Importance of Helicobacter pylori oipA in clinical presentation, gastric inflammation, and mucosal interleukin 8 production
Importance of Helicobacter pylori oipA in clinical presentation, gastric inflammation, and mucosal interleukin 8 production
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DOI：
10.1053/gast.2002.34781
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发表时间：
2002-08-01
期刊：
影响因子：
29.4
通讯作者：
Graham, DY
中科院分区：
文献类型：
--
作者：
Yamaoka, Y;Kikuchi, S;Graham, DY
背景与目的：幽门螺杆菌疾病相关的毒力因子可能不是相互独立的。目的是确定H。幽门螺杆菌毒力因子是胃炎症严重程度或临床结果的最重要预测因子。方法：采用聚合酶链反应（PCR）检测cag致病岛（派）、vacA、babA 2和iceA状态。oipA功能性基于通过基于PCR的测序确定的开关状态。进行了向后逐步多元回归分析，以确定哪些因素对临床结果以及与粘膜组织学的关系最具鉴别力（H。幽门螺杆菌密度、中性粒细胞浸润、肠化生和胃萎缩）和粘膜白细胞介素8（IL-8）产生。结果：H. pylori感染者247例（胃炎86例，十二指肠溃疡86例，胃癌75例）。尽管oipA状态与特定的cag派、vacA和babA 2基因型密切相关，但在最终模型中仅oipA状态可区分十二指肠溃疡和胃炎（调整后的比值比[OR] = 5，95%置信区间[CI] = 2.1-11.9）。在这些因素中，只有功能性oipA与高H显著相关。pylori密度、中性粒细胞浸润严重、黏膜IL-8水平升高（P < 0.001）。oipA状态与胃萎缩改变无关。结论：oipA功能状态与临床表现有关，H.幽门螺杆菌密度和胃炎症。cag派、babA 2或vacA状态仅作为功能性oipA基因的替代标志物显得重要。
Background & Aims: Disease-associated virulence factors of Helicobacter pylori may not be independent of one another. The aim was to determine which H. pylori virulence factor(s) was the most important predictor of severity of gastric inflammation or clinical outcome. Metho : cag Pathogenicity island (PAI), vacA, babA2, and iceA status were determined by polymerase chain reaction (PCR). oipA functionality was based on switch status determined by PCR-based sequencing. A backward stepwise multiple regression analysis was performed to determine which factor(s) was the most discriminating for clinical outcome as well as the relationship to mucosal histology (H. pylori density, neutrophil infiltration, intestinal metaplasia, and gastric atrophy) and mucosal interleukin 8 (IL-8) production. Results: H. pylori were obtained from 247 patients (86 with gastritis, 86 with duodenal ulcer, and 75 with gastric carcinoma). Although oipA status was closely linked to specific cag PAI, vacA, and babA2 genotypes, only oipA status remained in the final model to discriminate duodenal ulcer from gastritis (adjusted odds ratio [OR] = 5 and 95% confidence interval [CI] = 2.1-11.9). Among the factors, only a functional oipA was significantly associated with high H. pylori density, severe neutrophil infiltration, and high mucosal IL-8 levels (P < 0.001). oipA status had no relationship to gastric atrophic changes. Conclusions: oipA functional status was related to clinical presentation, H. pylori density, and gastric inflammation. cag PAI, babA2, or vacA status appear important only as surrogate markers for a functional oipA gene.