Displaying publications 1 - 20 of 56 in total

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  1. Fulltext High-dose rabeprazole-amoxicillin dual therapy and rabeprazole triple therapy with amoxicillin and levofloxacin for 2 weeks as first and second line rescue therapies for Helicobacter pylori treatment failures
    Goh KL, Manikam J, Qua CS
    Aliment Pharmacol Ther, 2012 May;35(9):1097-102.
    PMID: 22404486 DOI: 10.1111/j.1365-2036.2012.05054.x
    BACKGROUND:
    H. pylori eradication failures are difficult to treat and rescue therapies often consist of complex treatment regimens.

    AIM:
    To determine an effective and practical rescue therapeutic strategy for H. pylori treatment failures using two consecutive regimens: first rescue therapy - rabeprazole 20 mg t.d.s. and amoxicillin 1 g t.d.s. for 2 weeks and for failures a further second rescue therapy - rabeprazole 20 mg b.d., levofloxacin 500 mg b.d., amoxicillin 1 g b.d. for a further 2 weeks.

    METHODS:
    Consecutive patients who failed the proton pump inhibitor (PPI) 1-week triple therapy were recruited for the study. H. pylori status was determined by a C(13) urea breath test.

    RESULTS:
    One hundred and forty-nine patients received the first rescue therapy. Seven were not compliant to medication/defaulted follow-up. Eradication success- first rescue therapy: per protocol (PP) analysis-107/142 (75.4%) (95% CI (68.3-82.4%) and intention to treat (ITT) analysis-107/149 (71.8%) 95% CI (64.6-79.0%). Thirty-one of 35 patients who failed the first rescue therapy received the second rescue therapy. All were compliant with medications. Eradication success- PP and ITT was 28/31 (90.3%) 95% CI (74.2-98.0%). The cumulative eradication rate using both rescue therapies: PP analysis- 135/138 (97.8%) 95% CI: (93.8-99.6%), ITT analysis- 135/149 (90.6%) 95% CI: (84.7-94.8%).

    CONCLUSIONS:
    A 2-week high dose PPI-amoxicillin dual therapy followed by a PPI-amoxicillin-levofloxacin triple therapy were highly successful in achieving eradication in H. pylori treatment failures.
    Matched MeSH terms: Helicobacter Infections/microbiology
  2. Antigenic proteins of Helicobacter pylori of potential diagnostic value
    Khalilpour A, Santhanam A, Wei LC, Saadatnia G, Velusamy N, Osman S, et al.
    Asian Pac J Cancer Prev, 2013;14(3):1635-42.
    PMID: 23679248
    Helicobacter pylori antigen was prepared from an isolate from a patient with a duodenal ulcer. Serum samples were obtained from culture-positive H. pylori infected patients with duodenal ulcers, gastric ulcers and gastritis (n=30). As controls, three kinds of sera without detectable H. pylori IgG antibodies were used: 30 from healthy individuals without history of gastric disorders, 30 from patients who were seen in the endoscopy clinic but were H. pylori culture negative and 30 from people with other diseases. OFF-GEL electrophoresis, SDS-PAGE and Western blots of individual serum samples were used to identify protein bands with good sensitivity and specificity when probed with the above sera and HRP-conjugated anti-human IgG. Four H. pylori protein bands showed good (≥ 70%) sensitivity and high specificity (98-100%) towards anti-Helicobacter IgG antibody in culture- positive patients sera and control sera, respectively. The identities of the antigenic proteins were elucidated by mass spectrometry. The relative molecular weights and the identities of the proteins, based on MALDI TOF/ TOF, were as follows: CagI (25 kDa), urease G accessory protein (25 kDa), UreB (63 kDa) and proline/pyrroline- 5-carboxylate dehydrogenase (118 KDa). These identified proteins, singly and/or in combinations, may be useful for diagnosis of H. pylori infection in patients.
    Matched MeSH terms: Helicobacter Infections/microbiology
  3. Prevalence and Pattern of Antibiotic Resistant Strains of Helicobacter Pylori Infection in ASEAN
    Vilaichone RK, Quach DT, Yamaoka Y, Sugano K, Mahachai V
    Asian Pac J Cancer Prev, 2018 May 26;19(5):1411-1413.
    PMID: 29802708
    Objective: Antibiotic resistance has significantly impact on eradication rates for H. pylori infection and remains
    important cause of treatment failure worldwide including ASEAN countries. The aim of this study was to survey
    the prevalence and antibiotic resistant pattern of H. pylori infection in ASEAN. Methods: This study was a survey among
    26 experts from 9 ASEAN countries including Thailand, Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines,
    Singapore and Vietnam whom attended a meeting to develop the ASEAN consensus on H. pylori management in Bangkok
    in November 2015. A questionnaire was sent to each member of the consensus meeting. The detail of the questionnaire
    included information about prevalence of H. pylori infection, facilities to perform H. pylori culture, molecular testing
    for antibiotic resistance and antibiotic resistance rate in their countries. Results: H. pylori infection remain common
    in ASEAN ranging from 20% in Malaysia, 21-54% in Thailand and 69% in Myanmar. Most of ASEAN countries
    can perform H. pylori cultures and antibiotic susceptibility tests except Laos and Cambodia. In ASEAN countries,
    metronidazole resistant H pylori is quite common whereas amoxicillin resistance remain rare. Clarithromycin resistance
    results in a significant decrease in H. pylori eradication rate with clarithromycin-containing regimens. The prevalence of
    clarithromycin resistance varies in ASEAN countries being high in Vietnam (30%) and Cambodia (43%), moderate to high
    in Singapore (17%) and low in Malaysia (6.8%), Philippine (2%) and Myanmar (0%). In Thailand, clarithromycin
    resistance tends to higher in large cities (14%) than in rural areas (~3.7%). Conclusion: ASEAN countries should
    develop a standard protocol for regular susceptibility testing of H. pylori so that clinicians would be better able to
    choose reliably effective empiric therapies. The wide range of antibiotic resistance in ASEAN countries suggests that
    the preferred first line regimen should be depend on the local antibiotic resistance other than single recommendation.
    Matched MeSH terms: Helicobacter Infections/microbiology
  4. Fulltext Epidemiology of Helicobacter pylori among multiracial community in Northern Peninsular, Malaysia: effect of age across race and gender
    Sasidharan S, Lachumy SJ, Ravichandran M, Latha LY, Gegu SR
    Asian Pac J Trop Med, 2011 Jan;4(1):72-5.
    PMID: 21771421 DOI: 10.1016/S1995-7645(11)60037-0
    OBJECTIVE: To study the epidemiology of Helicobacter pylori (H. pylori) infection according to age group.

    METHODS: H. pylori infection data among 1 965 consecutive patients referred to the Endoscopy Unit collected at Sungai Petani Hospital for oesophagogastro-duodenoscopy (OGD). The patients were divided into 9 age groups (10-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80-89 and 90-99 years). In addition these groups were further divided into three minor group namely young adults (10-39), older adults (40-69) and geriatric groups (70-99).

    RESULTS: Overall prevalence of infection of H. pylori was analyzed and found that the prevalence increase with age (P<0.05). When the patients divided by ethnic and gender group with age, prevalence rate among young adults and older adults significantly higher (P<0.05) compared to geriatric groups across all races and gender (P<0.05). Furthermore, significantly higher number of males were infected compared to female (P<0.05) but such trend was only observed among older adult groups. In addition, there is a significant differences in H. pylori infection prevalence rates among ethnic groups (highest in Indians adults, followed Chinese and low in Malays, P<0.05).

    CONCLUSIONS: The overall prevalence of H. pylori did increase with age group across ethnicity and gender, in Northern Peninsular Malaysia.

    Matched MeSH terms: Helicobacter Infections/microbiology*
  5. Fulltext Population structure of Helicobacter pylori among ethnic groups in Malaysia: recent acquisition of the bacterium by the Malay population
    Tay CY, Mitchell H, Dong Q, Goh KL, Dawes IW, Lan R
    BMC Microbiol, 2009;9:126.
    PMID: 19538757 DOI: 10.1186/1471-2180-9-126
    Helicobacter pylori is a major gastric bacterial pathogen. This pathogen has been shown to follow the routes of human migration by their geographical origin and currently the global H. pylori population has been divided into six ancestral populations, three from Africa, two from Asia and one from Europe. Malaysia is made up of three major ethnic populations, Malay, Chinese and Indian, providing a good population for studying recent H. pylori migration and admixture.
    Matched MeSH terms: Helicobacter Infections/microbiology*
  6. Fulltext Helicobacter pylori recombinant UreG protein: cloning, expression, and assessment of its seroreactivity
    Khalilpour A, Osman S, Yunus MH, Santhanam A, Vellasamy N, Noordin R
    BMC Res Notes, 2014;7:809.
    PMID: 25406411 DOI: 10.1186/1756-0500-7-809
    Helicobacter pylori is a human pathogen and during the process of infection, antigens from the bacterium elicit strong host humoral immune responses. In our previous report, native H. pylori UreG protein showed good reactivity with sera from H. pylori patients. This study was aimed at producing the recombinant form of the protein (rUreG) and determining its seroreactivities.
    Matched MeSH terms: Helicobacter Infections/microbiology*
  7. Fulltext Helicobacter pylori Infection
    Hsu PI, Yamaoka Y, Goh KL, Manfredi M, Wu DC, Mahachai V
    Biomed Res Int, 2015;2015:278308.
    PMID: 26078943 DOI: 10.1155/2015/278308
    Matched MeSH terms: Helicobacter Infections/microbiology*
  8. Multiplex PCR for detection of Helicobacter pylori infection in gastric biopsies with lower inflammatory score
    Fadilah N, Hanafiah A, Razlan H, Wong ZQ, Mohamed Rose I, Rahman MM
    Br J Biomed Sci, 2016 Oct;73(4):180-187.
    PMID: 27922429
    BACKGROUND: No gold standard has yet been established for the diagnosis of H. pylori infection. A multiplex polymerase chain reaction (mPCR) was developed in this study for rapid, sensitive and specific detection of H. pylori from gastric biopsies.

    METHODS: H. pylori infections were determined by in-house rapid urease test (iRUT), culture, histology and multiplex PCR.

    RESULTS: A total of 140 (60.9%) from 230 patients were positive for H. pylori infection. H. pylori were detected in 9.6% (22/230), 17% (39/230), 12.6% (29/230) and 60% (138/230) of biopsy specimens by culture, iRUT, histology and mPCR, respectively. mPCR identified H. pylori infection in 100% of biopsies with positive histology and culture. All biopsies with positive iRUT yielded positive PCR except two cases. mPCR also detected H. pylori in additional 116, 101 and 109 biopsies that were negative by culture, iRUT and histology, respectively. Positive samples by mPCR showed lower average in H. pylori density, activity and inflammation scores. The Indians showed the highest prevalence of H. pylori infection compared to the Chinese and the Malays. In addition, Chinese patients with older age were significantly infected compared to other ethnicities.

    CONCLUSION: PCR was able to detect the highest numbers of positive cases although the lowest average scores were recorded in the activity, inflammatory and H. pylori density.

    Matched MeSH terms: Helicobacter Infections/microbiology
  9. Capsaicin and gastric ulcers
    Satyanarayana MN
    Crit Rev Food Sci Nutr, 2006;46(4):275-328.
    PMID: 16621751
    In recent years, infection of the stomach with the organism Helicobacter Pylori has been found to be the main cause of gastric ulcers, one of the common ailments afflicting humans. Excessive acid secretion in the stomach, reduction in gastric mucosal blood flow, constant intake of non-steroid anti-inflammatory drugs (NSAIDS), ethanol, smoking, stress etc. are also considered responsible for ulcer formation. The prevalent notion among sections of population in this country and perhaps in others is that "red pepper" popularly known as "Chilli," a common spice consumed in excessive amounts leads to "gastric ulcers" in view of its irritant and likely acid secreting nature. Persons with ulcers are advised either to limit or avoid its use. However, investigations carried out in recent years have revealed that chilli or its active principle "capsaicin" is not the cause for ulcer formation but a "benefactor." Capsaicin does not stimulate but inhibits acid secretion, stimulates alkali, mucus secretions and particularly gastric mucosal blood flow which help in prevention and healing of ulcers. Capsaicin acts by stimulating afferent neurons in the stomach and signals for protection against injury causing agents. Epidemiologic surveys in Singapore have shown that gastric ulcers are three times more common in the "Chinese" than among Malaysians and Indians who are in the habit of consuming more chillis. Ulcers are common among people who are in the habit of taking NSAIDS and are infected with the organism "Helicobacter Pylori," responsible for excessive acid secretion and erosion of the mucosal layer. Eradication of the bacteria by antibiotic treatment and avoiding the NSAIDS eliminates ulcers and restores normal acid secretion.
    Matched MeSH terms: Helicobacter Infections/microbiology
  10. The cag PAI is intact and functional but HP0521 varies significantly in Helicobacter pylori isolates from Malaysia and Singapore
    Schmidt HM, Andres S, Nilsson C, Kovach Z, Kaakoush NO, Engstrand L, et al.
    Eur J Clin Microbiol Infect Dis, 2010 Apr;29(4):439-51.
    PMID: 20157752 DOI: 10.1007/s10096-010-0881-7
    Helicobacter pylori-related disease is at least partially attributable to the genotype of the infecting strain, particularly the presence of specific virulence factors. We investigated the prevalence of a novel combination of H. pylori virulence factors, including the cag pathogenicity island (PAI), and their association with severe disease in isolates from the three major ethnicities in Malaysia and Singapore, and evaluated whether the cag PAI was intact and functional in vitro. Polymerase chain reaction (PCR) was used to detect dupA, cagA, cagE, cagT, cagL and babA, and to type vacA, the EPIYA motifs, HP0521 alleles and oipA ON status in 159 H. pylori clinical isolates. Twenty-two strains were investigated for IL-8 induction and CagA translocation in vitro. The prevalence of cagA, cagE, cagL, cagT, babA, oipA ON and vacA s1 and i1 was >85%, irrespective of the disease state or ethnicity. The prevalence of dupA and the predominant HP0521 allele and EPIYA motif varied significantly with ethnicity (p < 0.05). A high prevalence of an intact cag PAI was found in all ethnic groups; however, no association was observed between any virulence factor and disease state. The novel association between the HP0521 alleles, EPIYA motifs and host ethnicity indicates that further studies to determine the function of this gene are important.
    Matched MeSH terms: Helicobacter Infections/microbiology*
  11. Fulltext Helicobacter pylori cagA gene variants in Malaysians of different ethnicity
    Mohamed R, Hanafiah A, Rose IM, Manaf MR, Abdullah SA, Sagap I, et al.
    Eur J Clin Microbiol Infect Dis, 2009 Jul;28(7):865-9.
    PMID: 19247698 DOI: 10.1007/s10096-009-0712-x
    We have defined DNA repeat variability in the 3'-terminus of the cagA gene of Helicobacter pylori strains from Malaysian patients of different ethnicities. We identified different alleles based on the EPIYA repeats. cagA types A-B-D and A-B-B-D are more similar to the sequence of Japanese strains, whereas cagA types A-B-C, A-B-C-C, A-B and A-C displayed similarity to strain 26695 sequences. A significant association was found between cagA genotypes and patients' ethnicity, with cagA type A-B-D being predominantly isolated from Chinese patients and cagA type A-B-C from Malays and Indians. Our data further corroborate the possibility that variant biological activity of CagA may affect the host specificity and/or pathogenicity of H. pylori.
    Matched MeSH terms: Helicobacter Infections/microbiology*
  12. Role of vacuolating cytotoxin A in Helicobacter pylori infection and its impact on gastric pathogenesis
    Ansari S, Yamaoka Y
    Expert Rev Anti Infect Ther, 2020 10;18(10):987-996.
    PMID: 32536287 DOI: 10.1080/14787210.2020.1782739
    Introduction Helicobacter pylori causes, via the influence of several virulence factors, persistent infection of the stomach, which leads to severe complications. Vacuolating cytotoxin A (VacA) is observed in almost all clinical strains of H. pylori; however, only some strains produce the toxigenic and pathogenic VacA, which is influenced by the gene sequence variations. VacA exerts its action by causing cell vacuolation and apoptosis. We performed a PubMed search to review the latest literatures published in English language. Areas covered Articles regarding H. pylori VacA and its genotypes, architecture, internalization, and role in gastric infection and pathogenicity are reviewed. We included the search for recently published literature until January 2020. Expert opinion H. pylori VacA plays a crucial role in severe gastric pathogenicity. In addition, VacA mediated in vivo bacterial survival leads to persistent infection and an enhanced bacterial evasion from the action of antibiotics and the innate host defense system, which leads to drug evasion. VacA as a co-stimulator for the CagA phosphorylation may exert a synergistic effect playing an important role in the CagA-mediated pathogenicity.
    Matched MeSH terms: Helicobacter Infections/microbiology
  13. cagA gene variants in Malaysian Helicobacter pylori strains isolated from patients of different ethnic groups
    Ramelah M, Aminuddin A, Alfizah H, Isa MR, Jasmi AY, Tan HJ, et al.
    FEMS Immunol. Med. Microbiol., 2005 May 1;44(2):239-42.
    PMID: 15866222
    Helicobacter pylori infection of a distinct subtype of cagA may lead to different pathological manifestation. The aim of this study is to determine the presence of cagA gene and its variants in H. pylori infection among different ethnic groups and its effect on gastroduodenal diseases. Overall detection of cagA among the 205 clinical isolates of H. pylori was 94%. Variations in size of the 3' region of cagA gene were examined among 192 Malaysian H. pylori cagA-positive strains. Results showed that three cagA variants differing in fragment length of PCR products were detected and designated as type A (621-651bp), type B (732-735bp) and type C (525 bp). Although there was no association between any of the cagA subtypes with peptic ulcer disease (p>0.05), an association between cagA subtypes with a specific ethnic group was observed. Specific-cagA subtype A strains were predominantly isolated from Chinese compared to Malays and Indians (p<0.0005), and cagA subtype B strains were predominantly isolated from Malays and Indians compared to Chinese (p<0.05). The cagA type A strains of H. pylori is commonly found in the Chinese patients who have a higher risk of peptic ulcer disease, thus indicating that it could be used as an important clinical biomarker for a more severe infection.
    Matched MeSH terms: Helicobacter Infections/microbiology
  14. Fulltext Helicobacter pylori and gut microbiota modulate energy homeostasis prior to inducing histopathological changes in mice
    Khosravi Y, Bunte RM, Chiow KH, Tan TL, Wong WY, Poh QH, et al.
    Gut Microbes, 2016;7(1):48-53.
    PMID: 26939851 DOI: 10.1080/19490976.2015.1119990
    Helicobacter pylori have been shown to influence physiological regulation of metabolic hormones involved in food intake, energy expenditure and body mass. It has been proposed that inducing H. pylori-induced gastric atrophy damages hormone-producing endocrine cells localized in gastric mucosal layers and therefore alter their concentrations. In a recent study, we provided additional proof in mice under controlled conditions that H. pylori and gut microbiota indeed affects circulating metabolic gut hormones and energy homeostasis. In this addendum, we presented data from follow-up investigations that demonstrated H. pylori and gut microbiota-associated modulation of metabolic gut hormones was independent and precedes H. pylori-induced histopathological changes in the gut of H. pylori-infected mice. Thus, H. pylori-associated argumentation of energy homeostasis is not caused by injury to endocrine cells in gastric mucosa.
    Matched MeSH terms: Helicobacter Infections/microbiology
  15. Helicobacter pylori in 2013: multiplying genomes, emerging insights
    Ahmed N, Loke MF, Kumar N, Vadivelu J
    Helicobacter, 2013 Sep;18 Suppl 1:1-4.
    PMID: 24011237 DOI: 10.1111/hel.12069
    We describe features of key additions to the existing pool of publicly accessible Helicobacter pylori genome sequences and sequences of Helicobacter pylori phages from April 2012 to March 2013. In addition, important studies involving H. pylori genomes, especially those pertaining to genomic diversity, disease outcome, H. pylori population structure and evolution are reviewed. High degree of homologous recombination contributes to increased diversity of H. pylori genomes. New methods of resolving H. pylori population structure to an ultrafine level led to the proposal of new subpopulations. As the magnitude of diversity in the H. pylori gene pool becomes more and more clear, geographic and demographic factors should be brought to analysis while identifying disease-specific biomarkers and defining new virulence mechanisms.
    Matched MeSH terms: Helicobacter Infections/microbiology*
  16. Association of Malaysian Helicobacter pylori virulence polymorphisms with severity of gastritis and patients' ethnicity
    Alfizah H, Ramelah M, Rizal AM, Anwar AS, Isa MR
    Helicobacter, 2012 Oct;17(5):340-9.
    PMID: 22967117 DOI: 10.1111/j.1523-5378.2012.00956.x
    Polymorphisms of Helicobacter pylori cagA and vacA genes do exist and may contribute to differences in H. pylori infection and gastroduodenal diseases among races in the Malaysian population. This study was conducted to characterize the polymorphisms in H. pylori cagA and vacA in Malaysian population.
    Matched MeSH terms: Helicobacter Infections/microbiology*
  17. Fulltext Epidemiology of Helicobacter pylori infection and public health implications
    Goh KL, Chan WK, Shiota S, Yamaoka Y
    Helicobacter, 2011 Sep;16 Suppl 1:1-9.
    PMID: 21896079 DOI: 10.1111/j.1523-5378.2011.00874.x
    This review summarizes studies on the epidemiology and public health implications of Helicobacter pylori published in peer-reviewed journals from April 2010 through March 2011. Prevalence rates vary widely between different geographical regions and ethnic groups. An interesting study from the USA identified the degree of African ancestry as an independent predictor of H. pylori infection. Two studies have demonstrated early childhood as the period of transmission of infection and identified an infected sibling as an important risk factor. An oral-oral route of spread has been substantiated with several studies showing the presence of H. pylori in the oral cavity. Studies have shown the presence of H. pylori in drinking water and the role of poor living conditions and sanitation in H. pylori infection, supporting an oral-fecal route of spread. Screening for H. pylori as a gastric cancer pre-screening strategy has been described in Japan, and the importance of H. pylori eradication as a gastric cancer-prevention strategy has now been further emphasized in Japanese guidelines. Two studies have shown a decrease in the burden of dyspepsia and peptic ulcer disease with H. pylori eradication.
    Matched MeSH terms: Helicobacter Infections/microbiology
  18. High Helicobacter pylori resistance to metronidazole but zero or low resistance to clarithromycin, levofloxacin, and other antibiotics in Malaysia
    Goh KL, Navaratnam P
    Helicobacter, 2011 Jun;16(3):241-5.
    PMID: 21585611 DOI: 10.1111/j.1523-5378.2011.00841.x
    OBJECTIVE: Bacterial resistance to antibiotics is the single most important determinant of treatment success. The objective of this study was to determine the prevalence of Helicobacter pylori resistance to clarithromycin, amoxicillin, metronidazole, tetracycline, levofloxacin, rifabutin, and furazolidone in our local bacterial strains.
    METHODS: Samples from consecutive ninety patients were obtained for culture and sensitivity testing. Resistance to individual antibiotics were tested using the E-test and MIC(90) read from the strips. Resistance to rifampicin and nitrofurantoin were used as a surrogate for rifabutin and furazolidine.
    RESULTS: There was a high prevalence of resistance to metronidazole 68/90 (75.5%). No male (34/45 (75.5%) versus female (35/45 (77.7%) difference in frequency of metronidazole resistance was noted (p = 1.000). There was zero resistance (0) to clarithromycin, levofloxacin, amoxicillin, and nitrofurantoin/furazolidone. Resistance to rifampicin/rifabutin was for breakpoints of 1 and 4 μg/mL of 14.4 and 2.2% respectively.
    CONCLUSIONS: Although there was high bacterial resistance to metronidazole, the absence of resistance particularly to the key antibiotics used in H. pylori eradication therapy: clarithromycin and levofloxacin is reassuring to note. Continued monitoring of antibiotic resistance should be carried out.
    Matched MeSH terms: Helicobacter Infections/microbiology*
  19. Analysis of antibiotic susceptibility patterns of Helicobacter pylori isolates from Malaysia
    Ahmad N, Zakaria WR, Mohamed R
    Helicobacter, 2011 Feb;16(1):47-51.
    PMID: 21241412 DOI: 10.1111/j.1523-5378.2010.00816.x
    The prevalence of antibiotic resistance varies in geographic areas. The information on the antibiotic susceptibility patterns of Helicobacter pylori (H. pylori) in our local setting is therefore relevant as a guide for the treatment options.
    Matched MeSH terms: Helicobacter Infections/microbiology*
  20. Distinct cagA EPIYA motifs are associated with ethnic diversity in Malaysia and Singapore
    Schmidt HM, Goh KL, Fock KM, Hilmi I, Dhamodaran S, Forman D, et al.
    Helicobacter, 2009 Aug;14(4):256-63.
    PMID: 19674129 DOI: 10.1111/j.1523-5378.2009.00684.x
    In vitro studies have shown that the biologic activity of CagA is influenced by the number and class of EPIYA motifs present in its variable region as these motifs correspond to the CagA phosphorylation sites. It has been hypothesized that strains possessing specific combinations of these motifs may be responsible for gastric cancer development. This study investigated the prevalence of cagA and the EPIYA motifs with regard to number, class, and patterns in strains from the three major ethnic groups within the Malaysian and Singaporean populations in relation to disease development.
    Matched MeSH terms: Helicobacter Infections/microbiology
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