Evaluation of the clinical relevance of the iceA1 gene in patients with Helicobacter pylori infection in Japan

A novel Helicobacter pylori gene, iceA, has two allelic variants, and the iceAI strain is associated with peptic ulcer disease. The aims of this study were to evaluate whether the possession of iceA1 gene is associated with gastric cancer or the severity of gastritis. Methods: Ninety-seven subjects (46 patients with early gastric cancer and 51 control subjects) infected with H. pylori were studied. DNA was extracted from isolated H. pylori strains, and the presence of the iceA1 gene was examined by polymerase chain reaction. The features of gastritis were graded in accordance with the updated Sydney System, using gastric biopsy specimens. Results: iceA1 was found in 61% of patients with gastric cancer and 53% of control subjects (NS). The grade of gastritis in iceA1-positive and -negative gastric mucosa was compared. Higher polymorphonuclear cell infiltration was observed in iceA1-positive subjects (P < 0.05). However, no significant difference was observed in the grades of mononuclear cell infiltration, glandular atrophy, and H. pylori density. Conclusions: Our results suggest that the iceA1 gene is not associated with the development of gastric cancer in Japan, whereas the iceA1-positive strain may induce more enhanced active gastric inflammation in cagA-positive and vacA sl/ml strains.