Prevalence of EPIYA motifs in Helicobacter pylori strains isolated from patients with dyspeptic disorders in northern Iran

Background and aim: cytotoxin-associated gene a (caga)-positivestrains of helicobacter pylori are associated with gastroduodenal diseases.evidences have suggested that the type of h. pylori caga epiya motifs may beassociated with recurrent dyspepsia (i.e. gastritis, peptic ulcer, or gastric cancer).we investigated the prevalence of different epiya motifs (a, b, c, or d) inh. pylori strains isolated from patients with recurrent dyspepsia who underwentupper gastrointestinal (gi) endoscopy.we investigated the prevalence of different epiya motifs (a, b, c, or d) in h.pylori strains isolated from patients with recurrent dyspepsia who underwentupper gastrointestinal (gi) endoscopy.methods: h. pylori strains were isolated from biopsy specimens of 220patients with recurrent dyspepsia. the presence of glmm gene, as a housekeepinggene, caga gene, and pattern of caga epiya motifs were determined usingpolymerase chain reaction (pcr) method. the association between the type ofmotifs and disease state was determined by the chi-square test, fisher’s exact test,and logistic regression.results: caga-positive h. pylori strains were identified in 125 (57%) ofpatients, including 36 (28.6%) gastritis, 31 (24.6%) duodenal ulcer, and 58(46.4%) gastric cancer. the frequency of pattern of caga epiya motifs weredetected as 39 (31.2%) ab motifs, 54 (43.2%) abc motifs, 32 (25.6%) abccmotifs,and no d motifs. the risk of gastric cancer occurrence was estimated to be2.57 times higher in patients infected by strains with abcc motif when comparedwith gastritis and duodenal ulcer patients (p=0.03). moreover, patients withc-containing motifs were 2.27 times more likely to be afflicted with gastric cancerthan with duodenal ulcer. ab motif was more associated with gastritis andduodenal ulcer than abc and abcc motifs.conclusion: the results suggested that caga-epiya abcc might beassociated with gastric cancer, while epiya-ab might be associated withduodenal ulcer.