Human leukocyte antigen class II genes and Helicobacter pylori infection: does genotype overwhelm environmental exposure?

Risk factors for gastric precancerous and cancers lesions in Latin American counties with difference gastric cancer risk

OBJECTIVE

To evaluate the risk factors associated with pre-neoplastic lesions and gastric cancer in countries with different cancer risk in Latin America.

METHODS

1222 questionnaires of risk factors related to pre-neoplastic lesions and gastric cancer were obtained from patients from Mexico (N = 559), Colombia (N = 461) and Paraguay (N = 202), who were treated at the gastroenterology or oncology service of participant hospitals. In addition, biopsies specimens to establish histological diagnosis and blood to detect IgG antibodies against Helicobacter-pylori (H. pylori) whole-cell antigens and CagA protein using an ELISA were collected. These consisted of 205 gastric cancer, 379 pre-neoplastic (intestinal metaplasia (IM) / atrophic gastritis) and 638 control (normal /non-atrophic gastritis) cases. The odds ratio (OR) and 95% confidence intervals (CI) associated with potential risk factors were estimated by polynomial logistic regression model.

RESULTS

Seropositivity to H. pylori was associated with risk of pre-neoplastic lesions, with OR = 1.9 (CI 95% 1.2-2.9; p = 0.006). Grain / cereal intake (OR = 1.6, 95% CI 1.0-2.5 ; p = 0.049) and egg intake (OR = 1.7 95% CI 1.1-2.6 ; p = 0.021) were related to gastric cancer. Among, people who did not developed gastric cancer, smoking more than five cigarette per day had the highest risk of being infected by H. pylori (OR = 1.9; CI 95% 1.1-3.3 ; p = 0.028).

CONCLUSION

The present study in Latin American countries confirmed that similar environmental factors such as smoking and grain/cereal consumption were associated with H. pylori infection and its induced gastric lesions as reported in other regions where dominant H. pylori strains differ.

Association between HLA-Ⅱgene polymorphism and Helicobacter pylori infection in Asian and European population: A meta-analysis

BACKGROUND

It is generally considered that HLA-Ⅱ genes contribute to the Helicobacter pylori (Hp) infection and disease development process.

AIMS

To perform a meta-analysis to explore the relationship between HLA-Ⅱgene polymorphism and host susceptibility to Hp infection.

METHODS

Relevant cohort studies, case-control studies and cross-sectional studies were identified by searching Cochrane Library, PubMed, EMBASE, Web of Science and CBM up to July 2014. The data were extracted and methodological quality of the studies were evaluated. RevMan5.0 software was used to perform statistical analysis.

RESULTS

In Asian population, HLA-DQB1*0303 acted as the protective gene in Hp infection (statistically significant pooled OR = 0.54) and the susceptible genes in Hp infection involved HLA-DQB1*0401, HLA-DQA1*0103 and HLA-DQA1*0301 (statistically significant pooled OR and 95%CI were 3.34(1.93,5.77), 1.64(1.16,2.33) and 2.03(1.20,3.44) respectively). No statistically significant difference between DQB1*0303, HLA-DQA1*0103 and DQA1*0301 and Hp infection in European population (P>0.05). And no statistically significant difference (P>0.05) in the overall effect of the association between the rest of HLA-Ⅱalleles and Hp infection.

CONCLUSIONS

In Asian population, the protective gene HLA-DQB1*0303 and the susceptible genes HLA-DQB1*0401, HLA-DQA1*0103 and HLA-DQA1*0301 in Hp infection were established by meta-analysis. And there was no HLA-Ⅱallele was found to associate with Hp infection among European population.