Helicobacter pylori vacA transcription is genetically-determined and stratifies the level of human gastric inflammation and atrophy

Aims Helicobacter pylori infection is the major cause of peptic ulceration and gastric cancer, and an important virulence determinant is its vacuolating cytotoxin, vacA. Previously, we have described allelic variation in vacA which determines toxin activity and disease risk. We now aimed to quan...

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Main Authors: Sinnett, Charlotte G., Letley, Darren P., Narayan, Geetha L., Patel, Sapna Rohitbhai, Hussein, Nawfal Rasheed, Zaitoun, Abed M., Robinson, Karen, Atherton, John C.
Format: Article
Published: BMJ Publishing Group Ltd 2016
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Online Access:https://eprints.nottingham.ac.uk/32869/
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author Sinnett, Charlotte G.
Letley, Darren P.
Narayan, Geetha L.
Patel, Sapna Rohitbhai
Hussein, Nawfal Rasheed
Zaitoun, Abed M.
Robinson, Karen
Atherton, John C.
author_facet Sinnett, Charlotte G.
Letley, Darren P.
Narayan, Geetha L.
Patel, Sapna Rohitbhai
Hussein, Nawfal Rasheed
Zaitoun, Abed M.
Robinson, Karen
Atherton, John C.
author_sort Sinnett, Charlotte G.
building Nottingham Research Data Repository
collection Online Access
description Aims Helicobacter pylori infection is the major cause of peptic ulceration and gastric cancer, and an important virulence determinant is its vacuolating cytotoxin, vacA. Previously, we have described allelic variation in vacA which determines toxin activity and disease risk. We now aimed to quantify vacA mRNA expression in the human stomach, define its genetic determinants and assess how well it predicted gastric pathology. Methods Gastric biopsies were donated by 39 H. pylori-infected patients attending for endoscopy at Queen’s Medical Centre, Nottingham, UK. Total RNA was extracted, and vacA mRNA quantified by reverse transcriptase quantitative polymerase chain reaction. Separate biopsies were histologically scored for inflammation and atrophy using the updated Sydney system. H. pylori strains were isolated from further biopsies, and the nucleotide sequence upstream of vacA determined. Results vacA mRNA levels in human stomachs varied by two orders of magnitude independently of vacA allelic type. Among vacA i1-type (toxic) strains, increased vacA expression was strongly associated with higher grade gastric inflammation (p<0.02), neutrophil infiltration (p<0.005), and the presence of atrophy (p<0.01). A polymorphism at nucleotide +28 near the base of a potential stem- loop structure within the 5’ untranslated region was significantly associated with vacA transcript level and inflammation. Conclusions Increased gastric vacA expression during H. pylori infection is associated with inflammation and premalignant pathology. The +28 nucleotide within the vacA 5’ stem-loop stratifies disease risk amongst toxic vacA i1-type strains.
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spelling nottingham-328692020-05-04T17:47:31Z https://eprints.nottingham.ac.uk/32869/ Helicobacter pylori vacA transcription is genetically-determined and stratifies the level of human gastric inflammation and atrophy Sinnett, Charlotte G. Letley, Darren P. Narayan, Geetha L. Patel, Sapna Rohitbhai Hussein, Nawfal Rasheed Zaitoun, Abed M. Robinson, Karen Atherton, John C. Aims Helicobacter pylori infection is the major cause of peptic ulceration and gastric cancer, and an important virulence determinant is its vacuolating cytotoxin, vacA. Previously, we have described allelic variation in vacA which determines toxin activity and disease risk. We now aimed to quantify vacA mRNA expression in the human stomach, define its genetic determinants and assess how well it predicted gastric pathology. Methods Gastric biopsies were donated by 39 H. pylori-infected patients attending for endoscopy at Queen’s Medical Centre, Nottingham, UK. Total RNA was extracted, and vacA mRNA quantified by reverse transcriptase quantitative polymerase chain reaction. Separate biopsies were histologically scored for inflammation and atrophy using the updated Sydney system. H. pylori strains were isolated from further biopsies, and the nucleotide sequence upstream of vacA determined. Results vacA mRNA levels in human stomachs varied by two orders of magnitude independently of vacA allelic type. Among vacA i1-type (toxic) strains, increased vacA expression was strongly associated with higher grade gastric inflammation (p<0.02), neutrophil infiltration (p<0.005), and the presence of atrophy (p<0.01). A polymorphism at nucleotide +28 near the base of a potential stem- loop structure within the 5’ untranslated region was significantly associated with vacA transcript level and inflammation. Conclusions Increased gastric vacA expression during H. pylori infection is associated with inflammation and premalignant pathology. The +28 nucleotide within the vacA 5’ stem-loop stratifies disease risk amongst toxic vacA i1-type strains. BMJ Publishing Group Ltd 2016-04-07 Article PeerReviewed Sinnett, Charlotte G., Letley, Darren P., Narayan, Geetha L., Patel, Sapna Rohitbhai, Hussein, Nawfal Rasheed, Zaitoun, Abed M., Robinson, Karen and Atherton, John C. (2016) Helicobacter pylori vacA transcription is genetically-determined and stratifies the level of human gastric inflammation and atrophy. Journal of Clinical Pathology . ISSN 1472-4146 (In Press) Bacterial toxin; pathogenesis; Helicobacter pylori; vacuolating cytotoxin; VacA
spellingShingle Bacterial toxin; pathogenesis; Helicobacter pylori; vacuolating cytotoxin; VacA
Sinnett, Charlotte G.
Letley, Darren P.
Narayan, Geetha L.
Patel, Sapna Rohitbhai
Hussein, Nawfal Rasheed
Zaitoun, Abed M.
Robinson, Karen
Atherton, John C.
Helicobacter pylori vacA transcription is genetically-determined and stratifies the level of human gastric inflammation and atrophy
title Helicobacter pylori vacA transcription is genetically-determined and stratifies the level of human gastric inflammation and atrophy
title_full Helicobacter pylori vacA transcription is genetically-determined and stratifies the level of human gastric inflammation and atrophy
title_fullStr Helicobacter pylori vacA transcription is genetically-determined and stratifies the level of human gastric inflammation and atrophy
title_full_unstemmed Helicobacter pylori vacA transcription is genetically-determined and stratifies the level of human gastric inflammation and atrophy
title_short Helicobacter pylori vacA transcription is genetically-determined and stratifies the level of human gastric inflammation and atrophy
title_sort helicobacter pylori vaca transcription is genetically-determined and stratifies the level of human gastric inflammation and atrophy
topic Bacterial toxin; pathogenesis; Helicobacter pylori; vacuolating cytotoxin; VacA
url https://eprints.nottingham.ac.uk/32869/