Association Between CagA EPIYA Motifs with Diverse Gastroduodenal Outcomes in Egyptian Patients Infected with Helicobacter pylori

Background and Aim: Helicobacter pylori CagA gene is a major virulence factor that undergoes tyrosine phosphorylation in a region holding differing numbers of repeat sequences (EPIYAs) resulting in modulation of the inflammatory response. The aim of this cross-sectional study is to determine the correlation between CagA EPIYA motifs with diverse gastroduodenal outcomes. Methods: Gastric biopsies were collected from 54 Egyptian patients (11 patients with PUD and 43 chronic non atrophic gastritis). Molecular detection of H. pylori, CagA gene with determination of the EPIYA motifs in CagA positive cases were done. Results: Out of the 54 H. pylori positive cases, CagA gene was detected in 31 patients. EPIYA-ABC was the most presented pattern in 22 cases (71 %) and the least common pattern was EPIYA-ABCCC, which was positive only in one case (3.2%). Both EPIYA-AB and EPIYA-ABCC were presented in 4 cases for each (12.9% for each). Conclusion: There was a significant statistical correlation between the presence of CagA gene and both PUD and GU. Furthermore, the structure of the variable region of the CagA gene in Egyptian strains was Western type with a variable number of EPIYA‑C.