Helicobacter pylori infection in children and adults: a single pathogen but a different pathology |
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Authors: | Gallo Nicoletta Zambon Carlo-Federico Navaglia Filippo Basso Daniela Guariso Graziella Grazia Piva Maria Greco Eliana Mazza Saverio Fogar Paola Rugge Massimo Di Mario Francesco Plebani Mario |
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Institution: | Departments of Laboratory Medicine,;Pediatrics,;Medical and Surgical Sciences,;Pathology, University of Padova;;Department of Gastroenterology, University of Parma, Italy |
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Abstract: | Background. The aims of this retrospective study were to ascertain in large series of children and adults: the relationship of the infecting strain to gastric mucosal lesions; and the relationship of the infecting strain to its duodenal localization. Materials and Methods. We studied 307 and 604 consecutive children and adults. In gastric mucosal samples H. pylori was cultured, genotyped and histologically assessed, while inflammation, activity and intestinal metaplasia were graded. In a subset of 171 patients H. pylori ureaseA (ureA) and cagA genes were amplified (PCR) using mucosal biopsies from the duodenum. Results. H. pylori infection was diagnosed in 40 children and 308 adults. cagA was identified in 50% and 65.5% of infected children and adults. Antral activity was associated with the density of infecting bacteria (p < .001) and with cagA (p < .01). Intestinal metaplasia was correlated with cagA (p < .001). The ureA gene was found in 56 duodenal samples from 82 H. pylori positive patients. Duodenal H. pylori ureA was significantly more frequent in patients with duodenal diseases than in those without (p < .01), cagA positive strains being mainly involved in the infection of this anatomical area (p < .01). Conclusions. A severe H. pylori‐associated gastritis is more prevalent when the density of infecting bacteria is high and when cagA positive strains cause the infection. The most virulent cagA positive H. pylori colonizes not only the gastric, but also the duodenal mucosa, which can be directly damaged by the bacteria itself or by its products. |
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Keywords: | Gastric mucosal lesions infecting strains cagA ureA gene density of infecting bacteria |
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