Clinical significance of infection with cag A and vac A positive helicobacter pylori strains

• Main Authors: Sokić-Milutinović Aleksandra, Todorović Vera N., Milosavljević Tomica
• Format: Article
• Language: English
• Published: Serbian Medical Society 2004-01-01
• Series: Srpski Arhiv za Celokupno Lekarstvo
• Subjects: Helicobacter pylori; cytotoxin associated protein (cag A); vacuolization cytotoxin (vac A)
• Online Access: http://www.doiserbia.nb.rs/img/doi/0370-8179/2004/0370-81790412458S.pdf

Clinical relevance of infection with different Helicobacter pylori strains was reviewed in this paper. Helicobacter pylori (H. pylori) infection plays a role in pathogenesis of chronic gastritis, peptic ulcer disease, gastric adenocarcinoma and MALT lymphoma. Extragastric manifestations of H. pylori infection most probably include acne rosacea and chronic urticaria, while the importance of H. pylori infection for pathogenesis of growth retardation in children, iron deficiency anemia, coronary heart disease, stroke and idiopathic thrombocytopenic purpura remains vague. The expression of two H. pylori proteins, cytotoxin associated protein (cag A) and vacuolization cytotoxin (vac A) is considered to be related with pathogenicity of the bacterium. It is clear that presence of cag A+ strains is important for development of peptic ulcer; nevertheless, it is also protective against esophageal reflux disease. On the other hand, cag A+ strains are common in gastric adenocarcinoma and MALT lymphoma patients, but it seems that certain subtypes of vac A cytotoxin are more important risk factors. Infection with cag A+ strains is more common in patients with acne rosacea, stroke and coronary heart disease.