The role of caga status on histological virulence, clinical presentation and eradication treatment outcomes in helicobacter pylori positive patients with functional dyspepsia Heli̇cobacter pylori̇ pozi̇ti̇f fonksi̇yonel di̇spepsi̇li̇ hastalarda cag a durumunun hi̇stoloji̇k vi̇rülans, kli̇ni̇k ve eradi̇kasyon tedavi̇si̇üzeṙndeki̇ rolü
Nobel Medicus, cilt.8, sa.1, ss.52-60, 2012 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 8 Sayı: 1
- Basım Tarihi: 2012
- Dergi Adı: Nobel Medicus
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.52-60
- Anahtar Kelimeler: CagA, Eradication treatment, Functional dyspepsia, H.pylori
- Sağlık Bilimleri Üniversitesi Adresli: Hayır
Özet
Objective: To investigate the role of cagA status in eradication treatment outcomes and clinical presentation in Hp positive patients with functional dyspepsia (FD). Material and Method: In this double-blind, placebocontrolled trial, Hp infected patients with FD (unaware of the Cytotoxin Associated Gene A status assigned to receive seven days twice daily a lansoprazole-based triple therapy (49 patients) or lansoprazole alone (48 patients), randomly. Two months after the completion of treatment, Hp status was reassessed with the Carbon-14 Urea Breath Test ( 14C-UBT) and symptoms were reassessed with a five-point Likert scale. Results: The rate of treatment success was significantly higher among patients who became Hp-negative (34 of 41), as compared with among those who were still Hp-positive (24 of 56) at two months (82.9% vs. 42.9%; p<0.001), regardless of treatment groups. Cytotoxin Associated Gene A (CagA) gene positivity and cagA seropositivity were associated with marked chronic (p=0.021) and active (p=0.009) inflammation, respectively. CagA-PCR result (p=0.271) was positive 75.6% (31 of 41) of the patients who had Hp eradicated and 64.3% (36 of 56) of the patients with persistant infection. The rate of the cases positive for cagA-PCR was not significant between the patients who were considered as successfully treated (42 of 58) and those who were not (25 of 39) at two months (72.4% vs 64.1%; p=0.502). Conclusion: Curing the infection in Hp positive patients with FD leads to relief of symptoms in short term follow-up. Although genetic presence and serologic detection of cagA is associated with the intensity of gastric inflammation, this virulence is not associated with clinical presentation and eradication treatment outcomes.