3′ region of cagA , while 4/10 strains from patients with gastric cancer had the longest fragment length in this region (p<0.02 versus gastritis alone). CONCLUSION: In this study, the vacA s1 genotype, and fragment length of the 3′ region of cagA identified isolates associated with significant clinical disease. The vacA s1bm1 genotype seems to be strongly associated with gastric cancer.
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Only a small fraction of infected hosts will develop cancer, likely because of differences in bacterial genetics, host genetics, age of infection acquisition, and environmental factors.
“Yet only a small fraction of infected hosts will develop cancer, likely because of differences in bacterial genetics, host genetics, age of infection acquisition, and environmental factors.107”
From Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. (2024) · cites this paper as [107]
The introductory passage in our copy (labelled Abstract; page unavailable) says H. pylori infection only sometimes leads to clinically significant disease and identifies strain virulence, host susceptibility, and environmental cofactors as possible contributors. The Discussion also considers those factors in relation to gastric adenocarcinoma. Neither passage specifically establishes that only a small fraction of infected hosts develop cancer or mentions host genetics or age at infection acquisition. (LLM, conf=0.85)
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- Letley D, Lastovica A, Louw J, et al. Analysis of vacA diver- sity among Helicobacter pylori isolates from South Africa reveals existence of a vacA s2m1 allele [abstract]. Gastroen- terology 1998;113:A458.
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“107 Other risk factors for noncardia gastric cancer include alcohol consumption, tobacco smoking, and foods preserved by salting, with low consumption of fruit intake and high consumption of processed meat, grilled or barbecued meat, and fish possibly also increasing risk.”
Background
- Authors
- Kidd, M., Lastovica, A. J., Atherton, J. C., & Louw, J. A.
- Affiliations
- University of Nottingham (GB)
- Corresponding author
- Louw, J A
- ORCID
- Kidd, M
- Venue
- Gut
- Publisher
- BMJ
- Published
- 1999-10-01
- Volume
- 45
- Issue
- 4
- Pages
- 499-502
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- PMC
- PMC1727692
- OpenAlex
- W2125587655
- Cited by
- 148
- References
- 31
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 2 · 2023: 5 · 2022: 2 · 2021: 9 · 2019: 2 · 2018: 4 · 2017: 1 · 2016: 11 · 2015: 4 · 2014: 4 · 2013: 5 · 2012: 4
- FWCI
- 8.44
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gut (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Helicobacter pylori-related gastroenterology studies
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Surgery › Gastrointestinal disorders and treatments
- Keywords
- Helicobacter pylori, vacA gene, cagA gene, virulence markers, peptic ulcer, gastric adenocarcinoma, gastritis, gastroduodenal diseases, South Africa, African populations
- MeSH terms
- Adenocarcinoma, Antigens, Bacterial, Bacterial Proteins, Gastritis, Gastrointestinal Diseases, Genotype, Humans, Peptic Ulcer, Species Specificity, Stomach Neoplasms, Virulence, Polymerase Chain Reaction, Helicobacter pylori
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