| Autor: |
Phuc BH; Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu, 879-5593, Japan.; Department of Microbiology, Cho Ray Hospital, Ho Chi Minh City, 749000, Vietnam., Tuan VP; Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu, 879-5593, Japan.; Department of Endoscopy, Cho Ray Hospital, Ho Chi Minh City, 749000, Vietnam., Dung HDQ; Department of Endoscopy, Cho Ray Hospital, Ho Chi Minh City, 749000, Vietnam., Binh TT; Department of Endoscopy, Cho Ray Hospital, Ho Chi Minh City, 749000, Vietnam., Tung PH; Department of Endoscopy, Cho Ray Hospital, Ho Chi Minh City, 749000, Vietnam., Tri TD; Department of Endoscopy, Cho Ray Hospital, Ho Chi Minh City, 749000, Vietnam., Thuan NPM; Department of Endoscopy, Cho Ray Hospital, Ho Chi Minh City, 749000, Vietnam., Van Khien V; Department of Hepatogastroenterology, 108 Military Central Hospital, Hanoi, 749000, Vietnam., Trang TTH; Department of Molecular Biology, 108 Military Central Hospital, Hanoi, 749000, Vietnam., Akada J; Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu, 879-5593, Japan., Matsumoto T; Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu, 879-5593, Japan., Yamaoka Y; Department of Environmental and Preventive Medicine, Faculty of Medicine, Oita University, Yufu, 879-5593, Japan. yyamaoka@oita-u.ac.jp.; Department of Medicine, Gastroenterology and Hepatology Section, Baylor College of Medicine, Houston, 77030, TX, USA. yyamaoka@oita-u.ac.jp.; Global Oita Medical Advanced Research Center for Health, Oita University, Yufu, 879-5593, Japan. yyamaoka@oita-u.ac.jp. |
| Abstrakt: |
Although the type 4 secretion system of the integrating and conjugative elements (tfs ICE) is common in Helicobacter pylori, its clinical association with the cag pathogenicity island (cagPAI) have not yet been well-investigated. In this study, Vietnamese patient H. pylori samples (46 duodenal ulcer (DU), 51 non-cardia gastric cancer (NCGC), 39 chronic gastritis (CG)) were fully sequenced using next-generation sequencing and assembled into contigs. tfs3, tfs4, and cagPAI genes were compared with the public database. Most (94%) H. pylori strains possessed a complete cagPAI, which was the greatest risk factor for clinical outcomes, while the prevalences of tfs3 and tfs4 were 45% and 77%, respectively. Complete tfs3 and tfs4 were found in 18.3% and 17.6% of strains, respectively. The prevalence of H. pylori strains with complete tfs3 ICE in DU patients was significantly higher than that in NCGC patients (30.4% vs 11.7%, P < 0.05). In addition, the prevalence of strains with complete tfs3 ICE and cagPAI was significantly higher in DU patients than that in NCGC (28.4% vs 9.8%, P = 0.038) and CG patients (28.2% vs 7.7%, P = 0.024). cagPAI and complete tfs3 increased the risk of DU compared to NCGC (OR = 3.56, 95%CI: 1.1-14.1, P = 0.038) and CG (OR = 4.64, 95%CI: 1.1-27.6, P = 0.024). A complete cluster of tfs3 ICE was associated with gastroduodenal diseases in Vietnam. However, there was a low prevalence of the dupA/complete dupA cluster (15.4%) in the Vietnam strains. The prevalence of cagPAI in Vietnam strains was significantly higher than in US (P = 0.01) and Indonesia (P < 0.0001); the prevalence of the dupA cluster was also higher in the Vietnam strains than in the Indonesian strains (P < 0.05). In addition, the prevalence of ctkA, an accessory gene of tfs3, was significantly different between Vietnam and US strains (28% vs 2%, P = 0.0002). In summary, the acquisition of tfs3/4 ICE was common in H. pylori strains in patients with gastroduodenal disease in Vietnam, and the complete cluster of tfs3 ICE was a reliable marker for the severity of disease in the H. pylori infected population. |
