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Journal of Clinical Microbiology, July 1999, p. 2274-2279, Vol. 37, No. 7
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Relationship between Helicobacter pylori iceA, cagA, and vacA Status and Clinical Outcome: Studies in Four Different Countries

Yoshio Yamaoka,1,2,* Tadashi Kodama,2 Oscar Gutierrez,3 Jong G. Kim,4 Kei Kashima,2 and David Y. Graham1

Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas1; Third Department of Internal Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan2; Universidad Nacional de Colombia, Bogota, Colombia3; and Guro Hospital, Korea University College of Medicine, Seoul, Korea4

Received 24 November 1998/Returned for modification 4 March 1999/Accepted 16 April 1999

There is continuing interest in identifying Helicobacter pylori virulence factors that might predict the risk for symptomatic clinical outcomes. It has been proposed that iceA and cagA genes are such markers and can identify patients with peptic ulcers. We compared H. pylori isolates from four countries, looking at the cagA and vacA genotypes, iceA alleles, and presentation of the infection. We used PCR to examine iceA, vacA, and cagA status of 424 H. pylori isolates obtained from patients with different clinical presentations (peptic ulcer, gastric cancer, and atrophic gastritis). The H. pylori isolates examined included 107 strains from Bogota, Colombia, 70 from Houston, Tex., 135 from Seoul, Korea, and 112 from Kyoto, Japan. The predominant genotype differed among countries: the cagA-positive iceA1 vacA s1c-m1 genotype was predominant in Japan and Korea, the cagA-positive iceA2 vacA s1b-m1 genotype was predominant in the United States, and the cagA-positive iceA2 vacA s1a-m1 genotype was predominant in Colombia. There was no association between the iceA, vacA, or cagA status and clinical outcome in patients in the countries studied. iceA status shows considerable geographic differences, and neither iceA nor combinations of iceA, vacA, and cagA were helpful in predicting the clinical presentation of an H. pylori infection.

* Corresponding author. Mailing address: Veterans Affairs Medical Center (111D), 2002 Holcombe Blvd., Houston, TX 77030. Phone: (713) 794-7232. Fax: (713) 790-1040. E-mail: yoshio{at}wt.net.

Journal of Clinical Microbiology, July 1999, p. 2274-2279, Vol. 37, No. 7
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


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