<i>Helicobacter pylori</i> CagA Status, Mucosal Oxidative Damage and Gastritis Phenotype: A Potential Pathway to Cancer?

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<jats:title>ABSTRACT</jats:title><jats:p><jats:bold>Background.</jats:bold> Oxidative DNA damage is associated with <jats:italic>Helicobacter pylori</jats:italic> infection, atrophy and intestinal metaplasia. <jats:italic>H. pylori‐cagA</jats:italic>‐positive strains are associated with the highest risk of gastric cancer.</jats:p><jats:p><jats:bold>Aims.</jats:bold> To ascertain whether <jats:italic>cagA</jats:italic>‐positive <jats:italic>H. pylori</jats:italic> infection correlates with higher concentrations of 8OHdG and the presence of precancerous changes.</jats:p><jats:p><jats:bold>Patients and Methods.</jats:bold> 118 patients were studied (65M/53F, age 61 ± 14 years). Twelve were <jats:italic>H. pylori‐</jats:italic>negative. Among the <jats:italic>H. pylori</jats:italic>‐positive patients, 34 were <jats:italic>cagA</jats:italic>‐positive and 40 were <jats:italic>cagA </jats:italic>negative. In 32 patients <jats:italic>H. pylori</jats:italic> had been eradicated at least 6 months before endoscopic sampling.</jats:p><jats:p>The phenotype of the gastritis (atrophic compared with nonatrophic, with and without intestinal metaplasia) was scored in biopsy samples obtained from the antrum, corpus, and <jats:italic>angularis incisura</jats:italic>. In antral biopsy samples, 8‐hydroxydeoxyguanosine was assessed by HPLC (electrochemical detector). <jats:italic>CagA</jats:italic> status was determined by PCR.</jats:p><jats:p><jats:bold>Results.</jats:bold> The highest scores for both mononuclear inflammation and activity of gastritis were significantly associated with <jats:italic>cagA</jats:italic> status (<jats:italic>p</jats:italic> = 0.036 antrum and <jats:italic>p</jats:italic> = 0.02 corpus). <jats:italic>cagA</jats:italic>‐positive infection significantly correlated with a higher prevalence of atrophic‐metaplastic lesions (<jats:italic>p</jats:italic> = 0.04). <jats:italic>cagA</jats:italic>‐positive patients had higher 8‐hydroxydeoxyguanosine levels than both <jats:italic>cagA</jats:italic>‐negative and <jats:italic>H. pylori</jats:italic>‐negative cases (<jats:italic>p</jats:italic> = 0.01). The 8‐hydroxydeoxyguanosine levels were significantly higher in multifocal atrophic gastritis (<jats:italic>p</jats:italic> = 0.04). The odds ratio for <jats:italic>cagA‐</jats:italic>positive patients having 8OHdG levels above a cut‐off calculated on the basis of the ROC curves were 7.12, overall, reaching 11.25 when only patients younger than 50 were considered.</jats:p><jats:p><jats:bold>Conclusions.</jats:bold> <jats:italic>cagA</jats:italic>‐positive patients were characterized: first, for higher scores for gastritis, activity and atrophic and metaplastic lesions; and second for greater oxidative DNA damage overall, at younger age and in the presence of multifocal atrophy. This setting may represent a cancer‐prone biological context.</jats:p>

収録刊行物

  • Helicobacter

    Helicobacter 8 (3), 227-234, 2003-05-14

    Wiley

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