Gut Liver.
2018 Jan;12(1):51-57. 10.5009/gnl17053.
Characterizing Helicobacter pylori cagA in Myanmar
- Affiliations
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- 1Department of Gastroenterology, Yangon General Hospital, University of Medicine (1), Yangon, Myanmar.
- 2Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu, Japan. yyamaoka@oita-u.ac.jp
- 3Department of Medicine, Gastroenterology and Hepatology Section, Baylor College of Medicine, Houston, TX, USA.
- 4Gastroentero-Hepatology Division, Department of Internal Medicine, Dr. Soetomo Teaching Hospital-Faculty of Medicine-Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia.
- 5Gastroenterology Unit, Department of Medicine, Thammasat University Hospital, Pathumthani, Thailand.
- 6Department of Gastroenterology, Mandalay General Hospital, University of Medicine (Mandalay), Mandalay, Myanmar.
- 7Department of Gastroenterology, Thingangyun Sanpya General Hospital, University of Medicine (2), Thingangyun, Myanmar.
- 8Department of Molecular Pathology, Oita University Faculty of Medicine, Yufu, Japan.
- 9GI and Liver Center, Bangkok Medical Center, Bangkok, Thailand.
- KMID: 2404717
- DOI: http://doi.org/10.5009/gnl17053
Abstract
- BACKGROUND/AIMS
Differences in the Helicobacter pylori infection rate are not sufficient to clarify the dissimilarity of gastric cancer incidence between Myanmar and its neighboring countries. To better understand this trend, the H. pylori virulence gene cagA was characterized in Myanmar.
METHODS
Glutamate-proline-isoleucine-tyrosine-alanine (EPIYA) patterns and CagA multimerization (CM) motifs of cagA genotypes were examined by performing polymerase chain reactions and DNA sequencing.
RESULTS
Of 69 tested H. pylori strains, cagA-positive patients had significantly more severe histological scores in their antrum than cagA-negative patients. Sequence analysis revealed that 94.1% of strains had Western-type cagA containing an EPIYA motif (92.6%) or EPIYT motif (6.4%). The intestinal metaplasia scores in the antral of patients infected with the ABC and ABCC types of cagA were significantly higher than those of patients with AB-type cagA. Interestingly, in patients infected with H. pylori, 46.3% of strains with three EPIYA motifs contained two identical Western-typical CM motifs, and these patients showed significantly higher antrum inflammation scores than patients infected with two identical nontypical-CM motif strains (p=0.02).
CONCLUSIONS
In Myanmarese strains, Western-type cagA was predominant. The presence of CM motifs and the proportion of multiple EPIYA-C segments might partially explain the intermediate gastric cancer risk found in Myanmar.
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