Genetic variation in the cag pathogenicity island of Helicobacter pylori strains detected from gastroduodenal patients i
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CLINICAL MICROBIOLOGY - RESEARCH PAPER
Genetic variation in the cag pathogenicity island of Helicobacter pylori strains detected from gastroduodenal patients in Thailand Wongwarut Boonyanugomol 1 & Worrarat Kongkasame 2 & Prasit Palittapongarnpim 3 & Seung-Chul Baik 4 & Myung-hwan Jung 4 & Min-Kyoung Shin 4 & Hyung-Lyun Kang 4 & Woo-Kon Lee 4 Received: 12 January 2020 / Accepted: 30 April 2020 # Sociedade Brasileira de Microbiologia 2020
Abstract There is a lack of evidence of genetic variation in the Helicobacter pylori cag-PAI in Thailand, a region with the low incidence of gastric cancer. To clarify this issue, variation in the H. pylori cag-PAI in strains detected in Thailand was characterized and simultaneously compared with strains isolated from a high-risk population in Korea. The presence of ten gene clusters within cag-PAI (cagA, cagE, cagG, cagH, cagL, cagM, cagT, orf13, virB11, and orf10) and IS605 was characterized in H. pylori strains detected from these two countries. The cagA genotypes and EPIYA motifs were analyzed by DNA sequencing. The overall proportion of the ten cag-PAI genes that were detected ranged between 66 and 79%; additionally, approximately 48% of the strains from Thai patients contained an intact cag-PAI structure, while a significantly higher proportion (80%) of the strains from Korean patients had an intact cag-PAI. A significantly higher proportion of IS605 was detected in strains from Thai patients (55%). Analysis of cagA genotypes and EPIYA motifs revealed a higher frequency of Western-type cagA in Thai patients (87%) relative to Korean patients (8%) who were predominately associated with the East Asian-type cagA (92%). Variations in the Western-type cagA in the Thai population, such as EPIYA-BC patterns and EPIYA-like sequences (EPIYT), were mainly detected as compared with the Korean population (p < 0.05). In summary, H. pylori strains that colonize the Thai population tend to be associated with low virulence due to distinctive cag-PAI variation, which may partially explain the Asian paradox phenomenon in Thailand. Keywords Helicobacter pylori . cag pathogenicity island . IS605 . EPIYA motifs . Thailand
Introduction Helicobacter pylori usually colonizes the stomach and is well recognized as an etiological factor of several gastroduodenal
Responsible Editor: Elizabeth Andrade Marques. * Wongwarut Boonyanugomol [email protected] 1
Department of Sciences and Liberal Arts, Mahidol University, Amnatcharoen Campus, Amnatcharoen 37000, Thailand
2
Unit of Endoscopy Medicine, Sunpasitthiprasong Hospital, Ubon Ratchathani 34000, Thailand
3
Department of Microbiology, Faculty of Science, Mahidol University, Bangkok 10400, Thailand
4
Department of Microbiology, Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju 52727, Republic of Korea
diseases, including chronic gastritis, peptic ulcer diseases, and especially gastric cancer [1]. This bacterium ordinarily causes chronic infections in more than half of the world’s population; however,
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