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Journal of Clinical Microbiology, May 1998, p. 1285-1289, Vol. 36, No. 5
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.

Identification and Analysis of a New vacA Genotype Variant of Helicobacter pylori in Different Patient Groups in Germany

Sonja Strobel,1 Stefan Bereswill,1,* Peter Balig,2 Peter Allgaier,3 Hans-Günther Sonntag,4 and Manfred Kist1

Institute of Medical Microbiology and Hygiene1 and Department of Internal Medicine, University Hospital,3 University of Freiburg, D-79104 Freiburg, Kaiser-Joseph-Straße 186-188, D-79098 Freiburg,2 and Institute of Hygiene, University of Heidelberg, D-69120 Heidelberg,4 Germany

Received 10 September 1997/Returned for modification 16 December 1997/Accepted 16 February 1998

The vacuolating cytotoxin of Helicobacter pylori (VacA) is known to cause cell damage to mammalian cells and is suspected to give rise to gastric epithelial lesions that might lead to peptic ulcer disease. As shown recently, the gene encoding VacA exhibits genetic variation, with three different families of signal sequences (s1a, s1b, and s2) and two families of midregion sequences (m1 and m2). In order to investigate the relationship between the presence of specific vacA genotypes and peptic ulceration, the vacA genotypes of 158 clinical isolates of H. pylori were determined. The study group consisted of 106 patients with duodenal ulceration; 52 patients with nonulcer dyspepsia (NUD) were used as controls. H. pylori of genotype s1 was isolated from 96% of the patients with ulcerations, whereas genotype s2 was only present in 4%, indicating a strong correlation between the vacA genotype and peptic ulceration (P < 0.001). In contrast, 31% of the patients from the NUD control group were infected with strains of vacA genotype s2. Particular midregion genotypes (m1 and m2) were not associated with clinical manifestations. The midregions from 18% of the isolates could not be classified by the proposed scheme. DNA sequencing revealed high homology between the untypeable midregions and that of genotype m1, with multiple base pair exchanges, some affecting the primer annealing site. Compared to those of m1 and m2 alleles, the divergent midregions from untypeable strains showed clustering, indicating the presence of a further subfamily of sequences in the midregion of vacA in German isolates, for which we propose the term "m1a." A new specific primer that we designed for typing m1a isolates might be useful in other studies.

* Corresponding author. Mailing address: Institute of Medical Microbiology and Hygiene, Department of Medical Microbiology and Hygiene, University of Freiburg, Hermann-Herder-Straße 11, D-79104 Freiburg, Germany. Phone: 49 761 203 6539. Fax: 49 761 203 6562. E-mail: bereswil{at}sun1.ukl.uni-freiburg.de.

Journal of Clinical Microbiology, May 1998, p. 1285-1289, Vol. 36, No. 5
0095-1137/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.


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