The impacts of H. pylori virulence factors on the development of gastroduodenal diseases.
The impacts of H. pylori virulence factors on the development of gastroduodenal diseases.
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DOI：
10.1186/s12929-018-0466-9
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发表时间：
2018-09-11
影响因子：
11
通讯作者：
Sheu BS
中科院分区：
文献类型：
--
作者：
Chang WL;Yeh YC;Sheu BS
虽然大多数H。幽门螺杆菌感染者没有症状，有些可能发展成严重的疾病，如胃腺癌、胃高恶性B细胞淋巴瘤和消化性溃疡。流行病学和基础研究表明，H.携带特定毒力因子的幽门螺杆菌可导致更严重的结果。与胃腺癌发生相关的毒力因子包括细胞毒素相关基因A的存在、表达强度和类型（CagA，特别是EPIYA-D型和EPIYA-C的多拷贝）和IV型分泌系统CagL多态性导致其易位到宿主细胞中，空泡细胞毒素A的基因型（vacA，s1/i1/m1型）和血型抗原结合粘附素（BabA，低产量或与BabB嵌合）的表达强度。CagA的存在也与胃高级别B细胞淋巴瘤的发生有关。消化性溃疡与cagA基因阳性、vacA s1/m1基因型、babA 2基因阳性（编码BabA蛋白）、十二指肠溃疡促进基因簇（dupA簇）和上皮细胞接触诱导基因A1（iceA 1）的存在以及外部炎性蛋白（OipA）的表达状态密切相关。这些毒力因子在H.幽门螺杆菌分离自不同的地理区域和种族群体，这可以解释疾病发病率的差异。例如，在全球胃癌发病率最高的东亚，几乎所有的H。pylori分离株cagA基因阳性，vacA s1/i1/m1和BabA表达。因此，选择合适的毒力标记和测试方法是很重要的，当使用它们来确定疾病的风险。本文综述了H.幽门螺杆菌毒力因子与胃十二指肠疾病的关系，并讨论了地理差异和适当的方法分析这些毒力标记。
Although most H. pylori infectors are asymptomatic, some may develop serious disease, such as gastric adenocarcinoma, gastric high-grade B cell lymphoma and peptic ulcer disease. Epidemiological and basic studies have provided evidence that infection with H. pylori carrying specific virulence factors can lead to more severe outcome. The virulence factors that are associated with gastric adenocarcinoma development include the presence, expression intensity and types of cytotoxin-associated gene A (CagA, especially EPIYA-D type and multiple copies of EPIYA-C) and type IV secretion system (CagL polymorphism) responsible for its translocation into the host cells, the genotypes of vacuolating cytotoxin A (vacA, s1/i1/m1 type), and expression intensity of blood group antigen binding adhesin (BabA, low-producer or chimeric with BabB). The presence of CagA is also related to gastric high-grade B cell lymphoma occurrence. Peptic ulcer disease is closely associated with cagA-genopositive, vacA s1/m1 genotype, babA2-genopositive (encodes BabA protein), presence of duodenal ulcer promoting gene cluster (dupA cluster) and induced by contact with epithelium gene A1 (iceA1), and expression status of outer inflammatory protein (OipA). The prevalence of these virulence factors is diverse among H. pylori isolated from different geographic areas and ethnic groups, which may explain the differences in disease incidences. For example, in East Asia where gastric cancer incidence is highest worldwide, almost all H. pylori isolates were cagA genopositive, vacA s1/i1/m1 and BabA-expressing. Therefore, selection of appropriate virulence markers and testing methods are important when using them to determine risk of diseases. This review summarizes the evidences of H. pylori virulence factors in relation with gastroduodenal diseases and discusses the geographic differences and appropriate methods of analyzing these virulence markers.
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影响因子：
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作者：
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