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Association between Helicobacter pylori genotypes and severity of chronic gastritis, peptic ulcer disease and gastric mucosal interleukin-8 levels: evidence from a study in the Middle East

机译:幽门螺杆菌基因型与慢性胃炎,消化性溃疡病和胃粘膜白细胞介素-8水平的关系:中东研究的证据

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摘要

Background: The varied clinical presentations of Helicobacter pylori (H. pylori) infection are most likely due to differences in the virulence of individual strains, which determines its ability to induce production of interleukin-8 (IL-8) in the gastric mucosa. The aim of this study was to examine association between cagA, vacA-s1 and vacA-s2 genotypes of H. pylori and severity of chronic gastritis and presence of peptic ulcer disease (PUD), and to correlate these with IL-8 levels in the gastric mucosa. Methods: Gastric mucosal biopsies were obtained from patients during esophagogastroduodenoscopy. The severity of chronic gastritis was documented using the updated Sydney system. H. pylori cagA and vacA genotypes were detected by PCR. The IL-8 levels in the gastric mucosa were measured by ELISA. Results: H. pylori cagA and/or vacA genotypes were detected in 99 patients (mean age 38.4±12.9; 72 males), of whom 52.5% were positive for cagA, 44.4% for vacA-s1 and 39.4% for vacA-s2; and 70.7% patients had PUD. The severity of inflammation in gastric mucosa was increased with vacA-s1 (p=0.017) and decreased with vacA-s2 (p=0.025), while cagA had no association. The degree of neutrophil activity was not associated with either cagA or vacA-s1, while vacA-s2 was significantly associated with decreased neutrophil activity (p=0.027). PUD was significantly increased in patients with cagA (p=0.002) and vacA-s1 (p=0.031), and decreased in those with vacA-s2 (p=0.011). The level of IL-8 was significantly increased in patients with cagA (p=0.011) and vacA-s1 (p=0.024), and lower with vacA-s2 (p=0.004). Higher levels of IL-8 were also found in patients with a more severe chronic inflammation (p=0.001), neutrophil activity (p=0.007) and those with PUD (p=0.001). Conclusions: Presence of vacA-s1 genotype of H. pylori is associated with more severe chronic inflammation and higher levels of IL-8 in the gastric mucosa, as well as higher frequency of PUD. Patients with vacA-s2 have less severe gastritis, lower levels of IL-8, and lower rates of PUD. The presence of cagA genotype is not associated with the severity of gastritis or IL-8 induction in the gastric mucosa. The association of cagA with PUD may be a reflection of its presence with vacA-s1 genotype.
机译:背景:幽门螺杆菌(H. pylori)感染的临床表现各异,最有可能是由于个别菌株的毒力差异所致,这决定了其在胃粘膜中诱导白介素8(IL-8)产生的能力。这项研究的目的是检查幽门螺杆菌的cagA,vacA-s1和vacA-s2基因型与慢性胃炎的严重程度和消化性溃疡疾病(PUD)的相关性,并将它们与IL-8水平相关联。胃粘膜。方法:在食管胃十二指肠镜检查中对患者进行胃粘膜活检。使用更新的悉尼系统记录了慢性胃炎的严重程度。通过PCR检测幽门螺杆菌cagA和vacA基因型。通过ELISA测量胃粘膜中的IL-8水平。结果:在99例患者中检测到幽门螺杆菌cagA和/或vacA基因型(平均年龄38.4±12.9;男性72例),其中cagA阳性52.5%,vacA-s1阳性44.4%,vacA-s2阳性39.4%。 70.7%的患者患有PUD。胃粘膜炎症的严重程度随着vacA-s1的增加而增加(p = 0.017),而随着vacA-s2的降低而减少(p = 0.025),而cagA没有相关性。中性粒细胞活性的程度与cagA或vacA-s1都不相关,而vacA-s2与中性粒细胞活性的降低显着相关(p = 0.027)。 cagA(p = 0.002)和vacA-s1(p = 0.031)患者的PUD显着升高,而vacA-s2的患者PUD降低(p = 0.011)。 cagA(p = 0.011)和vacA-s1(p = 0.024)患者的IL-8水平显着升高,而vacA-s2(p = 0.004)患者较低。在患有更严重的慢性炎症(p = 0.001),嗜中性粒细胞活性(p = 0.007)和患有PUD的患者(p = 0.001)中也发现了较高水平的IL-8。结论:幽门螺杆菌vacA-s1基因型的存在与更严重的慢性炎症和胃粘膜中IL-8的水平较高以及PUD的发生频率有关。 vacA-s2患者的胃炎严重程度较低,IL-8水平较低,PUD发生率较低。 cagA基因型的存在与胃粘膜胃炎的严重程度或IL-8的诱导无关。 cagA与PUD的关联可能反映了其与vacA-s1基因型的存在。

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