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Infection and Immunity, February 2004, p. 880-888, Vol. 72, No. 2
0019-9567/04/$08.00+0     DOI: 10.1128/IAI.72.2.880-888.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Evaluation of the Association of Nine Helicobacter pylori Virulence Factors with Strains Involved in Low-Grade Gastric Mucosa-Associated Lymphoid Tissue Lymphoma

Philippe Lehours,1 Armelle Ménard,1 Sandrine Dupouy,1 Bernard Bergey,1 Fréderique Richy,1 Frank Zerbib,1 Agnès Ruskoné-Fourmestraux,2 Jean Charles Delchier,3 and Francis Mégraud1*

Laboratoire de Bactériologie, Université Victor Segalen Bordeaux 2, Bordeaux,1 Service de Gastroentérologie, Hôpital Hôtel-Dieu, Paris,2 Service d'Hépatologie-Gastroentérologie, Hôpital Henri Mondor, Créteil, France3

Received 27 May 2003/ Returned for modification 2 September 2003/ Accepted 6 November 2003

Helicobacter pylori has been associated with the development of two malignant diseases: gastric adenocarcinoma and gastric mucosa-associated lymphoid tissue (MALT) lymphoma. Although the cag pathogenicity island, especially the cagA gene, has been linked with adenocarcinoma, few data concerning H. pylori pathogenic factors involved in low-grade gastric MALT lymphoma are available. The goal of this study was to analyze the prevalence of and correlation between genes coding for seven H. pylori virulence factors (cagA, cagE, vacA, iceA, babA, hopQ, and oipA) and two novel adhesins (sabA and hopZ) by comparing a collection of 43 H. pylori strains isolated from patients with low-grade gastric MALT lymphoma to 39 strains isolated from age-matched patients with gastritis only. Our results show that taken individually, none of the nine genes tested can be considered associated with MALT strains and allow us to conclude that MALT pathogenesis is not linked with more proinflammatory H. pylori strains. We demonstrated that in patients infected with strains harboring the iceA1 allele, sabA functional status, and hopZ "off" status, the odds of developing a MALT lymphoma were 10 times higher. However, the low prevalence of such strains (10 of 43 MALT strains) renders this triple association a low-sensitivity marker for MALT strains. Our data confirmed that H. pylori virulence factors are correlated with one another. If the involvement of H. pylori in MALT lymphoma is well established, the pathomechanism by which gastric lymphoma occurs remains to be identified.

* Corresponding author. Mailing address: Laboratoire de Bactériologie, Université Victor Segalen Bordeaux 2, 146 Rue Léo Saignat, 33076 Bordeaux Cedex, France. Phone: 33 5 56 79 59 10. Fax: 33 5 56 79 60 18. E-mail: francis.megraud{at}chu-bordeaux.fr.

Editor: V. J. DiRita

Infection and Immunity, February 2004, p. 880-888, Vol. 72, No. 2
0019-9567/04/$08.00+0     DOI: 10.1128/IAI.72.2.880-888.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



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