Detection of Helicobacter pylori CagA EPIYA in gastric biopsy specimens and its relation to gastric diseases

Abstract CagA of Helicobacter pylori undergoes tyrosine phosphorylation in a region containing differing numbers of repeat sequences (EPIYAs), which can result in a modulation of the inflammatory response. This study investigated whether the presence of CagA EPIYA variations in strains of H . pylori that are positive for this region contributes to differing degrees of disease severity in the gastric mucosa. In this study, 157 H . pylori –positive patients were included, and of those, 40.8% (64/157) were infected with cagA -positive strains, which were assayed for the presence of CagA EPIYA-ABC, EPIYA-ABCC, and EPIYA-ABCCC. Peptic ulcers were significantly more prevalent in patients infected with strains containing CagA EPIYA-ABCC/ABCCC than in those with CagA EPIYA ABC strains ( P  = 0.044). This suggests that the number of repetitions of EPIYA-C influences the development of gastroduodenal lesions, highlighting the importance and usefulness of evaluating the cagA gene sequence when making therapeutic intervention decisions in patients infected with H . pylori .