{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:44:31Z","timestamp":1790297071831,"version":"4.1.0"},"reference-count":30,"publisher":"American Society for Microbiology","issue":"4","license":[{"start":{"date-parts":[[1998,4,1]],"date-time":"1998-04-01T00:00:00Z","timestamp":891388800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[1998,4]]},"abstract":"ABSTRACT<\/jats:title>\n \n The vacuolating cytotoxin and the cytotoxin-associated protein, encoded by\n vacA<\/jats:italic>\n and\n cagA<\/jats:italic>\n , respectively, are important virulence determinants of\n Helicobacter pylori<\/jats:italic>\n . Sixty-five\n H. pylori<\/jats:italic>\n strains were isolated from dyspeptic patients (19 with peptic ulcer disease, 43 with chronic gastritis, and 3 with gastric cancer) and studied for differences in the\n vacA<\/jats:italic>\n and\n cagA<\/jats:italic>\n genes and their relationship to VacA and CagA expression, cytotoxin activity, and the clinical outcome of infection. By PCR, fifty-four (83.1%) of 65 strains had the\n vacA<\/jats:italic>\n signal sequence genotype s1 and only 10 (15.4%) had the type s2. After primer modification, the\n vacA<\/jats:italic>\n middle-region types m1 and m2 were detected in 24 (36.9%) and 41 (63.1%) strains, respectively. The combinations s1-m2 (31 [47.7%]) and s1-m1 (23 [35.4%]) occurred more frequently than s2-m2 (10 [15.4%]) (\n P<\/jats:italic>\n = 0.01). No strain with the combination s2-m1 was found. All 19 patients with peptic ulcers harbored type s1 strains, in contrast to 32 (74.4%) of 43 patients with gastritis (\n P<\/jats:italic>\n = 0.02). The\n vacA<\/jats:italic>\n genotype s1 was associated with the presence of\n cagA<\/jats:italic>\n (\n P<\/jats:italic>\n < 0.0001), VacA expression (\n P<\/jats:italic>\n < 0.0001), and cytotoxin activity (\n P<\/jats:italic>\n = 0.003). The\n cagA<\/jats:italic>\n gene was detectable in 48 (73.8%) of 65 isolates and present in 16 (84.2%) of 19 ulcer patients and 29 (67.4%) of 43 patients with gastritis (\n P<\/jats:italic>\n = 0.17). The\n vacA<\/jats:italic>\n genotypes of German\n H. pylori<\/jats:italic>\n isolates are identical to those previously reported.\n H. pylori<\/jats:italic>\n strains of\n vacA<\/jats:italic>\n type s1 are associated with the occurrence of peptic ulceration and the presence of\n cagA<\/jats:italic>\n , cytotoxin activity, and VacA expression.\n <\/jats:p>","DOI":"10.1128\/jcm.36.4.944-948.1998","type":"journal-article","created":{"date-parts":[[2019,12,31]],"date-time":"2019-12-31T17:29:18Z","timestamp":1577813358000},"page":"944-948","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":163,"title":["Diversity of\n Helicobacter pylori vacA<\/i>\n and\n cagA<\/i>\n Genes and Relationship to VacA and CagA Protein Expression, Cytotoxin Production, and Associated Diseases"],"prefix":"10.1128","volume":"36","author":[{"given":"Jochen","family":"Rudi","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology,1 and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christof","family":"Kolb","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology,1 and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Maiwald","sequence":"additional","affiliation":[{"name":"Institute of Microbiology,2 University of Heidelberg, Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Kuck","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology,1 and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Sieg","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology,1 and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter R.","family":"Galle","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology,1 and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"Stremmel","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology,1 and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.270.30.17771"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(97)70223-3"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.93.25.14648"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.90.12.5791"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1128\/iai.61.12.5008-5012.1993"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1128\/iai.58.3.603-610.1990"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1128\/iai.59.4.1264-1270.1991"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0021-9258(17)34097-8"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/166.5.1073"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.45.8.733"},{"key":"e_1_3_2_12_2","first-page":"1264","article-title":"Mucosal IgA recognition of Helicobacter pylori 120 kDa protein, peptic ulceration and gastric pathology","volume":"59","author":"Crabtree J. 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