Helicobacter pylori virulence genes in the five largest islands of Indonesia. Issue 1 (December 2015)

• Record Type: Journal Article
• Authors: Miftahussurur, Muhammad; Syam, Ari; Makmun, Dadang; Nusi, Iswan; Zein, Lukman; Zulkhairi, ; Akil, Fardah; Uswan, Willi; Simanjuntak, David; Uchida, Tomohisa; Adi, Pangestu; Utari, Amanda; Rezkitha, Yudith; Subsomwong, Phawinee; Nasronudin, ; Yamaoka, Yoshio
• Is Part Of: Gut pathogens. Volume 7:Issue 1(2015)
• Page Start: 1
• Page End: 10
• Publication Date: 2015-12
• Subjects: Helicobacter pylori -- Indonesia -- Virulence factors; Gastrointestinal system -- Microbiology -- Periodicals; 616.3
• DOI: 10.1186/s13099-015-0072-2
• Languages: English
• ISSNs: 1757-4749

Abstract

Abstract Background It remains unclear whether the low incidence of gastric cancer in Indonesia is due to low infection rates only or is also related to lowHelicobacter pylori pathogenicity. We collectedH. pylori strains from the five largest islands in Indonesia and evaluated genetic virulence factors. Methods The genotypes ofH. pylori virulence factors were determined by polymerase chain reaction (PCR)-based sequencing. Histological severity of the gastric mucosa was classified into 4 grades, according to the updated Sydney system. Results A total of 44 strains were analyzed. Forty-three (97.7 %) werecagA -positive: 26 (60.5 %) were East-Asian-type-cagA, 9 (20.9 %) were Western-type-cagA, and 8 (18.6 %) were novel ABB-type, most of which were obtained from Papuan. EPIYT sequences were more prevalent than EPIYA sequences (P = 0.01) in the EPIYA-B motif of all types of cagA. The majority ofcagA -positive strains (48.8 %, 21/43) had a 6-bp deletion in the first pre-EPIYA region. Subjects infected with East-Asian-type-cagA strains with a 6-bp deletion had significantly lower inflammation and atrophy scores in the corpus than those infected with Western-type-cagA strains (both P = 0.02). In total, 70.4 % of strains possessed thevacA s1m1 genotype and 29.5 % were m2. All strains from peptic ulcer patients were of theiceA1 genotype, which occurred at a significantly higher proportion in peptic ulcer patients than that in gastritis patients (55.3 %, P = 0.04). The double positive genotype ofjhp0562 /β -(1, 3)galT was predominant (28/44, 63.6 %), and subjects infected with this type had significantly higher inflammation scores in the corpus than those with thejhp0562 negative/β -(1, 3)galT positive genotype (mean [median]; 1.43 [1] vs. 0.83 [1], P = 0.04). There were significant differences incagA and pre-EPIYAcagA type, oipA status, andjhp0562 /β -(1, 3)galT type among different ethnic groups (P < 0.05). Conclusions In addition to a lowH. pylori infection rate, the low incidence of gastric cancer in Indonesia might be attributed to less virulent genotypes in predominant strains, which are characterized by the East-Asian-type-cagA with a 6-bp deletion and EPIYT motif, a high proportion of m2, dupA negative or short typedupA, and thejhp0562 /β -(1, 3)galT double positive genotype.