Vacuolating Cytotoxin A (VacA) Gene in Peptic Ulcer Disease and Nonulcer Dyspepsia

Abstract

Background: Vaculating cytotoxic A (vacA) gene is one of the multiple Helicobacter pylori genotypes that produce a cytotoxin protein (VacA).This gene is a major cause of chronic peptic ulcers and gastric cancer. The aim of this study was to determine the correlation between vacA gene with peptic ulcer disease (PUD) and non-ulcer dyspepsia (NUD). Methods: This was a case control study of 130 patients, aged 16-64, with positive H. pylori in histological and Giemsa reports. The case and control groups included 65 PUD patients and 65 NUD patients, respectively. The presence of the vacA gene genotypes was determined using polymerase chain reaction (PCR) on biopsy samples, taken by endoscopy. Results: In the case group, gastric ulcer was detected in 41.5% (27) of the participants; of whom, 77.8% (21) were female; and duodenal ulcer was found in 58.5% (38) of the participants, of whom,42.1 % (16)were female. The control group (NUD) included 65 patients; of them,45% (29) were female and the average age was 36.4 ±10.8 years (18 to 60).The total frequency of the vacA gene was 53% (69/130),with 60% in the PUD and 46% in the NUD groups (Odds ratio:1.75,95% CI:1.42-2.12,P=0.25). Conclusion: The vacA gene alone could not be a reliable diagnostic marker for discriminating peptic ulcer disease from non-ulcer dyspepsia in the Iranian population under study.

Keywords

• Peptic ulcer disease
• Non-ulcer dyspepsia
• Vaculating cytotoxin A (VacA) gene
• Vaculating cytotoxic protein (VacA)