Genotypes of Helicobacter pylori in patients with peptic ulcer bleeding

AIM:Helicobacter pyloricauses chronic gastritis,peptic ulcer,gastric cancer and MALT-lymphoma.Different genotypes ofHelicobacter pyloriare confirmed from diverse geographicareas.Its association with bleeding peptic ulcer remainscontroversial.The aim of this study was to investigate theHelicobacter pylori vacA alleles,cagA and iceA in patientswith bleeding peptic ulcer.METHODS:We enrolled patients with bleeding,non-bleeding peptic ulcers and chronic gastritis.Biopsy specimenswere obtained from the antrum of the stomach for rapidurease test,bacterial culture and PCR assay.DNA extractionand polyrnerase chain reaction were used to detect thepresence or absence of cagA and to assess the polymorphismof vacA and iceA.RESULTS:A total of 168 patients(60.4%)(25 patientswith chronic gastritis,26 patients with bleeding gastric ulcer,51 patients with non-bleeding gastric ulcer,26 patients withbleeding duodenal ulcer,and 40 patients with non-bleedingduodenal ulcer)were found to have positive PCR resultsbetween January 2001 and December 2002.Concerninggenotypes,we found cagA(139/278,50%),vacA sla(127/278,45.7%),and iceA1(125/278,45%)predominatedin all studied patients.In patients with bleeding peptic ulcers,vacA sla and m1T were fewer than those in patients withnon-bleeding peptic ulcers(37/106 vs 69/135,P=0.017,and4/106 vs 21/135,P=0.002).CONCLUSION:In patients with peptic ulcers,Hpylori vacAsla and m1T prevent bleeding complication.