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Genotyping of Helicobacter pylori in paraffin-embedded gastric biopsy specimens: relation to histological parameters and effects on therapy.

AbstractOBJECTIVES:
Colonization with Helicobacterpylori can lead to GI disease. Bacterial genotypes and host factors, such as acid production, can influence the progress of disease. We investigated H. pylori genotypes and histological parameters in the same paraffin-embedded gastric biopsy specimens.
METHODS:
Paraffin-embedded antrum and corpus biopsy samples from 75 gastroesophageal reflux disease patients were histologically examined and tested for H. pylori vacA (s and m regions), cagA, and iceA genotypes. Patients were investigated at baseline (58 H. pylori positive and 17 H. pylori negative) and after treatment with omeprazole with or without additional antibiotic therapy.
RESULTS:
Genotyping at baseline was complete in 52 (90%) of the 58 H. pylori positive patients. Multiple genotypes were detected in eight (14%) of these. Genotypes were highly consistent between antrum and corpus biopsy specimens at baseline and in follow-up samples. Genotypes from paraffin sections matched those from corresponding cultured strains in 10 selected cases. In the antrum, the degree of inflammation was associated with vacA s1 and cagA+ genotypes, and the degree of neutrophil activity was associated with the cagA+ genotype. In the corpus, the degree of inflammation was significantly associated with vacA s1, cagA+, and iceA1 genotypes and the degree of atrophy was associated with vacA s1, m1, and cagA+ genotypes, whereas the degree of neutrophil activity was associated with vacA s1 and cagA+ genotypes. vacA s2 and cagA-strains appeared more resistant to antibiotic therapy, irrespective of resistance to clarithromycin.
CONCLUSIONS:
Our findings confirm the relevance of the H. pylori genotypes for the severity of gastric disease and the efficacy of antibiotic therapy.
AuthorsGer H A Scholte, Leen-Jan van Doorn, Annemieke Cats, Elisabeth Bloemena, Jan Lindeman, Wim G V Quint, Stefan G M Meuwissen, Ernst J Kuipers
JournalThe American journal of gastroenterology (Am J Gastroenterol) Vol. 97 Issue 7 Pg. 1687-95 (Jul 2002) ISSN: 0002-9270 [Print] United States
PMID12135019 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)
Chemical References
  • Anti-Bacterial Agents
  • Antigens, Bacterial
  • Bacterial Outer Membrane Proteins
  • Bacterial Proteins
  • VacA protein, Helicobacter pylori
  • cagA protein, Helicobacter pylori
  • ice nucleation protein
  • Amoxicillin
  • Clarithromycin
  • Omeprazole
Topics
  • Amoxicillin (therapeutic use)
  • Anti-Bacterial Agents (administration & dosage)
  • Antigens, Bacterial
  • Bacterial Outer Membrane Proteins (genetics)
  • Bacterial Proteins (genetics)
  • Bacterial Typing Techniques
  • Biopsy
  • Clarithromycin (therapeutic use)
  • Gastroesophageal Reflux (drug therapy, microbiology, pathology)
  • Genotype
  • Helicobacter Infections (drug therapy, microbiology, pathology)
  • Helicobacter pylori (classification, genetics)
  • Humans
  • Omeprazole (therapeutic use)
  • Paraffin Embedding
  • Stomach (microbiology, pathology)

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