不同消化性疾病来源的Hp毒力基因检测与临床意义
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摘要
目的研究不同消化性疾病来源的幽门螺杆菌(Hp)毒力基因的检测与意义。方法选择2016年10月-2017年10月于医院就诊的消化性疾病患者127例的胃活检样本,分离培养Hp,检测其携带的毒力基因,并探讨Hp与慢性萎缩性胃炎(Chronic Atrophic Gastritis,CAG)、慢性浅表性胃炎(Chronic Superficial Gastritis,CSG)、消化性溃疡(PUD)发生的关系。结果 127例不同消化性疾病患者Hp阳性率为42.52%(54/127);Hp共检测6种毒力基因(cagA、iceA、oipA、vacA、dupA、luxS)。Hp分离菌株中成功检出oipA、vacA及luxS,未发现vacA s2,其中vacA s1+阳性率100.00%;vacA m2+阳性率66.67%,vacA m1+阳性率31.48%,提示vacA m1+与vacA m2+关系互补;iceA1+/iceA2+、vacA s1 m1/iceA2对CSG的发生相关,vacA s1 m2+iceA2和iceA1+iceA2增加PUD发生风险,dupA+对十二指肠溃疡的发生相关。结论不同消化性疾病来源疾病(CAG、CSG、PUD)与Hp感染因素关系密切,加强感染Hp毒力基因检测可为以上消化性疾病预测评估、诊断等提供重要参考依据。
OBJECTIVE To study the detection of Helicobacter pylori(Hp)virulence genes from different digestive diseases and its significance.METHODS The gastric biopsy samples of 172 patients with digestive diseases treated in the hospital from Oct.2016 to Oct.2017 were collected for H.pylori isolation,and their virulence genes were detected.The correlation between Helicobacter pylori and the occurrence of chronic atrophic gastritis(CAG),chronic superficial gastritis table gastritis(CSG),and peptic ulcer(PUD)was discussed.RESULTS The positive rate of Hp in 127 patients with different digestive diseases was 42.52%(54/127).Six virulence genes(cagA,iceA,oipA,vacA,dupA,luxS)were detected for Helicobacter pylori.OipA,vacAand luxS were detected in Helicobacter pylori isolates.The positive rate of vacA s1+ was 100.00%,the positive rate of vacA m2+ was66.67% and the positive rate of vacA m1 was 31.48%,indicating a complementary relationship between vacA m1+ and vacA m2+.No vacA s2 was detected.iceA1 +/iceA2 +,vacA s1 m1/iceA2 were risk factors for CSG,vacA s1 m2+iceA2 and iceA1+iceA2 significantly increased the risk of PUD,whereas dupA + was a risk factor for duodenal ulcer.CONCLUSION The diseases with different digestive diseases(CAG,CSG,PUD)are closely related to Hp infection.Strengthening the detection of virulence genes of Hp infection can provide important reference for the prediction,evaluation and diagnosis of upper digestive diseases..
OBJECTIVE To study the detection of Helicobacter pylori(Hp)virulence genes from different digestive diseases and its significance.METHODS The gastric biopsy samples of 172 patients with digestive diseases treated in the hospital from Oct.2016 to Oct.2017 were collected for H.pylori isolation,and their virulence genes were detected.The correlation between Helicobacter pylori and the occurrence of chronic atrophic gastritis(CAG),chronic superficial gastritis table gastritis(CSG),and peptic ulcer(PUD)was discussed.RESULTS The positive rate of Hp in 127 patients with different digestive diseases was 42.52%(54/127).Six virulence genes(cagA,iceA,oipA,vacA,dupA,luxS)were detected for Helicobacter pylori.OipA,vacAand luxS were detected in Helicobacter pylori isolates.The positive rate of vacA s1+ was 100.00%,the positive rate of vacA m2+ was66.67% and the positive rate of vacA m1 was 31.48%,indicating a complementary relationship between vacA m1+ and vacA m2+.No vacA s2 was detected.iceA1 +/iceA2 +,vacA s1 m1/iceA2 were risk factors for CSG,vacA s1 m2+iceA2 and iceA1+iceA2 significantly increased the risk of PUD,whereas dupA + was a risk factor for duodenal ulcer.CONCLUSION The diseases with different digestive diseases(CAG,CSG,PUD)are closely related to Hp infection.Strengthening the detection of virulence genes of Hp infection can provide important reference for the prediction,evaluation and diagnosis of upper digestive diseases..
引文
[1]邱新萍,王洪,邹济源,等.清利化浊方联合铋剂四联治疗幽门螺杆菌相关慢性非萎缩性胃炎脾胃湿热证40例临床观察[J].中医杂志,2016,57(5):405-408.
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[7] Nakano M,Yahiro K,Yamasaki E,et al.Helicobacter pylori VacA,acting through receptor protein tyrosine phosphataseα,is crucial for CagA phosphorylation in human duodenum carcinoma cell line AZ-521[J].Dis Model Mech,2016,9(12):1473-1481.
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[10] Alikhani MY,Arebestani MR,Sayedin Khorasani M,et al.Evaluation of Helicobacter pylori vacA and cagA genotypes and correlation with clinical outcome in patients with dyspepsia in Hamadan Province Iran[J].Iran Red Crescent Med J,2014,16(11):e19173.
[11] Ranjbar R,Khamesipour F,Jonaidi‐Jafari N,et al.Helicobacter pylori isolated from Iranian drinking water:vacA,cagA,iceA,oipA and babA2genotype status and antimicrobial resistance properties[J].Febs Open Bio,2016,6(5):433-441.
[12] Ang TL,Fock KM,Teo EK,et al.Helicobacter pylori eradication versus prokinetics in the treatment of functional dyspepsia:a randomized,double-blind study[J].J Gastroenterol,2016,41(7):647-653.
[13]韩佰南.幽门螺杆菌根除治疗对幽门螺杆菌阳性的功能性消化不良患者的质量效果[J].中国妇幼健康研究,2016,27(2):299-299.
[14] Zhang XS,Tegtmeyer N,Traube L,et al.A specific A/T polymorphism in Western tyrosine phosphorylation B-motifs regulates Helicobacter pylori CagA epithelial cell interactions[J].PLos Pathlog,2015,11(2):e1004621.
[15] Boonyanugomol W,Khuntikeo N,Pugkhem A,et al.Genetic characterization of Helicobacter pylori vacA and cagA genes in Thai gastro-duodenal and hepatobiliary patients[J].J Infect Dev Ctries,2017,11(1):42-50.
[16]孙新超,秦旭,张德洋,等.老年患者胃黏膜不同病理形态幽门螺杆菌感染相关性研究[J].中华医院感染学杂志,2016,26(17):3881-3882.
[17] Ghosh N,Ghosh P,Kesh K,et al.Attenuation of Helicobacter pylori-induced gastric inflammation by prior cag(-)strain(AM1)infection in C57BL/6 mice[J].Gut Pathog,2017,9:14.
[18] Yuan XY,Yan JJ,Yang YC,et al.Helicobacter pylori,with East Asian-type cag PAI genes is more virulent than strains with Western-type in some cag PAI genes[J].Braz J Microbiol,2017,48(2):218-224.
[2] Amieva M,Peek RM Jr.Pathobiology of Helicobacter pylori-induced gastric cancer[J].Gastroenterology,2016,150(1):64-78.
[3] Almeida N,Donato MM,Romaozinho JM,et al.Correlation of Helicobacter pylori genotypes with gastric histopathology in the central region of a South-European country[J].Dig Dis Sci,2015,60(1):74-85.
[4]骆泉,赵洁,徐关根,等.幽门螺杆菌感染与不同胃炎及病理之间的关系[J].中华医院感染学杂志,2016,26(11):2476-2478.
[5] Vannarath S,Vilaichone RK,Rasachak B,et al.Virulence genes of Helicobacter pylori in gastritis,peptic ulcer and gastric cancer in Laos[J].Asian Pac J Cancer Prev,2014,15(20):9027-9031.
[6]范红云,储建坤,牛巍巍,等.胃液pH值在克拉霉素、呋喃唑酮根除幽门螺杆菌中的价值[J].临床内科杂志,2014,31(6):397-398.
[7] Nakano M,Yahiro K,Yamasaki E,et al.Helicobacter pylori VacA,acting through receptor protein tyrosine phosphataseα,is crucial for CagA phosphorylation in human duodenum carcinoma cell line AZ-521[J].Dis Model Mech,2016,9(12):1473-1481.
[8] Cover TL.Helicobacter pylori diversity and gastric cancer risk[J].Mbio,2016,7(1):e01869-15.
[9]吴戌年,周伟,王猛,等.河西走廊地域幽门螺杆菌vacA和cagA基因型分布研究[J].临床消化病杂志,2016,28(4):212-215.
[10] Alikhani MY,Arebestani MR,Sayedin Khorasani M,et al.Evaluation of Helicobacter pylori vacA and cagA genotypes and correlation with clinical outcome in patients with dyspepsia in Hamadan Province Iran[J].Iran Red Crescent Med J,2014,16(11):e19173.
[11] Ranjbar R,Khamesipour F,Jonaidi‐Jafari N,et al.Helicobacter pylori isolated from Iranian drinking water:vacA,cagA,iceA,oipA and babA2genotype status and antimicrobial resistance properties[J].Febs Open Bio,2016,6(5):433-441.
[12] Ang TL,Fock KM,Teo EK,et al.Helicobacter pylori eradication versus prokinetics in the treatment of functional dyspepsia:a randomized,double-blind study[J].J Gastroenterol,2016,41(7):647-653.
[13]韩佰南.幽门螺杆菌根除治疗对幽门螺杆菌阳性的功能性消化不良患者的质量效果[J].中国妇幼健康研究,2016,27(2):299-299.
[14] Zhang XS,Tegtmeyer N,Traube L,et al.A specific A/T polymorphism in Western tyrosine phosphorylation B-motifs regulates Helicobacter pylori CagA epithelial cell interactions[J].PLos Pathlog,2015,11(2):e1004621.
[15] Boonyanugomol W,Khuntikeo N,Pugkhem A,et al.Genetic characterization of Helicobacter pylori vacA and cagA genes in Thai gastro-duodenal and hepatobiliary patients[J].J Infect Dev Ctries,2017,11(1):42-50.
[16]孙新超,秦旭,张德洋,等.老年患者胃黏膜不同病理形态幽门螺杆菌感染相关性研究[J].中华医院感染学杂志,2016,26(17):3881-3882.
[17] Ghosh N,Ghosh P,Kesh K,et al.Attenuation of Helicobacter pylori-induced gastric inflammation by prior cag(-)strain(AM1)infection in C57BL/6 mice[J].Gut Pathog,2017,9:14.
[18] Yuan XY,Yan JJ,Yang YC,et al.Helicobacter pylori,with East Asian-type cag PAI genes is more virulent than strains with Western-type in some cag PAI genes[J].Braz J Microbiol,2017,48(2):218-224.