Helicobacter pylori cytotoxic genotype is associated with peptic ulcer and influences serology

Am J Gastroenterol. 1998 Feb;93(2):227-30. doi: 10.1111/j.1572-0241.1998.00227.x.


Objective: We studied 146 patients with peptic ulcer disease (n = 72), antral gastritis (n = 58), or duodenitis (n = 16) to ascertain whether the cytotoxic genotype of Helicobacter pylori (Hp) is associated with peptic ulcer disease and/or antral gastritis and whether it influences the circulating levels of total anti-Hp antibodies, anti-cagA antibodies, and pepsinogens.

Methods: A gastric juice sample was obtained from each patient. After DNA extraction, polymerase chain reaction was used to amplify the genes urease A (ureA), cagA, and vacA of Hp.

Results: A significant association was found between peptic ulcer disease and the cytotoxic genotypes, characterized by the presence of s1 and m1 alleles of vacA and by cagA. Patients with a cagA-positive genotype showed a significant increase in anti-cagA antibodies and also had significantly increased circulating levels of pepsinogen C.

Conclusions: Cytotoxic Hp strains are mainly involved in determining peptic ulcer disease, but not antral gastritis. The higher levels of circulating pepsinogen C found in patients infected with cytotoxic genotypes may reflect the higher degree of inflammation sustained by these strains.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Bacterial / analysis
  • Cytotoxins / genetics*
  • Cytotoxins / metabolism
  • DNA, Bacterial / analysis
  • Duodenitis / microbiology
  • Female
  • Gastritis / microbiology
  • Genes, Bacterial
  • Genotype
  • Helicobacter pylori / genetics*
  • Helicobacter pylori / immunology
  • Helicobacter pylori / metabolism
  • Humans
  • Male
  • Middle Aged
  • Pepsinogens / blood
  • Peptic Ulcer / microbiology*
  • Polymerase Chain Reaction
  • Urease / genetics


  • Antibodies, Bacterial
  • Cytotoxins
  • DNA, Bacterial
  • Pepsinogens
  • Urease