目的 了解来自于江西地区胃十二指肠疾病儿童感染的幽门螺杆菌 （H.pylori）临床分离菌株cagA、vacA和iceA基因亚型分布情况，并探讨H.pyloricagA、vacA和iceA基因亚型与儿童胃十二指肠疾病类型之间的关系。方法 从来自江西地区的316例患有胃十二指肠疾病儿童的胃窦黏膜中，培养出107株H.pylori菌株，提取菌株基因组DNA，采用PCR法检测H.pyloriureA、cagA、vacA及iceA基因亚型。结果 在107株H.pylori临床分离菌株中，H.pyloriureA基因和cagA基因检出率分别为100% （107/107）和94.4% （101/107）。vacA基因总检出率为100% （107/107），vacAs1a、vacAs1c、vacAm1和vacAm2基因检出率分别为74.8% （80/107）、25.2% （27/107）、29.9% （32/107）和69.2% （74/107），其中0.9% （1/107）H.pylori菌株同时检测出vacAm1和vacAm2基因型；在vacA基因的嵌合体中，vacAs1a/m1、vacAs1a/m2、vacAs1c/m1和vacAs1c/m2基因检出率分别为26.2% （28/107）、51.4% （55/107）、3.7% （4/107）和17.8% （19/107） （P<0.001）。iceA1和iceA2基因阳性检出率分别为79.4% （85/107）和9.3% （10/107） （P<0.001）；iceA1和iceA2基因亚型均阳性的检出率为7.5% （8/107）。H.pylori各基因亚型在消化性溃疡、慢性胃炎和十二指肠球炎3组间的检出率比较差异无统计学意义 （P>0.05）。结论 来自于江西地区胃十二指肠疾病儿童感染的H.pylori优势基因亚型是cagA、vacAs1a/m2和iceA1；H.pylori感染存在不同基因型菌株混合感染；H.pylori基因亚型与胃十二指肠疾病类型无相关性。
Abstract
Objective To investigate the prevalence of cagA, vacA, and iceA genotypes in the isolated strains of Helicobacter pylori (H.pylori) from children with gastroduodenal diseases in Jiangxi, China, as well as the association between cagA, vacA, and iceA genotypes and the type of gastroduodenal diseases. Methods The samples of gastric antral mucosa were collected from 316 children with gastroduodenal diseases in Jiangxi, and a total of 107 strains of H.pylori were isolated. The genomic DNA of these strains was extracted, and PCR was used to determine the ureA, cagA, vacA, and iceA genotypes. Results Of all the 107 isolated strains of H.pylori, the detection rates of ureA and cagA genes were 100% (107/107) and 94.4% (101/107) respectively. The overall detection rate of vacA gene was 100% (107/107), and the detection rates of vacAs1a, vacAs1c, vacAm1, and vacAm2 genes were 74.8% (80/107), 25.2% (27/107), 29.9% (32/107), and 69.2% (74/107) respectively, with both vacAm1 and vacAm2 genes detected in 0.9% (1/107) of all H.pylori strains. In the chimera of vacA gene, the detection rates of vacAs1a/m1, vacAs1a/m2, vacAs1c/ m1, and vacAs1c/m2 genes were 26.2% (28/107), 51.4% (55/107), 3.7% (4/107), and 17.8% (19/107) respectively (P<0.001). The detection rates of iceA1 and iceA2 genes were 79.4% (85/107) and 9.3% (10/107), respectively (P<0.001), and both iceA1 and iceA2 genes were detected in 7.5% (8/107) of all strains. The detection rates of the genotypes of H.pylori showed no significant differences between the peptic ulcer, chronic gastritis, and duodenal bulbar inflammation groups (P>0.05). Conclusions The dominant genotypes of H.pylori are cagA, vacAs1a/m2, and iceA1, and there are mixed infections with H.pylori strains of different genotypes in children with gastroduodenal disease from Jiangxi, China. The genotypes of H.pylori are not associated with the type of gastroduodenal disease.
关键词
幽门螺杆菌 /
基因型 /
胃十二指肠疾病 /
儿童
Key words
Helicobacter pylori /
Genotype /
Gastroduodenal disease /
Child
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参考文献
[1] 张万岱, 胡伏莲, 萧树东, 等. 中国自然人群幽门螺杆菌感染的流行病学调查[J]. 现代消化及介入诊疗, 2010, 15(5): 265-270.
[2] Pacifico L, Osborn JF, Tromba V, et al. Helicobacter pylori infection and extragastric disorders in children: a critical update[J]. World J Gastroenterol, 2014, 20(6): 1379-1401.
[3] Hasosah M, Satti M, Shehzad A, et al. Prevalence and risk factors of Helicobacter pylori infection in Saudi children: a three-year prospective controlled study[J]. Helicobacter, 2015, 20(1): 56-63.
[4] Braga LL, Oliveira MA, Gonçalves MH, et al. CagA phosphorylation EPIYA-C motifs and the vacA i genotype in Helicobacter pylori strains of asymptomatic children from a high-risk gastric cancer area in northeastern Brazil[J]. Mem Inst Oswaldo Cruz, 2014, 109(8): 1045-1049.
[5] Iwanczak B, Laszewicz W, Iwanczak F, et al. Genotypic and clinical differences of seropositive Helicobacter pylori children and adults in the Polish population[J]. J Physiol Pharmacol, 2014, 65(6): 801-807.
[6] 周颖, 黄瑛, 邵彩虹, 等. 上海地区部分儿童幽门螺杆菌 cagA、vacA、iceA 基因型别分析[J]. 中国当代儿科杂志, 2010, 12(4): 267-271.
[7] De Gusmão VR, Nogueira Mendes E, De Magalhães Queiroz DM, et al. vacA genotypes in Helicobacter pylori strains isolated from children with and without duodenal ulcer in Brazil[J]. J Clin Microbiol, 2000, 38(8): 2853-2857.
[8] Yamaoka Y, Kodama T, Gutierrez O, et al. Relationship between Helicobacter pylori iceA, cagA, and vacA status and clinical outcome: studies in four different countries[J]. J Clin Microbiol, 1999, 37(7): 2274-2279.
[9] Ito Y, Azuma T, Ito S, et al. Analysis and typing of the vacA gene from cagA-positive strains of Helicobacter pylori isolated in Japan[J]. J Clin Microbiol, 1997, 35(7): 1710-1714.
[10] Reyes-Leon A, Atherton JC, Argent RH, et al. Heterogeneity in the activity of Mexican Helicobacter pylori strains in gastric epithelial cells and its association with diversity in the cagA gene[J]. Infect Immun, 2007, 75(7): 3445-3454.
[11] 石碧坚, 刘厚钰. 幽门螺杆菌的致病机理[M]// 胡伏莲, 周殿元. 幽门螺杆菌感染的基础与临床. 第3 版. 北京: 中国科学技术出版社, 2010: 63-81.
[12] Shiota S, Suzuki R, Yamaoka Y. The significance of virulence factors in Helicobacter pylori[J]. J Dig Dis, 2013, 14(7): 341- 349.
[13] Kim JY, Kim N, Nam RH, et al. Association of polymorphisms in virulence factor of Helicobacter pylori and gastroduodenal diseases in South Korea[J]. J Gastroenterol Hepatol, 2014, 29(5): 984-991.
[14] Kolaylı F, Karadenizli A, Bingöl R, et al. Differences of vacA alleles and cagA gene positivity of Helicobacter pylori strains isolated from two different countries: Turkey and Germany[J]. Mikrobiyol Bul, 2012, 46(2): 332-334.
[15] Mendoza-Elizalde S, Cortés-Márquez AC, Giono-Cerezo S, et al. Analysis of the genotypic diversity of strains of Helicobacter pylori isolated from pediatric patients in Mexico[J]. Infect Genet Evol, 2015, 29: 68-74.
[16] 姚淑雯, 关锐梨, 龚四堂, 等. 广州地区幽门螺杆菌儿童分离株空泡毒素基因A 的分型[J]. 广东医学, 2013, 34(20): 3117-3119.
[17] Khan A, Farooqui A, Raza Y, et al. Prevalence, diversity and disease association of Helicobacter pylori in dyspeptic patients from Pakistan[J]. J Infect Dev Ctries, 2013, 7(3): 220-228.
[18] Biernat MM, Gościniak G, Iwańczak B. Prevalence of Helicobacter pylori cagA, vacA, iceA, babA2 genotypes in Polish children and adolescents with gastroduodenal disease[J]. Postepy Hig Med Dosw (Online), 2014, 68: 1015-1021.
[19] Goncalves MH, Silva CI, Braga-Neto MB, et al. Helicobacter pylori virulence genes detected by string PCR in children from an urban community in northeastern Brazil[J]. J Clin Microbiol, 2013, 51(3): 988-989.
[20] 林燕芬, 龚四堂, 区文玑, 等. 广州地区患儿感染幽门螺杆菌vacA、cagA 及iceA 基因研究[J]. 中华儿科杂志, 2007, 45 (9): 703-707.
[21] Ko JS, Kim KM, Oh YL, et al. cagA, vacA, and iceA genotypes of Helicobacter pylori in Korean children[J]. Pediatr Int, 2008, 50(5): 628-631.
[22] Boyanova L, Yordanov D, Gergova G, et al. Association of iceA and babA genotypes in Helicobacter pylori strains with patient and strain characteristics[J]. Antonie Van Leeuwenhoek, 2010, 98(3): 343-350.
[23] Ozbey G, Dogan Y, Demiroren K. Prevalence of Helicobacter pylori virulence genotypes among children in Eastern Turkey[J]. World J Gastroenterol, 2013, 19(39): 6585-6589.
[24] Tanih NF, McMillan M, Naidoo N, et al. Prevalence of Helicobacter pylori vacA, cagA and iceA genotypes in South African patients with upper gastrointestinal diseases[J]. Acta Trop, 2010, 116(1): 68-73.
[25] Homan M, Šterbenc A, Kocjan BJ, et al. Prevalence of the Helicobacter pylori babA2 gene and correlation with the degree of gastritis in infected Slovenian children[J]. Antonie Van Leeuwenhoek, 2014, 106(4): 637-645.
[26] Almeida N, Donato MM, Romãozinho JM, et al. Correlation of Helicobacter pylori genotypes with gastric histopathology in the central region of a South-European country[J]. Dig Dis Sc, 2015, 60(1): 74-85.
[27] Vaziri F, Najar Peerayeh S, Alebouyeh M, et al. Diversity of Helicobacter pylori genotypes in Iranian patients with different gastroduodenal disorders[J]. World J Gastroenterol, 2013, 19(34): 5685-5692.
[28] Sugimoto M, Zali MR, Yamaoka Y. The association of vacA genotypes and Helicobacter pylori-related gastroduodenal diseases in the Middle East[J]. Eur J Clin Microbiol Infect Dis, 2009, 28(10): 1227-1236.
[29] Falsafi T, Khani A, Mahjoub F, et al. Analysis of vacA/cagA genotypes/status in Helicobacter pylori isolates from Iranian children and their association with clinical outcome[J]. Turk J Med Sci, 2015, 45(1): 170-177.
[30] Homan M, Luzar B, Kocjan BJ, et al. Prevalence and clinical relevance of cagA, vacA, and iceA genotypes of Helicobacter pylori isolated from Slovenian children[J]. J Pediatr Gastroenterol Nutr, 2009, 49(3): 289-296.
[31] Sedaghat H, Moniri R, Jamali R, et al. Prevalence of Helicobacter pylori vacA, cagA, cagE, iceA, babA2, and oipA genotypes in patients with upper gastrointestinal diseases[J]. Iran J Microbiol, 2014, 6(1): 14-21.
基金
江西省科技厅科技支撑计划资助项目（20151BBG70092）。
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