Molecular Typing of CAG A and VAC A Gene of Helicobacter Pylori Strains Causing Gastro Duodenal Diseases in Patients from North East India

Abstract

Helicobacter pylori is a gram negative micro-aerophilic gastric pathogen which infects 25% population of the developed countries and 70-90% population of the developing countries. It has been seen that various virulent genes of H pylori which are associated with the pathogenesis of the H pylori infection are cytotoxin associated antigen (cagA), vacuolating cytotoxin gene A (vacA), iceA gene which is induced upon contact with epithelium, blood group antigen binding adhesion encoded by a polymorphic gene babA and Tumor necrosis factor (TNF and#945;) inducing protein (tip and#945;). CagA is a polymorphic gene with different numbers of repeat sequences of Glu-Pro-Ile-Tyr-Ala (EPIYA motifs) located in the 3and#712; region of different strains of H pylori . newlineIn this study from North-East India we found that the GE was most prevalent among all the disease category but the prevalence of H pylori associated gastric disease was found more in Esophagitis patients and most of the virulent genes are present in Normal patients, Miscellaneous patients, Gastric Ulcer patients. We have seen in our study that the resistance for clarithromycin, amoxicillin and furazoledone was less in North-East Indian strains, but high resistance was observed for levofloxacin indicating that first line therapy should consist of the antibiotics most sensitive to H pylori like amoxicilline, furazolidone, clarithromycin effective for eradication of H pylori in this region. To the best of our knowledge our study is the first report that showed antibiotic susceptibility pattern for clarithromycin and levofloxacin by mutation analysis. By partial sequencing of 23s rRNA and gyrase A gene we found that North East Indian strains are geographically distinct. newline newline