Association between Helicobacter pylori Virulence Factors and Gastroduodenal Diseases in Okinawa, Japan

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  • Osamu Matsunari
    Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu-City, Oita, Japan
  • Seiji Shiota
    Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu-City, Oita, Japan
  • Rumiko Suzuki
    Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu-City, Oita, Japan
  • Masahide Watada
    Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu-City, Oita, Japan
  • Nagisa Kinjo
    Department of Endoscopy, University Hospital, University of the Ryukyus, Nishihara, Okinawa, Japan
  • Kazunari Murakami
    Department of Gastroenterology, Oita University Faculty of Medicine, Yufu-City, Oita, Japan
  • Toshio Fujioka
    Department of Gastroenterology, Oita University Faculty of Medicine, Yufu-City, Oita, Japan
  • Fukunori Kinjo
    Department of Endoscopy, University Hospital, University of the Ryukyus, Nishihara, Okinawa, Japan
  • Yoshio Yamaoka
    Department of Environmental and Preventive Medicine, Oita University Faculty of Medicine, Yufu-City, Oita, Japan

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<jats:title>ABSTRACT</jats:title> <jats:p> The incidence of gastric cancer in Okinawa is lowest in Japan. Some previous reports using small number of strains suggested that the high prevalence of <jats:named-content content-type="genus-species">Helicobacter pylori</jats:named-content> with Western-type <jats:italic>cagA</jats:italic> in Okinawa compared to other areas in Japan might contribute to the low incidence of gastric cancer. It has still not been confirmed why the prevalence of Western-type <jats:italic>cagA</jats:italic> strains is high in Okinawa. We examined the association between the virulence factors of <jats:named-content content-type="genus-species">H. pylori</jats:named-content> and gastroduodenal diseases in Okinawa. The genotypes of <jats:italic>cagA</jats:italic> and <jats:italic>vacA</jats:italic> of 337 <jats:named-content content-type="genus-species">H. pylori</jats:named-content> strains were determined by PCR and gene sequencing. The genealogy of these Western-type <jats:italic>cagA</jats:italic> strains in Okinawa was analyzed by multilocus sequence typing (MLST). Overall, 86.4% of the strains possessed <jats:italic>cagA</jats:italic> : 70.3% were East-Asian type and 16.0% were Western type. After adjustment by age and sex, the presence of East-Asian-type <jats:italic>cagA</jats:italic> / <jats:italic>vacA</jats:italic> s1m1 genotypes was significantly associated with gastric cancer compared to gastritis (odds ratio = 6.68, 95% confidence interval = 1.73 to 25.8). The structure of Western-type CagA in Okinawa was different from that of typical Western-type CagA found in Western countries. Intriguingly, MLST analysis revealed that the majority of Western-type <jats:italic>cagA</jats:italic> strains formed individual clusters but not hpEurope. Overall, low prevalence of gastric cancer in Okinawa may result from the high prevalence of non-East-Asian-type <jats:italic>cagA</jats:italic> strains. The origin of Western-type <jats:italic>cagA</jats:italic> strains in Okinawa may be different from those of Western countries. </jats:p>

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