Correlación Endoscópica-Histopatológica del Cag-A del Helicobacter Pylori / Endoscopic-Hystopathological Correlation of Helicobacter Pylory Cag-A

Resumen En la actualidad más de la mitad de la población mundial esta infectada con Helicobacter Pylori pero solo del 10 al 20 % desarrollan la enfermedad. La variación en el resultado clínico de la patología inducida por el H. Pylori es multifactorial, entre estos están los factores de la virulencia habiéndose identificado los genotipos cagA, vacA e ice A. que contribuyen en su patogenia. El genotipo cagA ha sido asociado con la enfermedad ulcero péptica, atrofia de la mucosa gástrica y cáncer gástrico, identificado entonces como un factor de virulencia del H. Pylori y responsable de éstas complicaciones en muchas series mundiales. El objetivo de nuestro trabajo fue deternimar el genotipo cagA de H. Pylori en nuestro medio, mediante ELISA y ver su correlación con los hallazgos endoscópicos e histopatológicos de la mucosa gástrica en pacientes del Instituto de Gastroenterología Boliviano Japonés de Cochabamba. Se incluyeron en el estudio a 171 pacientes positivos para H. Pylori, diagnosticados por cualquiera de los tres métodos utilizados: Test rápido de Ureasa, Serología e Histología. En los pacientes diagnosticados mediante serología con ELISA se detectó positividad para cagA en 101 (59.1 %) de los pacientes, con un 66.3% del sexo femenino y 33.7% varones y una edad promedio de 39.5 años, con un rango de 29 a 59 años. La gastritis verrucosa, gastritis nodular, gastritis erosiva y la ulcera duodenal fueron los hallazgos endoscópicos mas frecuentes en los pacientes con H. Pylori cag A (+). En los pacientes con diagnóstico histopatológico de metaplasia intestinal y atrofia gástrica, no se encontró diferencia estadísticamente significativa entre los pacientes cag A positivos Vs los negativos, pero sí en aquellos con gastritis crónica activa (67. 7%) H .Pylori cagA positivo.

Abstract Currently more of half people of the world is infected with Helicobacter Pilory but only from 10 to 20 % develops the di-sease, the variation in the clinical result of the pathology induced by the Helicobacter Pilory is multifactorial, one of these factors is the virulence factor, having been identified the genotypes, cagA, vacA and ice A. that contribuys in the pa-thogeny. The genotype cagA has been associated with peptic ulcer, atrophy of the mucous gastric and gastric cáncer, identified as a factor of virulence of H. pylori and the causer for these complications in many world series. The aim of our work was to determinet the genotype cagA of helicobacter in our enviroment, by means of ELISA and to see his correlation with the finds endoscopios and histopatologics of the gastric mucous in patients of the Bolivian Japa-nese Institute of Gastroenterology of cochabamba. They were included in the study 171 positive patients to H. pylori, diagnosed by any ofthree used methods: rapid Test of Ureasa, Serology and Histology, in these patients by means serology with ELISA there were detected positivity To cagA in 101 (59.1 % ) ofthe patients with 66.3 % ofthe females and 33.7 % males of 39.5 % years, with a range from 29 to 59years. The wart gastritis, nodular gastritis, erosive gastritis and the sore duodenal were the finds endoscopios more frequent in the patients with H.pylori cagA (+). In the patients with diagnosis histopatologic of metaplasia intestinal and gastric atrophy, not find statistically significant difference between the patients cagA positives vs the negatives, but ¡fin those with chronic active gastritis (67.7 % ) h. Pylori cagA positive.

Antibodies to Helicobacter pylori, CagA, VacA in the patients with gastroenteropathy and in healthy persons

Study was performed on 100 serum samples of patients (15-70 aged) treated of gastro-duodenal diseases and 31 healthy persons by Immunoblot assay. The results showed that: the prevalence of H.pylori positive in patients with gastric ulcer, duodenal ulcer and gastritis was 76.5, 95.8 and 73%, respectively. The prevalence of H. pylori seropositive was found 64.5% in healthy persons. The prevalence of anti-CagA and anti-VacA antibodies was 86.2% and 60.6% (respectively) in patients and was 70% and 40% (respectively) in healthy person.

The protein CagA enters the AGS cells via the interaction of the vesicles of Helicobacter pylori

The entry of gastric carcinoma cells ASG via the interaction of the vesicles of Helicobacter pylori VNH-85 strain was studied. The results showed that: The vesicles of Helicobacter pylori contained many protein toxins such formed from the outer membrane of bacterium H. pylori. The entry of them into gastric carcinoma cells ASG C120 led to increased synthesis of interleukin IL-8. So that, protein CagA could enter into gastric epithelium cells via interaction of bacteria, into gastric epithelium cells, protein CagA increased synthesis of interleukin IL-8 over 8 times.