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Abstract
Objectives: To investigate the prevalence of H. pylori virulence factors CagA, VacA and the phenotypes of CYP2C19 enzyme polymorphism in patients with peptic ulcer disease who have not received any H. pylori eradication therapy
Methods: A cross-sectional descriptive study was conducted on 216 patients with peptic ulcer disease at American International Hospital from October 2019 to September 2022. The CagA, VacA genes, and CYP2C19 enzyme-encoding genes were identified using PCR techniques.
Results: Among 216 patients, the mean age was 42.85 ± 11.76. H. pylori strains with CagA (+) virulence factor accounted for 72.69%, while CagA (-) strains accounted for 27.31%. There was no significant gender difference in CagA distribution (p = 0.488). All patients with peptic ulcer disease harbored H. pylori strains with VacA virulence, with the s1m1 type being the most common (50%). No significant difference in the distribution of VacA virulence by gender was observed (p = 0.78). There was a significant difference in VacA distribution between CagA (+) and CagA (-) groups. Patients with intermediate CYP2C19 metabolism phenotypes had the highest prevalence at 49.07%, followed by strong metabolizers (39.35%) and poor metabolizers (11.58%). There was no significant difference in CYP2C19 enzyme metabolism phenotypes between males and females (p = 0.454).
Conclusion: In untreated patients with H.pylori-induced peptic ulcer disease, CagA (+) genotype and VacA s1m1 genotype were predominant. These strains are associated with more severe tissue damage and higher activity levels compared to others. Patients with intermediate and strong CYP2C19 metabolizer phenotypes were relatively common. These patients may experience altered metabolism of proton pump inhibitors, which could impact treatment outcomes for peptic ulcer disease and H. pylori eradication.
References
Hooi JKY, Lai WY, Ng WK, Suen MMY, Underwood FE, Tanyingoh D, et al. Global Prevalence of Helicobacter pylori Infection: Systematic Review and Meta-Analysis. Gastroenterology. 2017;153(2): 420-429.
Iarc Working Group on the Evaluation of Carcinogenic Risks to Humans. Biological agents. Volume 100 B. A review of human carcinogens. IARC monographs on the evaluation of carcinogenic risks to humans. 2012;100(PtB): 1-441.
Yamaoka Y. Pathogenesis of Helicobacter pylori-Related Gastroduodenal Diseases from Molecular Epidemiological Studies. Gastroenterol Res Pract. 2012; 2012: 371503.
Backert S and Blaser MJ. The Role of CagA in the Gastric Biology of Helicobacter pylori. Cancer Research. 2016;76(14): 4028-4031.
Trần Ngọc Lưu Phương and Phạm Hùng Vân. Tính đa hình của enzym CYP2C19 trên BN Việt Nam bị viêm loét dạ dày do nhiễm H.pylori đã được điều trị. Tạp chí Khoa học tiêu hoá Việt Nam. 2014;9(37): 2391-2399.
Goldstein JA and de Morais SM. Biochemistry and molecular biology of the human CYP2C subfamily. Pharmacogenetics. 1994;4(6): 285-99.
Thái Thị Hồng Nhung and Nguyễn Thái Hòa. Nghiên cứu tỷ lệ mang gene caga của vi khuẩn helicobacter pylori và mối liên quan với bệnh lý dạ dày - tá tràng. Tạp chí Y Dược học Cần Thơ. 2023;36(67): 13-19.
Trần Thiện Trung, Nguyễn Tuấn Anh, and Quách Hữu Lộc. Kết quả nghiên cứu gen CagA và các gen VacA của Helicobacter pylori trên BN viêm dạ dày bằng phương pháp multiplex PCR. Tạp chí Khoa học tiêu hoá Việt Nam. 2013;8(33): 2102-2108.
Hussein NR, Mohammadi M, Talebkhan Y, Doraghi M, Letley DP, Muhammad MK, et al. Differences in Virulence Markers between Helicobacter pylori Strains from Iraq and Those from Iran: Potential Importance of Regional Differences in H. pylori- Associated Disease. 2008;46(5):1774-1779.
Kishk RM, Soliman NM, Anani MM, Nemr N, Salem A, Attia F, et al. Genotyping of Helicobacter pylori Virulence Genes CagA and VacA: Regional and National Study. International Journal of Microbiology. 2021; 2021:5540560.
Ito Y, Azuma T, Ito S, Miyaji H, Hirai M, Yamazaki Y, et al. Analysis and typing of the VacA gene from CagA-positive strains of Helicobacter pylori isolated in Japan. 1997;35(7): 1710-1714.
Bachir M, Allem R, Tifrit A, Medjekane M, Drici AEM, Diaf M, et al. Primary antibiotic resistance and its relationship with CagA and VacA genes in Helicobacter pylori isolates from Algerian patients. Brazilian Journal of Microbiology. 2018;49(3): 544-551.
Memon AA, Hussein NR, Deyi VYM, Burette A, and Atherton JC. Vacuolating Cytotoxin Genotypes Are Strong Markers of Gastric Cancer and Duodenal Ulcer-Associated Helicobacter pylori Strains: a Matched Case-Control Study. 2014;52(8): 2984-2989.
Le QH and Ha TMT. Determination of Helicobacter Pylori Caga Gene and Vaca Genotypes in Patients with Gastric Cancer. Journal of Medicine and Pharmacy. 2013;4(3): 118-125.
Morales-Espinosa R, Castillo-Rojas G, Gonzalez-Valencia G, Ponce de León S, Cravioto A, Atherton JC, et al. Colonization of Mexican patients by multiple Helicobacter pylori strains with different VacA and CagA genotypes 16. Atherton JC, Cao P, and Peek RM. Mosaicism in vacuolating cytotoxin alleles of helicobacter pylori: association of specific vaca types with cytotoxin production and peptic ulceration. Journal of Biological Chemistry. 1995;270(30):17771-17777.
Tassaneeyakul W, Mahatthanatrakul W, Niwatananun K, NaBangchang K, Tawalee A, Krikreangsak N, et al. CYP2C19 Genetic Polymorphism in Thai, Burmese and Karen Populations. Drug Metabolism and Pharmacokinetics. 2006;21(4): 286-290.
Alrajeh KY and Roman YM. The frequency of major CYP2C19 genetic polymorphisms in women of Asian, Native Hawaiian and Pacific Islander subgroups. 2022;19(4): 327-339.
Phan N. Nghiên cứu kiểu gen mã hóa cyp2c19 và mối liên quan đến hiệu quả điều trị helicobacterpylori của phác đồ hai thuốc liều cao (ppi, amoxicillin). Journal of Clinical Medicine- Hue Central Hospital. 2023;85:14-19.
He L, Chen S, Li J, Xie X, Huang L, Kuang Y, et al. Genetic and phenotypic frequency distribution of CYP2C9, CYP2C19 and CYP2D6 in over 3200 Han Chinese. Clin Exp Pharmacol Physiol. 2020;47(10): 1659-1663.
Sukprasong R, Chuwongwattana S, Koomdee N, Jantararoungtong T, Prommas S, Jinda P, et al. Allele frequencies of single nucleotide polymorphisms of clinically important drug-metabolizing enzymes CYP2C9, CYP2C19, and CYP3A4 in a Thai population. Scientific Reports. 2021;11(1): 12343.
El Rouby N, Lima JJ, and Johnson JA. Proton pump inhibitors: from CYP2C19 pharmacogenetics to precision medicine. Expert Opin Drug Metab Toxicol. 2018;14(4): 447-460.
| Published | 08-11-2024 | |
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| Issue | Vol. 16 No. 7 (2024) | |
| Section | Original article | |
| DOI | 10.38103/jcmhch.16.7.9 | |
| Keywords | VacA, CagA, H.pylori, kiểu hình CYP2C19, viêm loét dạ dày tá tràng VacA, CagA, H. pylori, CYP2C19 phenotypes, peptic ulcer disease |
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