Association Between Helicobacter Pylori Virulence Genes UreA and CagA with Histopathological Changes in Gastroduodenal Disease

Background: Helicobacter pylori (H. pylori) a spiral-shaped bacterium that infects roughly half the world’s population, leading to the development of severe complications such as peptic ulcer diseases, gastric cancer, and gastric mucosa-associated lymphoid tissue (MALT) lymphoma. Cytotoxin associated gene A (CagA) and α-subunit of urease (UreA) are two of the major virulence factors of H. pylori, and each of them has a distinct entry pathway and pathogenic mechanism during bacterial infection.
Objective: To investigate the relationship of UreA and CagA with the clinical and histopathological finding in patient with different gastro-duodenal diseases.
Methods: This is a cross-sectional study included a total of 194 specimens of gastric tissue biopsy (GTB) from patients diagnosed with different gastro-duodenal diseases in period from march 2022 to August 2022. In addition, a histopathologically normal GTBs were obtained from patients. Direct molecular identification of H. pylori Ure A and CagA.
Results: The results showed that 162/194 (83.5%) of specimens were positive for H. pylori UreA and 35/194 (18.0%) of specimens were positive for CagA. The association of positivity to H. pylori and oesophagogastroduodenoscopy (OGD) finding was statistically not significant as P-value = 0.079, except for congested mucosa, which was statistically significant as P-value 0.033. The association of positivity to CagA and OGD finding was statistically not significant, P-value = 0.107, except of nodular gastritis which was statistically significant, P-value= 0.001. The association of positivity to cagA with histopathological finding was statistically not significant, P-value= 0.639.
Conclusion: The association between UreA and CagA with the OGD and histopathological finding required more investigations. There is association between UreA and congested mucosa, while CagA is associated with nodular gastritis.
Keywords: Helicopacter pylori, UreA, CagA, conventional PCR
Citation: Mohammed AA, Ghadhban JM. Association between Helicobacter pylori virulence genes UreA and CagA with histopathological changes in gastroduodenal disease. Iraqi JMS. 2024; 22(2): 259-267. doi: 10.22578/IJMS.22.2.10