BACKGROUND: Determination of vacA mosaicism may be important because specific Helicobacter pylori vacA genotype can be used to predict different clinical outcome. The aim of this study was to assess the relationship of vacA genotypes of Helicobacter pylori to cagA status and its development of peptic ulcer diseases in Korean patients. METHODS: Gastric biopsy specimens were obtained from 53 patients with gastric ulcer(GU), 57 with duodenal ulcer (DU) and 26 with chronic gastritis(CG) patients; all patients were infected with Helicobacter pylori. Bacterial mRNAs in the gastric mucosa were amplified by RT-PCR, using synthetic oligonucleotide primers specific for the vacA and the cagA gene. Patients with vacA s1 subtype were further examined to determine whether they had s1a or s1b subtype. RESULTS: There was no correlation in frequency of vacA s1 and/or s1a genotype between CG and either GU or DU, as the vacA s1 and s1a/m1 were present in the majority of strains independent of clinical status(s1 ; 100.0% versus 94.3 % or 93.0 % and s1a/m1 ; 76.9% versus 62.3% or 64.9%, res pectively). Likewise, there was no difference in the prevalence of the cagA gene between CG and either GU or DU patients (92.3% versus 90.6% or 98.2%, respectively). In addition, the cagA-negative status did not predict the presence of vacA s2 genotype. CONCLUSION: These results strongly suggest that either cagA or vacA s1 and/or s1a is not proved to be a useful marker to distinguish disease-specific Helicobacter pylori strains for the development of peptic ulcer diseases in Korean patients.
Adolescence ; Adult ; Aged ; Aged, 80 and over ; Bacterial Proteins/analysis* ; Base Sequence ; Biopsy, Needle ; Chi-Square Distribution ; Chronic Disease ; Duodenal Ulcer/pathology ; Duodenal Ulcer/genetics ; Female ; Gastritis/pathology ; Gastritis/genetics ; Genotype ; Helicobacter Infections/pathology ; Helicobacter Infections/genetics* ; Helicobacter pylori/genetics* ; Human ; Korea ; Male ; Middle Age ; Molecular Sequence Data ; Peptic Ulcer/pathology ; Peptic Ulcer/genetics* ; Polymerase Chain Reaction ; Probability ; Prognosis ; Sensitivity and Specificity ; Stomach Ulcer/pathology ; Stomach Ulcer/genetics ; Support, Non-U.S. Gov't ; Tissue Culture

Antigens, Bacterial ; genetics ; metabolism ; Bacterial Proteins ; genetics ; metabolism ; Child ; Child, Preschool ; DNA, Bacterial ; genetics ; Gastritis ; pathology ; Gene Expression Regulation, Bacterial ; Helicobacter Infections ; microbiology ; pathology ; Helicobacter pylori ; genetics ; Humans ; Immunohistochemistry ; Peptic Ulcer ; microbiology ; pathology ; Polymerase Chain Reaction

Extranodal NK/T-cell lymphoma is a recently recognized distinct entity within the World Health Organization classification of lymphoid tumors. It is relatively prevalent in Asian and South American populations. It most commonly occurs in the nasal or paranasal areas and less frequently in the skin, the soft tissue, and the gastrointestinal tract. Among these, extranodal NK/T-cell lymphoma of the gastrointestinal tract has shown an aggressive clinical course. We report a case of CD56+ extranodal NK/T-cell lymphoma presenting as a duodenal ulcer bleeding. A 62-year-old male patient presented with melena and abdominal pain. Endoscopic examination of the upper gastrointestinal tract showed the duodenal ulcer covered by blood clot. Pathologic examination revealed the diffuse infiltration of atypical lymphocytes with an angiocentric growth pattern, which was positive for CD3, CD56, and granzyme. The patient showed rapid deteriorating clinical course and died on day 14 after admission. Thus, we report this case with the review of literatures.
Antigens, CD3/metabolism ; Antigens, CD56/*metabolism ; Bone Marrow/pathology ; Duodenal Ulcer/*diagnosis ; Herpesvirus 4, Human/genetics/metabolism ; Humans ; Lymphoma, Extranodal NK-T-Cell/*diagnosis/pathology ; Male ; Middle Aged ; Peptic Ulcer Hemorrhage/*diagnosis ; Tomography, X-Ray Computed

Helicobacter pylori has been strongly associated with gastritis, gastric and duodenal ulcers, and it is a risk factor for gastric cancer. Two major virulence factors of H. pylori have been described: the cytotoxin-associated gene product (cagA) and the vacuolating toxin (vacA). Since considerable geographic diversity in the prevalence of H. pylori virulence factors has been reported, the aim of this work was to determine if there is a significant correlation between different H. pylori virulence genes (cagA and vacA) in 68 patients, from Saudi Arabia, and gastric clinical outcomes. H. pylor was recognized in cultures of gastric biopsies. vacA and cagA genes were detected by polymerase chain reaction (PCR). The cagA gene was obtained with 42 isolates (61.8%). The vacA s- and m- region genotypes were determined in all strains studied. Three genotypes were found: s1/m1 (28%), s1/m2 (40%) and s2/m2 (26%). The s2/m1 genotype was not found in this study. The relation of the presence of cagA and the development of cases to gastritis and ulcer was statistically significant (P < 0.05). The study showed a significant correlation between the vacA s1/m2 genotype and gastritis cases, and a significant correlation between vacA s1/m1 genotype and peptic ulcer cases. The results of this study might be used for the identification of high-risk patients who are infected by vacA s1/m1 genotype of H. pylori strains. In conclusion, H. pylori strains of vacA type s1 and the combination of s1/m1 were associated with peptic ulceration and the presence of cagA gene.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antigens, Bacterial/*genetics ; Bacterial Proteins/*genetics ; DNA, Bacterial/genetics ; Female ; Gastritis/genetics/microbiology/pathology ; Genotype ; Helicobacter Infections/*epidemiology/*microbiology/pathology ; Helicobacter pylori/*genetics/isolation & purification ; Humans ; Male ; Middle Aged ; Peptic Ulcer/genetics/microbiology/pathology ; Polymerase Chain Reaction ; Saudi Arabia ; Virulence Factors/genetics ; Young Adult

BACKGROUND/AIMS: DNA double strand breaks (DSB) is one of the critical types of DNA damage. If unrepaired, DSB is accumulated in the nucleus of cells, the cells become apoptotic or transform to tumor by way of genomic instability. Some of malignant cancers and its premalignant lesions were proven to have DSB in their nuclei. There was no report that Helicobacter pylori (H. pylori), the gastric carcinogen, induce DNA DSB in gastric epithelium in vivo. The aim of this study was to investigate whether H. pylori induce DSB in the gastric epithelial cells of chronic gastritis. METHODS: Immunohistochemical stains were performed for the DSB markers, phospho-53BP1 and gammaH2AX, in the gastric epithelium derived from 44 peptic ulcer disease patients before and after H. pylori eradication. DNA fragmentation assay was performed in the cell line to investigate the DNA damage by H. pylori infection. RESULTS: The mean expression score of gammaH2AX was significantly higher in the H. pylori infected gastric epithelium as compared to the H. pylori eradicated gastric epithelium (8.8+/-5.5 vs. 6.2+/-5.3 respectively; p=0.008). The expression score of phospho-53BP1 between before and after eradication of H. pylori was not statistically different, but tended to be higher in H. pylori infection. DNA fragmentation was developed significantly more in the cell lines after infection with H. pylori. CONCLUSIONS: DSB of DNA damage was typical feature of H. pylori infection in the gastric epithelium.
Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents/therapeutic use ; Cell Line, Tumor ; DNA/metabolism ; *DNA Breaks, Double-Stranded ; Female ; Gastric Mucosa/*metabolism ; Helicobacter Infections/drug therapy/*metabolism ; Helicobacter pylori/*drug effects/pathogenicity ; Histones/genetics/metabolism ; Humans ; Immunohistochemistry ; Intracellular Signaling Peptides and Proteins/genetics/metabolism ; Male ; Middle Aged ; Peptic Ulcer/genetics/pathology