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Background: The MUC1 gene encodes glycoproteins attached to cell membrane that play a protective role in gastric cancer and protect epithelial surfaces against external factors such as Helicobacter pylori. H. pylori infection can induce a cascade of innate and acquired immune responses in gastric mucosa. Relationship between rs4072037G>A polymorphism of MUC1 gene and increased susceptibility to H. pylori infection aimed to investigate in patients with gastric cancer in Mazandaran, northern Iran. Methods: A case-control study was conducted on 99 patients with gastric cancer (H. pylori positive and negative) and 98 controls (H. pylori positive and negative) without gastric cancer (confirmed by pathological biopsy samples obtained during endoscopy). H. pylori infection was diagnosed by histological examination using Giemsa staining. Genomic DNA extracted from peripheral blood was analyzed by PCR-RFLP technique. Results: Analysis of all genetic models showed no significant relationship between rs4072037G>A polymorphism and risk of gastric cancer (GC). The relationship between H. pylori infection and rs4072037G>A polymorphism showed an increased susceptibility to gastric cancer in both positive and negative H. pylori groups (including case and control groups). The genetic model of GA/GG and H. pylori- positive versus GA/GG and H. pylori-negative showed a significantly increased susceptibility to gastric cancer (OR=0.251, CI: 0.128-0.493, P=0.000). Conclusion: These findings indicate that rs4072037G>A polymorphism may interact with H. pylori infection to increase the risk of GC. [ABSTRACT FROM AUTHOR]

Background: There is evidence of a direct relationship between peptic ulcer disease (PUD) and the risk of gastric cancer. This study determined the prevalence of gastric cancer in individuals with solitary proximal or distal gastric ulcers admitted to Shahid Rahimi Hospital in Khorramabad, Iran, from 2019 to 2021. Materials and Methods: In this cross-sectional study, 635 patients were included. Age group and sex as well as data related to the year of admission, pathological examination, and location of the ulcer, were recorded in a researcher-made checklist. Data were analyzed using the SPSS software version 22 at a significance level of 0.05. Results: Out of the 635 patients, 66.3% (421) were male, and 33.7% (214) were women. The mean age was 62.5±17.7 years. Overall, 16.7% of patients with gastric ulcers were diagnosed with gastric cancer by pathological examination. The frequency of malignancy was highest in the 80 years and older age group. There was a considerable association between malignancy and age group (P˂0.001; df=4; χ2=27.24). There was no significant association between malignancy and sex (P=0.144). A significant relationship was observed between malignancy and ulcer location (P˂0.001). Proximal ulcers were malignant in 24.6% of the cases (n=74), while distal ulcers were malignant in 9.6% (n=32). Conclusion: Older patients, men, and patients with gastric ulcers are more likely to develop gastric cancer. Therefore, more effective strategies should be developed to prevent this fatal condition. [ABSTRACT FROM AUTHOR]

Aim: We compared the efficacy of two different regimens for H. pylori eradication in areas with high antibiotic resistance. Background: Helicobacter pylori (H. pylori) is a gram-negative bacillus that has a strong association with chronic gastritis and peptic ulcer disease. Different regimens with varying degrees of effectiveness have been used for H. pylori eradication. Methods: The current randomized controlled trial (RCT) randomly assigned 217 patients who had indications for H. pylori eradication therapy to two groups. One group were administered concomitant quadruple therapy (pantoprazole 40 mg, amoxicillin 1 gr, clarithromycin 500 mg, and metronidazole 500 mg every 12 hours) for 14 days, and the second group received 14 days of high-dose dual therapy, consisting of esomeprazole 40 mg BID and amoxicillin 1g TDS. H. pylori eradication was assessed eight weeks after the end of treatment. Results H. pylori eradication rates by PP analysis for 14 days concomitant quadruple therapy and high-dose dual therapy were 88.6% (95% CI, 80.3-92.8) and 82.2% (95% CI, 74.8-89.5), respectively (p = 0.19). According to intention-to-treat (ITT) analysis, the eradication rates were 81.6% (95% CI, 74.5-88.6) and 80.6% (95% CI, 73-88.1), respectively (p = 0.58). Overall drug side effects were 20.8% in high-dose dual therapy and 49.6% in concomitant quadruple therapy (p < 0.001). Conclusion: Fourteen days concomitant quadruple therapy can be considered as a relatively acceptable regimen for H. pylori eradication in areas with high clarithromycin and metronidazole resistance. It seems that high-dose dual therapy could be a promising alternative regimen in these areas. [ABSTRACT FROM AUTHOR]

Background and Aim: Helicobacter Pylori (H. pylori) is one of the reasons for the gastric inflammation and peptic ulcers. It is a predisposing factor of gastric adenocarcinoma. Cytotoxin A encoded by the cagA gene is one of the major virulence factors in bacterial pathogenicity, which is of special importance due to genetic diversity in different geographical areas. The purpose of this study was to evaluate the prevalence of the cagA gene in the patients suffering from gastric ulcers. Materials and Methods: Seventy-five paraffin blocks of stomach biopsy samples from patients infected with H. pylori and suffering from gastric ulcers were randomly evaluated in the province of Kermanshah in the spring of 2016, Iran. DNA samples extracted by the boiling method were investigated using PCR by the use of particular primer pairs for a protected area in the glmM gene, and the existence of the cagA gene. Results: From the 75 samples, 56 cases (%74.66) were glmM-positive and among them, 39 cases (%69.64) tested positive for cagA gene. Comparing patients in terms of gender, the frequency of the cagA gene was 22 (%39.28) and 17 (%30.35) in males and females, respectively. Finally, comparing patients in terms of age, 16 cases (%21.33) were younger than 40 years old and 23 cases (%41.07) were older than 40 years old. Conclusion: The results of this study showed significant association between the frequency of the cagA gene and peptic ulcer in the studied patients. [ABSTRACT FROM AUTHOR]

Background: CagA, a 120- to 145-kD Helicobacter pylori (H. pylori) protein, increases the risk of atrophic gastritis and gastric cancer (GC). The pathogenic CagA contains a highly polymorphic Glu-Pro-Ile-Tyr-Ala (EPIYA) repeat region in the C-terminal portion of the protein. The aim of this study was to determine the number and type of EPIYA (glutamine–proline–isoleucine–tyrosine–alanine) motifs within the cagA 3' variable region among H. pylori isolates and their association with GC. Materials and Methods: The total number of 206 individuals (170 controls and 36 patients with GC) referring to the endoscopy units of several cities in Iran (2008-2014) were recruited. The polymerase chain reaction (PCR) amplification was performed to determine the presence of H. pylori, cagA gene, and EPIYA motifs. Results: In this study, 81 (47.6%) and 22 (61.1%) of the controls and patients with GC were carriers of cagA+ strains, respectively. The overall frequency of EPIYA-AB, EPIYA-ABC, EPIYA-ABCC, and EPIYA-ABCCC in patients with GC were 0%, 59%, 9%, and 31.8%, respectively. The results of regression analysis showed a significant association between EPIYA-ABCCC motif and the risk of GC [OR = 9.99 (95%CI: 2.17-45.88), p = 0.003]. Conclusion: We propose that patients infected with H. pylori strains harboring more than one CagA EPIYA C motif (EPIYA-ABCCC) have an increased risk of GC, thus, testing for this genotype may have clinical usefulness. [ABSTRACT FROM AUTHOR]

Background: Helicobacter pylori might become highly resistant to antibiotics taken through the life time of patients. This study examined the change in antibiotic resistance of H. pylori by time. Methods: Out of 985 dyspeptic patients who were referred to the endoscopy unit of Shariati hospital during 2010-2017, 218 patients with gastric biopsies positive for rapid urease test (RUT) and H. pylori culture were recruited in the study. H. pylori isolates were examined for resistance to 8 currently used antibiotics by the disc diffusion method. Results were compared with those from our three previous studies. The frequency of multidrug resistance (MDR) was also assessed. Results: The highest resistance rate was to metronidazole (MTZ) (79.4%) followed by ofloxacin (OFX) (58.7%), ciprofloxacin (CIP) (46.8%), levofloxacin (LVX) (45%), tetracycline (TET) (38.5%), clarithromycin (CLR) (34.4%), amoxicillin (AMX) (27.1%) and furazolidone (FRZ) (23.9%). No significant difference was found between resistance of H. pylori isolates from male and female <40 and >40 years old and patients with gastritis and peptic ulcer. The highest rates of MDR were to MTZ+OFX (4.6%), MTZ+OFX+TET (2.8%), MTZ+OFX+CIP+LVX (6.4%) and MTZ+OFX+TET+ CIP+LVX (5%). Conclusion: Resistance to MTZ increased from 33%-55.6% in previous studies to 79.4% by time, to CLR increased from 1.4-7.3% to 34.4%, to TET increased from 0-38.1% to 38.5%, to AMX increased from 1.4%-7.3% to 27.1% and to FRZ increased from 0%-4.5% to 23.9%. Resistance to FQs was 45%-58.7%. Increase in H. pylori antibiotic resistance indicates antibiotic misuse. In Iran, with a considerable number of H. pylori- infected patients, antibiotic therapy should be saved for high risk patients and according to local antibiotic resistance patterns. [ABSTRACT FROM AUTHOR]

Toll-like receptor-4 ( TLR4) polymorphisms may influence host immune response against Helicobacter pylori ( H. pylori). This study aimed to investigate whether TLR4 polymorphisms are associated with H. pylori susceptibility and risk of peptic ulcer development or not. The TLR4 + 3725 G/C polymorphism was studied using polymerase chain reaction with confronting two-pair primers ( PCR- CTPP). In addition, TLR4 Asp299Gly and Thr399Ile polymorphisms were evaluated by PCR-restriction fragment length polymorphism ( RFLP). There was no significant difference in TLR4 + 3725 G/C and Asp299Gly genotype frequencies between non-peptic ulcer ( NPUD) and peptic ulcer ( PUD) individuals in the context of peptic ulcer development and susceptibility to infection with H. pylori. Nevertheless, a significant association with increased risk for PUD development was observed for polymorphism TLR4 Thr399Ile [odds ratio ( OR) = 4.2; 95% confidence interval ( CI) = 1.35-13.26; p = 0.01]. Correspondingly, TLR4 Thr399Ile polymorphism was associated with H. pylori susceptibility ( OR = 0.27; 95% CI = 0.08-0.88; p = 0.04). In addition, TLR4 Thr399Ile polymorphism increased 4.2-fold, the risk of peptic ulcer development in individuals infected by H. pylori carrying CT + TT genotype. Our results showed that TLR4 Thr399Ile polymorphism along with H. pylori infection may play critical roles in peptic ulcer development in North of Iran. [ABSTRACT FROM AUTHOR]

Background: Treatment success of H. pylori eradication therapy has declined worldwide largely because of increased antimicrobial resistance. New therapeutic approaches are needed, especially for countries like Iran, where resistance to commonly used drugs is already widespread and traditional H. pylori therapies produce poor cure rates.Aim: To review the results of quadruple therapy trials containing bismuth and furazolidone in Iran.Methods: We searched PubMed, Google scholar as well as the references of all published papers for studies conducted in Iran, utilizing furazolidone in the treatment of H. pylori infections. The target population was four drug studies that utilized a combination of bismuth, furazolidone, amoxicillin, or tetracycline plus a proton pump inhibitor.Results: Eighteen studies with 22 arms including 1713 subjects were found. The weighted mean cure rate for 14-day studies (six studies) using 200 mg b.i.d. furazolidone was 80% intention to treat (ITT) and 87% per protocol (PP). Studies using 100 mg b.i.d. (three studies) were less effective (weighted mean ITT cure rate = 67%). One small 14-day study with furazolidone 100 mg q.i.d. achieved cure rates of 94.5% ITT and PP.Conclusions: Although furazolidone-bismuth quadruple therapy proved relatively effective in Iran, furazolidone-containing regimens remain to be optimized. Based on these data and results from China, it appears likely that 14-day therapy containing furazolidone 100 mg t.i.d. or q.i.d. is likely to provide the highest cure rates with lowest side effects; this remains to be experimentally tested. Detailed suggestions for further development of furazolidone-containing regimens are provided. [ABSTRACT FROM AUTHOR]

BACKGROUND: Over the past decade, cardiovascular diseases have been recognized as the leading cause of mortality worldwide. Myocardial infarction (MI) is one of the most prevalent types of cardiovascular diseases that is caused by the closure of coronary arteries and ischemic heart muscle. Numerous studies have analyzed the role of H. pylori as a possible risk factor for coronary artery diseases, in most of which the role of infection in coronary artery disease is not statistically significant. METHODS: These contradictory findings made us conduct a systematic review to analyze all relevant studies in Iran through a meta-analysis and report a comprehensive and integrated result. All published studies from September 2000 until September 2016were considered Using reliable Latin databases like PubMed, Google Scholar, Google search, Scopus, Science Direct and Persian databases like SID, Irandoc, Iran Mede and Magiran. After quality control, these studies were entered into a meta-analysis by using the random effects model. After evaluating the studies, 11 papers were finally selected and assessed. RESULTS: A total of 2517 participants had been evaluated in these studies, including 1253 cases and 1264 controls. Based on the results of meta-analysis and using random effects model, an overall estimate of OR Helicobacter Pylori with Presence of Myocardial Infarction in Iran was OR=2.53 (CI=1.37-4.67). CONCLUSIONS: The results of this review study show that H. pylori are associated with the incidence of MI so that the odds ratio of MI in the patients with helicobacter pylori is twice greater than that of the people without H. pylori. Future studies are recommended to evaluate the mechanisms associated with relation of H. pylori with MI as well as its association with time. [ABSTRACT FROM AUTHOR]

Background: Helicobacter pylori (H. pylori) is the cause of most cases of peptic ulcers and gastric cancers and cause some of the most important cause of stomach cancer and lymphoma. The objective of this study was to evaluate the time trend of Helicobacter pylori prevalence and presence of intestinal Metaplasia over the period of 7 years in gastritis Iranian patients. Materials and Methods: In this cross-section study data related to H. pylori and intestinal Metaplasia (IM) among 14,860 consecutive gastritis patients, who referred to the gastrointestinal department of Tehran's Taleghani Hospital in Iran, was examined across the sex and age group. Results: The overall prevalence rate among patient with H. pylori infection was 83.5% (12406/14860) and 11,394 (84.1%) of them were related to the gastritis. The prevalence rate of H. pylori among patient with gastritis significantly higher (p<0.05) compared to patients without gastritis. In addition, the prevalence decreased with age while the presence of intestinal metaplasia increased with age (p<0.05). Conclusion: The results of this study showed that the prevalence of H. pylori infection in Iranian population has declined in recent years; nevertheless it seems to be highly prevalent in Iran. We also find a significant positive relationship between H. pylori infection and IM with gastritis. There is no association between sex and infection but in contrast with the most studies its prevalence decreased with age. [ABSTRACT FROM AUTHOR]

The rates and routes of Helicobacter pylori transmission, in a high-prevalent country like Iran, with gastric cancer as the leading cause of male cancer mortality, are of great essence. Here, we have studied the H. pylori -associated risk factors and the likelihood of interspousal transmission. In a cohort of 686 young prewed couples, questionnaires were self-administered and serum samples were collected, for assessment of risk factors and H. pylori serostatus, at baseline and follow-up. Of the 475 H. pylori single- or double-seronegative couples, 201 returned for follow-up. The average follow-up duration was 2.2 (SD 0.6) years, with a total of 560.1 person-years. Logistic regression and Cox regression models were used to estimate the odds ratios (ORs) and hazard ratios (HRs). The risk of infection was higher in men than women (OR: 1.3, 95% CI: 1.0–1.8) and among metropolitan than rural residents (OR = 1.4, 95% CI: 1.1–1.9). It was also significantly higher among those with three (OR = 1.6, 95% CI: 1.1–2.2), and four or more siblings (OR = 1.4, 95% CI: 1.0–1.9), in reference to those with one or no siblings. Adult H. pylori acquisition occurred in 10.9% (27/247) of the seronegative participants. The risk of the acquisition was significantly associated with age (P value for trend=0,000). It was also significantly lower among participants who had various degrees of education as compared to illiterate subjects (HR = 0.2, 95% CI: 0.1–0.9). Nevertheless, our analysis did not find any evidence for interspousal transmission (HR = 1.0, 95% CI: 0.4–2.2). Whilst H. pylori acquisition was detected in the young adult Iranian population, our findings did not support interspousal transmission, as a mode of acquisition. [ABSTRACT FROM AUTHOR]

Infection with Helicobacter pyloriis the most common cause of stomach and duodenal ulcers. About more than 80 % of people are infected with H. pylori in developing countries. H. pylori uses urease enzyme product "ammonia" in order to neutralize and protect itself from the stomach acidic condition and urease enzyme activity has been shown to be essential to the colonization of H. pylori. Inhibitory activity of 20 traditional medicinal plants were examined and evaluated against Jack bean urease activity by Berthelot reaction to obtains natural sources of urease inhibitors. Each herb was extracted using 80% aqueous methanol, then tested its IC50 value was determined. Eight of the whole 20 studied plants crude extracts were found the most effective with IC50 values of less than 100 μg/mL including Laurus nobilis, Zingiber officinale, Nigella sativa, Angelica archangelica, Acorus calamus, Allium sativum,Curcuma longa, and Citrus aurantium extracts, from which most potent urease inhibitory was observed for Zingiber officinale, Laurus nobilis, and Nigella sativa with IC50 values of 48.54, 48.69 and 59.10 μg/mL, respectively [ABSTRACT FROM AUTHOR]

Background: Helicobacter pylori (H. pylori)-specific genotypes have been closely correlated with an increased risk of gastric cancer (GC). The present study aimed to determine the distribution of H. pylori pathogenic genotypes amongst Iranians infected with strains representing European ancestry in areas with different GC incidence. Methods: A total of 138 H. pylori isolates from ten districts in Iran were used for genotyping. Results: The following genotypic frequency was observed: vacA s1 (94.9%), s2 (5.1%), ml (24.6%), m2 (75.4%), d1 (39.9%), d2 (60.1%), i1 (40.6%), i2 (59.4%), iceA1 (76.8%), iceA2 (52.9%), iceA1/2 (29.7%), babA2 (40.6%), and cagA (65.9%). Hierarchical analyses of molecular variance (AMOVA) for the vacA d1, d2, i1, and i2 alleles and iceA1 and iceA1/2 genes found significant levels of genetic differentiation among populations (P < 0.05). Prevalence of the vacA d1, i1, and iceA1/2 (but not iceA1) genes and vacA d1/i1. vacA 6MiceA1, vacA d1/ iceA1/2, vacA d1 lcagA+; vacA \ViceA1, vacA \ViceA1/2, and vacA \McagA+ genotypes were significantly higher (>2- or 3-fold) among H. pylori isolates from high incidence GC areas that had age-standardized rates (ASRs) of >20/105 (max. 51.8/105) when compared with those from low incidence (ASRs <10/105) GC areas (P < 0.005, for the latter, P = 0.016). In contrast, the vacA d2/i2, m2/d2, and m2/i2 genotypes were significantly more prevalent in low compared to high incidence GC areas (P < 0.005). The results of Mantel's test only showed a low correlation between genetic and geographic distances for the iceA1 and iceA1/2 (but not vacA alleles, iceA2, babA2, and cagA) genes among ten districts of Iran (r = 0.098 and 0.074, respectively, P< 0.05). Conclusion: We propose that the H. pylori vacA d1/-i1 genotypes, which are new determinants of GC, have tremendous potential for differentiating H. pylori strains from high and low incidence GC areas in Iran. [ABSTRACT FROM AUTHOR]

Objective: Searching the H. pylori -DNAs in adenoid and IgA, IgG antibodies in serum of children. Methods: a cross- sectional study had done upon 53 children (Mean age 8 ±1.9 years) with adenoid surgery in ENT and Pediatric Department of Rasul Akram Hospital (2008-2010). Of 53 cases with adenoid surgery, 40 cases had rhino sinusitis (in sinus CT scan). The resected adenoid tissues (n=40) centrifuged and homogenized and its DNAs extracted and searched for H. pylori- DNAs by qualitative PCR. Serum H. pylori antibodies (IgG &IgA ELISA) calculated quantitatively. Chi square values (p<0.05) calculated for all categorical variables. The agreement between serologic test and PCR was assessed by the calculation of kappa statistic. Results: Positive PCR for H. pylori detected in 15%of cases; regardless of sex and age of cases. Positive IgA: 17.5% (7/40) and IgG: 20% (8/40) respectively. All cases with positive H .pylori- IgG were female; p=0.003 and meaningful differences in mean age of cases observed for positive IgA (p=0.001) and IgG (p=0.01). Poor agreement observed between positive PCR and serum IgG&IgA (Fisher's Exact test=0.3; 0.5). Conclusion: Positive PCR in adenoid tissue (15%) was very close to positive serum IgA (15%) but without any agreement for each case. The H .pylori infection may have a relative role at least in 15% of children with adenoid surgery. Chronic sinusitis and ear infection might be added to infected adenoid tissue as a reservoir for bacteria. The search by specific culture may elucidate better the role of H. pylori infections in both gastric and adenoid tissues. The decision for use of antibiotics to eradicate the H. pylori infection in recurrent or chronic adenotonsillar infections (with rhinosinusitis) before adenoid surgery needs Randomized Control Trial (RCT) studies. Drug of choice for eradication of H. pylori dependent to antibiotic sensitivity test in each country [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this research was to analyze cagA and vacA genotypes status in H. pylori isolates and relationship with clinical outcomes. Methods: Gastric biopsy specimens were cultured for H. pylori isolation and cagA and vacA genes were detected in these isolates. Data were collected and the results were analyzed using ?2 and Fishers exact tests by SPSS software version. 16. Results: Of the total 115 H. pylori isolates, 79 (68.7 %) were cagA positive and 82 (71.3%) of isolates contained the s1 allele which 33 (28.7%) were subtype s2. s1m2 was the most frequent vacA allelic combination in the H. pylori isolates examined (63 cases), followed by s2m2 (31 cases), s1m1 (19 cases) and s2m1 (2 case). Strains cagA positive were more frequent in peptic ulcer diseases patients than non ulcer diseases patients, as 47 (59.5%) and 32 (40.5%), while cagA negative were low, as 15 (41.7%) and 21 (58.3%), respectively. Conclusion: We found that the cagA and vacA status were not related to clinical outcomes in this area. Overall, in the present study, vacA s1/m2, cagA-positive strains were predominant irrespective of clinical outcome, but s2/m1 was rare. [ABSTRACT FROM AUTHOR]

Helicobacter pylori (H. pylori) is classified as a class I carcinogen. The low infection rate seen in developed countries (8.9%) compared with a high infection rate (52%-98%) in developing countries indicates a strong association between infection prevalence and socioeconomic status. Adhesion of H. pylori to gastric epithelial cells is an important aggressive factor. One of the genes that encodes for an adhesive protein is babA2, which facilitates the location of bacteria on gastric epithelial cells and delivery of toxic proteins (CagA, VacA) into the host cells. BabA2 is a 78 KD protein that binds to the Le antigens on gastric epithelial cells. Some studies have shown an association between babA2 and peptic ulcer disease or gastric cancer. The cagA gene which encodes an immunodominant protein has a mosaic structure composed of protected and various regions. The C-terminal region of CagA, which includes multiple numbers of EPIYA (Glu-Pro-Ile-Tyr-Ala) motifs, is tyrosine-phosphorylated. Western and East Asian strains represent EPIYA-C and EPIYA-D motifs, respectively. The C- and D- types serve as low-affinity and high-affinity SHP-2-binding sites and interfere with SHP-2 phosphatase activity. A majority of East Asian strains have shown strong conservation and lack of duplication in the D region while the Western strains have shown multiple numbers of the EPIYA-C motif, which increase gastric cancer risk. CagA, either tyrosine-phosphorylated (in its C-terminal motifs) or not in host cells, alters the expression of certain genes to cause gastric cancel. The importance of these genes in predicting clinical outcomes is related to the phylogeographical origins of the bacterium. If the mechanisms by which H. pylori causes cancer are elucidated, they can assist in achieving effective strategies for the prevention and treatment of gastric cancer. [ABSTRACT FROM AUTHOR]

Background. Gastroesophageal reflux, by exposing the pharynx to Helicobacter pylori (H. pylori), is a potential risk factor for laryngohypopharyngeal carcinoma. Its possible association has been inconsistent. In this case–control study, we investigated the relationship between H. pylori seropositivity and laryngohypopharyngeal carcinoma in Iran. Methods. We had 105 healthy controls (group A), 70 cases of laryngeal carcinoma (group B), and 28 cases of hypopharyngeal carcinoma group (group C). Age, sex, smoking habit, alcohol use, and H. pylori serology were determined for all subjects. Results. Groups were matched in age and alcohol use. Smoking and H. pylori seropositivity were more common in groups B and C, and male sex was more common in group B (compared with group A). In multivariate regression, the effect of smoking (p <.01, odds ratio [OR] = 2.92) and H. pylori seropositivity (p <.01, OR = 11.49) remained highly significant. Conclusion. H. pylori is an independent risk factor for laryngohypopharyngeal carcinoma. © 2008 Wiley Periodicals, Inc. Head Neck, 2008 [ABSTRACT FROM AUTHOR]

The urea breath test (UBT) which is carried out with 13C or 14C labeled urea is one of the most important non invasive methods for detection of Helicobacter pylori infection. Application of 13C-UBT is becoming increasingly popular because of its non radioactive nature which makes it suitable for diagnostic purposes in children and women of child bearing ages. While isotope ratio mass spectrometer (IRMS) is generally used to detect 13C in expired breath, this instrument is expensive and recently non dispersive isotope selective infrared (NDIR) spectroscopy which is a lower cost technique has been employed as a reliable counterpart for IRMS in small clinics. The aim of this study was to assess the validity of NDIR spectroscopy technique in Iranian population in comparison with histological examination, rapid urease test and 14C-urea breath test as gold standard. Seventy six patients with dyspepsia were underwent 13C-UBT for diagnosis of Helicobacter pylori infection. Good agreements were found between the 13C-UBT and gold standard methods. The 13C-UBT showed 100% sensitivity, 97.3% specificity, 97.56% positive predictive value, 100% negative predictive value and 98.65% accuracy. On the basis of these results it could be concluded that 13C-UBT performed with NDIR spectroscopy is a reliable, accurate and non invasive diagnostic tool for detection of Helicobacter pylori infection in the Iranian population. [ABSTRACT FROM AUTHOR]

Helicobacter pylori OipA (outer inflammatory protein A) is an outer membrane protein that involves in the binding and colonization of the bacterium in the stomach. The oipA status is associated with the risk of peptic ulcerations (PUs) and gastric cancer (GC) diseases. However, the association trend with PUs compared to GC is often different and highly challenging. We therefore aimed to determine the presence of this genotype in Iranian strains and assess its association with the risk of PUs and GC in a larger number of samples. A total of 319 strains were obtained from 172 patients with non-atrophic gastritis (NAG), 52 with PUs and 95 with GC. The prevalence of the oipA + vs. oipA − genotype was 67.7% (216/319). The total frequency of the oipA + vs. oipA − genotypes in NAG, PUs, GC, non-peptic ulceration (including NAG and GC), and non-tumor (including NAG and PUs) groups was 121/172 (70.3%), 50/52 (96.2%), 45/95 (47.4%), 166/267 (62.2%), and 171/224 (76.3%), respectively. In multiple logistic regression analysis, the oipA + vs. oipA − genotype showed a strong direct association with PUs; the OR adj (95% CI) was 18.751 (4.421–79.531), (p = 0.00007). In contrast, it had a significant reverse association with GC; the OR adj (95% CI) was 0.330 (0.179–0.607), (p = 0.00036). In the present study, we interestingly found a contrasting association of the H. pylori oipA genotype with the risk of PUs and GC in Iran. Therefore, the contrasting effect of this genotype may emphasize its independent role in predicting clinical outcomes. • The association of the H. pylori oipA + genotype with clinical outcomes was assessed in a large number of Iranian H. pylori isolates (N = 319). • The oipA + genotype was strongly associated with an increased risk of peptic ulcerations (adjusted OR adj = 18.751; p = 0.00007). • The oipA + genotype significantly reduced the risk of gastric cancer (OR adj = 0.330; p = 0.00036). • The contrasting effect of this genotype may emphasize its independent role in predicting clinical outcomes. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease is a chronic, relapsing-remitting gastrointestinal disorder which has become a serious global concern, and it imposes a great degree of health and economic burdens on communities worldwide. Although the presence of non-Helicobacter pylori Helicobacter (NHPH) microorganisms has been reported in various gastrointestinal disorders, their putative role in the pathogenesis of IBD has been a matter of controversy. The present study aimed to investigate the existence of gastric and enterohepatic NHPHs and their probable coinfection with H. pylori in IBD. Totally, 168 clinical specimens including 70 colonic biopsies and 98 fecal specimens were obtained from IBD patients. Genomic DNA was extracted from all samples, and its quality and concentration were assessed by β-globin PCR and spectrophotometry. The Helicobacter genus-specific PCR was performed using 16S rRNA gene. All samples were also tested for H. pylori infection by PCR of ureC gene fragment (glmM). The presence of NHPH was examined by using species-specific PCR assays. Based on PCR results, H. pylori was detected in 12.9% and 3.1% of colonic biopsies and fecal specimens, respectively. However, no statistically significant correlation was observed (P value > 0.05). We failed to find NHPH in both colonic biopsies and fecal specimens from IBD patients. Despite the fact that none of the IBD patients harbored the NHPH in the current work, further cohorts with larger sample size are required to determine the possible relationship between NHPH infection and IBD pathogenesis., (© 2021. Institute of Microbiology, Academy of Sciences of the Czech Republic, v.v.i.)

Background: H. pylori strains with different genetic contents may infect different or an individual human host. Genetic diversity of cagA is thought to contribute to differences in H. pylori strains pathogenicity. In this study, diversity of cagA genotype, EPIYA motif and copy number was assessed in H. pylori single colonies isolated from individual patients., Materials and Methods: Gastric biopsies from 14H. pylori-positive dyspeptic patients were cultured on selective brucella blood agar and incubated at 37 °C under microaerobic conditions. Four single colonies were obtained from each biopsy subculture on brucella blood agar under similar incubation condition. Presence of cagA and types of EPIYA motifs was determined by polymerase chain reaction (PCR) and cagA copy number by quantitative real-time (RT) PCR., Results: Single colonies of 5 patients showed no variation in cagA genotype, EPIYA motif and copy number. Out of the remaining 9 patients, 1 patient showed presence or absence of cagA gene, 2 patients had mixed EPIYA motifs, 2 patients had different cagA copy number, 1 patient showed absence or presence of cagA and mixed motifs, 2 patients had cagA genes with different nucleotide sequences, 1 patient showed presence or absence of cagA and difference in cagA nucleotide sequence. Four isolates that contained multiple copies of cagA, carried EPIYA-ABC motif., Conclusion: Genetic diversity of cagA among single colonies isolated from individual patients represents evidence that gastric mucosa of every individual is colonized with a specific and heterogeneous population of H. pylori. Future studies on patients in different disease groups may elucidate the role of mixed populations of H. pylori in development of gastric diseases., (Copyright © 2021 Elsevier B.V. All rights reserved.)

The association of the H. pylori cagA - / cagE -positive genotypes with the risk of gastric cancer (GC) in Ardabil—a high-risk area in North-West Iran—was assessed. Genotyping was performed in DNA from fresh gastric biopsies (N = 218). Occurrence of H. pylori infection was 85.32% (186/218). The total frequency of the cagA + vs. cagA −, cagE + vs. cagE −, cagA +/ cagE − vs. AGCs (all genotype combinations), cagA −/ cagE + vs. AGCs, cagA −/ cagE − vs. AGCs, cagA +/ cagE + vs. AGCs, cagA +/ cagE − vs. cagA −/ cagE + , and cagA +/ cagE + vs. cagA −/ cagE − genotypes was 102/186 (54.8%), 89/186 (47.8%), 38/186 (20.4%), 25/186 (13.4), 59/186 (31.7%), 64/186 (34.4%), 38/63 (38.63%), and 64/123 (52.0%), respectively. The cagE + vs. cagE − (59.6% (65/109) in GC vs. 31.2% (24/77) in non-atrophic gastritis, NAG) and the cagA +/ cagE + vs. cagA −/ cagE − genotypes (66.7% (40/60) in GC vs. 38.1% (24/63) in NAG) showed an increased association with the risk of GC in Ardabil (odds ratio [OR] = 3.262, 95% confidence interval [CI]: 1.763–6.038, p =.0001 and OR = 3.250; 95% CI: 1.552–6.808, p =.002, respectively). We propose that the H. pylori cagE + but not cagA + genotype significantly increased the risk of GC in this extremely high-risk population. Therefore, it may play a significant role in determining H. pylori -related clinical outcome. • Ardabil is a very high-risk area of gastric cancer (GC) in North-West Iran. • The frequency of the H. pylori cagA + and cagE + genotypes was 54.8% and 47.8%, respectively. • The frequency of the H. pylori cagA +/ cagE + vs. cagA −/ cagE − genotypes was 52.0%. • The H. pylori cagE + and cagA +/ cagE + genotypes strongly increased the risk of GC. • The H. pylori cagE + genotype is a stronger predictor of GC than cagA + in this high-risk population. [ABSTRACT FROM AUTHOR]

Purpose: Helicobacter pylori (H. pylori) infection is considered as one of the main cause of gastric cancer. Treatment failure of the infection often occurs due to antibiotic resistance. Herein, we aimed to evaluate the mutations in 23S rRNA gene of H. pylori which are associated with clarithromycin resistance and in rdxA and frxA genes of the bacterium which may be associated with metronidazole resistance, in paraffin-embedded gastric biopsies from patients with gastric adenocarcinoma and gastritis in Tabriz, the northwest of Iran., Methods: In the study, 80 paraffin-embedded tissue sections from 40 gastric cancer and 40 gastritis patients in the Imam Reza hospital, Tabriz, Iran were collected. The existence of ureC gene was verified by PCR method. Genotypical clarithromycin resistance was investigated by real-time PCR method and determination of the melting temperature. PCR reaction and sequencing were used for the evaluation of mutations in rdxA and frxA genes., Results: The results of ureC amplification showed that DNA of H. pylori was present in the 82.66% of the obtained DNA samples. About 45.16% of samples were resistant to the clarithromycin and 53.22% of them were resistant to the metronidazole. Based on the results from real-time PCR, the frequency of mutations was as follow A2143G 64.28%, A2142G 44.44% and A2142C 1.11%. The mutations of rdxA gene were 66.66% missense, 30.30% frameshift and 3.03% non-sense. The mutations of frxA gene were 36.36% missense, 54.54% frameshift and non-sense 9.09%., Conclusion: A2143G mutation is the most frequent mutation among clarithromycin resistant genes in Iran. Also, missense and frameshift mutations are frequent in rdxA and frxA genes. Screening for these mutations could help researchers to investigate the most effective anti-H. pylori antibiotics and to prevent antibiotic resistance.

Helicobacter pylori possesses virulence genes that are involved in the pathogenesis of the bacterium. There are little data regarding all constellations of five polymorphic sites of H. pylori vacA and cagA status. We therefore aimed to i) find any associations between H. pylori vacA alleles (s1/s2, m1/m2, i1/i2, d1/d2, and c1/c2) and cagA status and ii) determine the frequency of all five-genotype combinations of the vacA alleles with and without cagA gene, and their associations with risk of gastric cancer (GC). A total of 290 Iranian H. pylori isolates from gastrointestinal patients were obtained successfully by the cultivation of biopsies and genotyped. The patients included 144/290 with non-atrophic gastritis (NAG), 57/290 with peptic ulcer disease (PUD), and 89/290 with GC. We found that each of the vacA m1-, i1-, d1-, and c1-genotypes was significantly associated with cagA + status. The odds ratio(OR) and 95% confidence interval (95% CI) was 2.316 (1.241-4.301) for cagA + /vacA m1, 2.764 (1.540-4.960) for cagA + /vacA i1, 4.288 (2.305-7.977) for cagA + /vacA d1, and 2.639 (1.488-4.680) for cagA + /vacA c1, respectively. In this study, 43 five- and six-genotype combinations were found among 224 strains. The highest frequencies were observed for vacA s1m2i2d2c2 (85/224, 37.9%), s1m2i2d2c2/cagA (48/222, 21.6%), s1m1i1d1c1 (40/224, 17.9%) and s1m1i1d1c1/cagA (35/222, 15.8%). Logistic regression analysis showed that vacA s1m1i1d1c1, s1m2i1d2c1, s1m2i2d2c1, and s1m2i2d2c1/cagA had a high prevalence in GC patients compared to non-atrophic gastritis patients (p < .05). The ORs and 95% CI were 2.433 (1.070-5.531), 11.524 (1.253-106.023), 4.200 (1.261-13.993), and 6.263 (1.494-26.256), respectively. These results were also confirmed when the controls were non-tumors (NAG/PUD). We found novel five- and six-genotype combinations associated with the risk of GC. These associations seem to be strongly dependent on the presence of c1-type of vacA. Therefore, analysis of all combined genotypes of the vacA alleles and cagA status may play a significant role in determining H. pylori-related clinical outcomes., Competing Interests: Declaration of Competing Interest None., (Copyright © 2019 Elsevier B.V. All rights reserved.)

The cagL protein of Helicobacter pylori involving in pathogenesis of gastroduodenal disorders. Therefore, the current study was conducted to determine the cagL amino acid polymorphisms in patients with gastric diseases. One hundred gastric biopsies were collected from gastritis, peptic ulcer (PUD) and gastric cancer (GC) patients and were screened for cagL using polymerase chain reaction (PCR). Also, sequence variations of the cagL were assessed via sequence translation. The cagL geneopositivity was 71.6% in patients were infected with H. pylori. The cagL from PUD indicated a higher rate of D58 amino acid sequence polymorphism than those of the GC and gastritis (P < 0.05). The D58 polymorphism showed an increased risk of PUD up to 6.5-fold (95% CI: 1.2-35.7). This position was occupied with amino acid N58 in GC. The E59 polymorphism was more frequently found in PUD and GC than gastritis patients. Additionally, presence of Q62 and N122 significantly observed in PUD and GC, whereas I60 was detected in PUD patients. Our results demonstrated that presence of the D, I, Q and N at position 58, 60, 62 and 122, respectively increased the risk of peptic ulcer. However, amino acid N, M, Q and N at the same position alongside V134 increased the risk of gastric cancer., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Frequency of the Helicobacter pylori vacA gene polymorphism and its association with gastric cancer (GC) was assessed in Ardabil, a very high-risk area in Northwestern Iran. We determined the presence of the H. pylori 16S rDNA gene and the vacA s-, m-, i-, and d-region genotypes in DNA from fresh gastric biopsies. Patients with GC were classified based on both the anatomic site and the histopathologic type of tumor Of 135 patients, including 57 with non-atrophic gastritis (NAG) and 78 with GC, 103 were infected by H. pylori. The vacA i1 and d1 genotypes were significantly linked to an increased risk of GC, where both cardia (CGC) and non-cardia GC (NCGC) patients were entered into the analysis. The adjusted OR was 9.59 for i1 and 4.39 for d1. Furthermore, i1 was significantly linked to an increased risk of the intestinal-type adenocarcinoma (OR = 14.04) and d1 to the risk of the diffuse-type adenocarcinoma (OR = 7.71). The presence of the m1-type of vacA in combination with i1 or d1 further increased the risk of GC. When the analysis was restricted to NCGC, the adjusted OR for i1 and d1, was 37.52 and 7.17, respectively. No significant association was found between genotypes and the risk of GC in the cardia site of the stomach. It is proposed that the new types of H. pylori vacA, i1 and d1, might be important determinants of NCGC risk in Ardabil. The m1, not independently, but in combination might further define the risk of GC. i1and d1 might also predict the risk of the intestinal- and diffuse-type adenocarcinomas, respectively., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Background: Helicobacter pylori vacA genotypes play an important role in the pathogenesis of severe gastrointestinal disease., Materials and Methods: We identified a novel polymorphic site in the 3'-end region of H. pylori vacA gene, denoted by c1/-c2 (c1: with deletion of 15 bp), and examined associations of this and the previous four sites as well as cagA status with gastroduodenal diseases, in a total of 217 Iranian H. pylori isolates. Histopathologic evaluations were performed and patients with gastric cancer (GC) were further classified based on the anatomic site of tumor, including cardia and noncardia GC, and the histopathologic type of tumor, including intestinal- and diffuse-type GC., Results: The vacA m1, i1, d1, c1, and cagA genotypes were significantly associated with an increased risk of GC, the odds ratio (95% confidence interval) was 4.29 (2.03-9.08), 6.11 (2.63-14.19), 3.18 (1.49-6.76), 15.13 (5.86-39.01), and 2.59 (1.09-6.12), respectively. The vacA c1 genotype had an increased age- and sex-adjusted risk for GC by the multiple logistic regression analysis; the OR was 38.32 (95% CI, 6.60-222.29). This association was independent of and larger than the associations of the m-, i-, and d-type of vacA or cagA status with GC. No significant correlation was found between s1, whether independently or in combination, and the risk of GC or peptic ulcer disease (PUD). The vacA i1 and cagA genotypes were linked to an increased risk of PUD; the OR (95% CI) was 2.80 (1.45-5.40) and 2.62 (1.23-5.61), respectively. The presence of both the vacA i1 and cagA genotypes further increased the risk of PUD; the OR was 5.20 (95% CI, 1.92-14.03)., Conclusion: The H. pylori vacA c1 genotype might therefore be one of the strongest risk predictors of GC in male patients aged ≥55 in Iran., (© 2015 John Wiley & Sons Ltd.)