World Journal of Microbiology and Biotechnology

, Volume 30, Issue 9, pp 2481–2490 | Cite as

Clinical relevance of cagL gene and virulence genotypes with disease outcomes in a Helicobacter pylori infected population from Iran

  • Abbas Yadegar
  • Ashraf Mohabati Mobarez
  • Masoud Alebouyeh
  • Tabassom Mirzaei
  • Terry Kwok
  • Mohammad Reza Zali
Original Paper


Helicobacter pylori infection is common in Iran as in other developing countries. Certain genotypes of H. pylori have been associated with increased occurrence of chronic gastritis, peptic ulcers, and gastric adenocarcinoma. The aim of this study was to investigate the clinical relevance of cagL gene and other virulence genotypes of H. pylori isolates with clinical outcomes in Iranian patients. Totally, 126 symptomatic patients who underwent gastroduodenal endoscopy were enrolled in the study. Sixty-one H. pylori strains were isolated from the patients studied. The presence of the cagL, cagA, vacA, iceA, babA2 and sabA genes in the corresponding H. pylori isolates were determined by polymerase chain reaction and the results were compared with clinical outcomes and histopathology. The cagL, cagA, vacA s1, vacA s2, vacA m1, vacA m2, iceA1, iceA2, babA 2 , and sabA genotypes were detected in 96.7, 85.2, 75.4, 24.6, 29.5, 70.5, 42.6, 23, 96.7, and 83.6 % of the isolates, respectively. The three genotypic combinations, cagL/cagA/vacAs1m1/iceA1/babA2/sabA, cagL/cagA/vacAs1m2/iceA1/babA2/sabA, and cagL/cagA/vacAs1m2/iceA2/babA2/sabA were determined as the most prevalent combined genotypes. There was a significant correlation between the presence of cagL gene and cagA positivity (P = 0.02). No significant correlation was found between the various genotypes and clinical outcomes (P > 0.05). The present study showed a very high prevalence of cagL genotype among the H. pylori isolates from Iranian patients. Our results demonstrated that neither single genotype nor combination genotypes of virulence-associated genes was significantly helpful markers for predicting the severity of gastroduodenal disease associated with H. pylori infection in Iranian patients.


Helicobacter pylori cagL Virulence genotypes Clinical outcomes Iranian patients 



The authors are thankful to Dr. Mahsa Molaei from the Gastroenterology and Liver Diseases Research Center, Shahid Beheshti University of Medical Sciences. This study was funded by a research grant from the Gastroenterology and Liver Diseases Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. The project was also partially supported by a PhD grant from the Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

Conflict of interest

The authors have no conflict of interest to declare.


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Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  • Abbas Yadegar
    • 1
  • Ashraf Mohabati Mobarez
    • 1
  • Masoud Alebouyeh
    • 2
    • 3
  • Tabassom Mirzaei
    • 2
    • 3
  • Terry Kwok
    • 4
    • 5
  • Mohammad Reza Zali
    • 2
    • 3
  1. 1.Department of Bacteriology, Faculty of Medical SciencesTarbiat Modares UniversityTehranIran
  2. 2.Gastroenterology and Liver Diseases Research CenterShahid Beheshti University of Medical SciencesTehranIran
  3. 3.Basic and Molecular Epidemiology of Gastrointestinal Disorders Research CenterShahid Beheshti University of Medical SciencesTehranIran
  4. 4.Department of Biochemistry and Molecular BiologyMonash UniversityClaytonAustralia
  5. 5.Department of MicrobiologyMonash UniversityClaytonAustralia

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