HELICOBACTER-PYLORI CYTOTOXIC GENOTYPE IS ASSOCIATED WITH PEPTIC-ULCER AND INFLUENCES SEROLOGY

Objective: We studied 146 patients with peptic ulcer disease (n = 72), antral gastritis (n = 58), or duodenitis (n = 16) to ascertain whethe r the cytotoxic genotype of Helicobacter pylori (Hp) is associated wit h peptic ulcer disease and/or antral gastritis and whether it influenc es the circulating levels of total anti-Hp antibodies, anti-cagA antib odies, and pepsinogens. Methods: A gastric juice sample was obtained f rom each patient, After DNA extraction, polymerase chain reaction was used to amplify the genes urease A (ureA), cagA, and vacA of Hp, Resul ts: A significant association was found between peptic ulcer disease a nd the cytotoxic genotypes, characterized by the presence of s1 and m1 alleles of vacA and by cagA, Patients with a cagA-positive genotype s howed a significant increase in anti-cagA antibodies and also had sign ificantly increased circulating levels of pepsinogen C. Conclusions: C ytotoxic Hp strains are mainly involved in determining peptic ulcer di sease, but not antral gastritis, The higher levels of circulating peps inogen C found in patients infected with cytotoxic genotypes may refle ct the higher degree of inflammation sustained by these strains. (C) 1 998 by Am. Coll. of Gastroenterology.