Low-grade duodenal eosinophilia is associated with cagA in Helicobacter pylori-related dyspepsia

FERNANDO JAVIER BARREYRO; NICOLAS SANCHEZ; MARIA VIRGINIA CARONIA; KARINA ELIZONDO; GRACIELA JORDÁ; ADOLFO SCHNEIDER; PEDRO DARÍO ZAPATA

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY

WILEY-BLACKWELL PUBLISHING, INC

Lugar: Londres; Año: 2022 p. 1 - 9

0815-9319

Background and Aim: Functional dyspepsia (FD) is a multifactorial disorder.Helicobacter pylori (H. pylori)-related dyspepsia (HpD) may be considered a separate entity.Duodenal eosinophilia is a potential pathogenic mechanism in FD. However, the impactof duodenal eosinophilia and H. pylori virulence genes in HpD was not explored.We aim to evaluate the association of H. pylori virulence genes and low-grade duodenaleosinophilia in HpD.Methods: A multi-center cross-sectional study was conducted. A total of 301 patients whomeet Rome-III criteria were selected before upper endoscopy, and 95 patients were includedafter normal endoscopy and positive H. pylori in gastric biopsies were assessed.Clinical parameters, H. pylori virulence genes (cagA, oipA, and vacA) and duodenal histologywere evaluated.Results: Sixty-nine (72%) patients had epigastric pain syndrome (EPS), 17 (18%)post-prandial distress syndrome (PDS) and 9 (10%) EPS/PDS overlap. FD syndromes werenot associated with cagA or oipA strains. A significantly trend of vacA s1/m1 (78%) ands1/m2 (80%) positive strains in EPS was observed. Histological duodenal grading ofchronic inflammation, low-grade duodenal eosinophilia and intra-epithelial lymphocytesshowed no difference in oipA and vacA strains. Low-grade duodenal eosinophilia was significantin cagA positive strain, and the OR for low-grade duodenal eosinophilia with H.pylori cagA positive strain was 4.2 (95% CI, 1.78–9.93). Adjusting for age, gender,smoking, diabetes, alcohol, PPI, and NSAID, the OR was 5.44 (1.989–14.902).Conclusion: Our findings suggest that low-grade duodenal eosinophilia is significantly associatedwith cagA strain in HpD.