ABSTRACT
Background: CagA, a 120- to 145-kD Helicobacter pylori [H. pylori] protein, increases the risk of atrophic gastritis and gastric cancer [GC]. The pathogenic CagA contains a highly polymorphic Glu-Pro-Ile-Tyr-Ala [EPIYA] repeat region in the C-terminal portion of the protein. The aim of this study was to determine the number and type of EPIYA [glutamine-proline-isoleucine-tyrosine-alanine] motifs within the cagA 3' variable region among H. pylori isolates and their association with GC.
Materials and methods: The total number of 206 individuals [170 controls and 36 patients with GC] referring to the endoscopy units of several cities in Iran [2008-2014] were recruited. The polymerase chain reaction [PCR] amplification was performed to determine the presence of H. pylori, cagA gene, and EPIYA motifs.
Results: In this study, 81 [47.6 percent] and 22 [61.1 percent] of the controls and patients with GC were carriers of cagA+ strains, respectively. The overall frequency of EPIYA-AB, EPIYA-ABC, EPIYA-ABCC, and EPIYA-ABCCC in patients with GC were 0 percent, 59 percent, 9 percent, and 31.8 percent, respectively. The results of regression analysis showed a significant association between EPIYA-ABCCC motif and the risk of GC [OR = 9.99 [95 percentCI: 2.17-45.88], p = 0.003].
Conclusion: We propose that patients infected with H. pylori strains harboring more than one CagA EPIYA C motif [EPIYA-ABCCC] have an increased risk of GC, thus, testing for this genotype may have clinical usefulness