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Infect Immun, May 1998, p. 1822-1826, Vol. 66, No. 5
0019-9567/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
cagA-Positive Helicobacter
pylori Populations in China and The Netherlands Are
Distinct
Arie
van der
Ende,1,*
Zhi-Jun
Pan,1,2,
Aldert
Bart,1
René W. M.
van der Hulst,3
Monique
Feller,1
Shu-Dong
Xiao,2
Guido N. J.
Tytgat,3 and
Jacob
Dankert1
Departments of Medical
Microbiology1 and
Gastroenterology,3 Academic Medical
Center, University of Amsterdam, Amsterdam, The Netherlands, and
Shanghai Institute of Digestive Disease, Shanghai Second
Medical University, Shanghai, People's Republic of
China2
Received 26 November 1997/Returned for modification 23 January
1998/Accepted 11 February 1998
The aim of this research was to study whether and to what extent
Chinese cagA-positive Helicobacter pylori
isolates differ from those in The Netherlands. Analysis of random
amplified polymorphic DNA (RAPD)-PCR-assessed DNA fingerprints of
chromosomal DNA of 24 cagA-positive H. pylori isolates from Dutch (n = 12) and Chinese (n = 10) patients yielded the absence of clustering.
Based on comparison of the sequence of a 243-nucleotide part of
cagA, the Dutch (group I) and Chinese (group II)
H. pylori isolates formed two separate branches with
high confidence limits in the phylogenetic tree. These two clusters
were not observed when the sequence of a 240-bp part of
glmM was used in the comparison. The number of nonsynonymous substitutions was much higher in cagA than in
glmM, indicating positive selection. The average levels of
divergence of cagA at the nucleotide and protein levels
between group I and II isolates were found to be high, 13.3 and 17.9%,
respectively. Possibly, the pathogenicity island (PAI) that has been
integrated into the chromosome of the ancestor of H. pylori now circulating in China contained a different
cagA than the PAI that has been integrated into the
chromosome of the ancestor of H. pylori now circulating in The Netherlands. We conclude that in China and The
Netherlands, two distinct cagA-positive H. pylori populations are circulating.
*
Corresponding author. Mailing address: Academic Medical
Center, Department of Medical Microbiology, University of Amsterdam, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands. Phone:
31-20-5664862. Fax: 31-20-6979271. E-mail:
a.vanderende{at}amc.uva.nl.

Present address: Department of Molecular Biology, School of
Medicine, Washington University, St. Louis, MO 63110.
Infect Immun, May 1998, p. 1822-1826, Vol. 66, No. 5
0019-9567/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
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