{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T01:15:54Z","timestamp":1788225354008,"version":"build-2803163510"},"reference-count":48,"publisher":"American Society for Microbiology","issue":"7","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82371769"],"award-info":[{"award-number":["82371769"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002858","name":"China Postdoctoral Science Foundation","doi-asserted-by":"publisher","award":["GZC20233232"],"award-info":[{"award-number":["GZC20233232"]}],"id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100021171","name":"Basic and Applied Basic Research Foundation of Guangdong Province","doi-asserted-by":"publisher","award":["2022A1515011122"],"award-info":[{"award-number":["2022A1515011122"]}],"id":[{"id":"10.13039\/501100021171","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Shenzhen Futian Healthcare Research Project","award":["FTWS2023096"],"award-info":[{"award-number":["FTWS2023096"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82402057"],"award-info":[{"award-number":["82402057"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2026,7,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      The contact-induced epithelium gene A (\n                      <jats:italic toggle=\"yes\">iceA<\/jats:italic>\n                      ), with allelic variants\n                      <jats:italic toggle=\"yes\">iceA1<\/jats:italic>\n                      and\n                      <jats:italic toggle=\"yes\">iceA2<\/jats:italic>\n                      , remains a controversial virulence factor in\n                      <jats:italic toggle=\"yes\">Helicobacter pylori<\/jats:italic>\n                      due to inconsistent clinical outcomes. In this study, we analyzed 1,427\n                      <jats:italic toggle=\"yes\">H. pylori<\/jats:italic>\n                      genomes from the NCBI database and 200 clinical isolates from Shenzhen, China, to elucidate the global distribution of\n                      <jats:italic toggle=\"yes\">iceA<\/jats:italic>\n                      genotypes and their associations with other virulence factors, bacterial gene expression, and the relationship with gastric diseases. We found that\n                      <jats:italic toggle=\"yes\">iceA<\/jats:italic>\n                      genotypes varied significantly across regions, with\n                      <jats:italic toggle=\"yes\">iceA1<\/jats:italic>\n                      predominating in Asia and Europe, and\n                      <jats:italic toggle=\"yes\">iceA2<\/jats:italic>\n                      being more prevalent in North America. This suggests adaptive evolution to regional host environments. The association between\n                      <jats:italic toggle=\"yes\">iceA<\/jats:italic>\n                      genotypes and\n                      <jats:italic toggle=\"yes\">cagA<\/jats:italic>\n                      status also exhibited regional patterns. Additionally,\n                      <jats:italic toggle=\"yes\">iceA1<\/jats:italic>\n                      was linked to higher\n                      <jats:italic toggle=\"yes\">ureA<\/jats:italic>\n                      expression, potentially enhancing acid resistance and colonization potential (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05). Importantly, patients infected with\n                      <jats:italic toggle=\"yes\">iceA1<\/jats:italic>\n                      genotype strains were more likely to present with gastric erosion (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05); however, they showed no association with peptic ulcer disease in any region. These findings highlight the geographical heterogeneity of\n                      <jats:italic toggle=\"yes\">iceA1<\/jats:italic>\n                      genotypes and their potential role in\n                      <jats:italic toggle=\"yes\">H. pylori<\/jats:italic>\n                      -related gastric diseases.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>IMPORTANCE<\/jats:title>\n                    <jats:p>\n                      Our study found that the iceA1 genotype of\n                      <jats:italic toggle=\"yes\">Helicobacter pylori<\/jats:italic>\n                      , which is relatively common in Asia, is associated with increased urea hydrolysis capacity and shows a specific association with erosive gastritis in Chinese patients. These findings suggest that iceA1 may potentially serve as an early biomarker for the identification of patients at risk of progressive gastric damage. Clinically, detecting iceA1 could improve risk stratification in high-prevalence regions, guiding more targeted monitoring and early intervention strategies. This research supports incorporating bacterial genotyping into clinical practice to optimize personalized treatment and prevent disease progression in susceptible populations.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/spectrum.02024-25","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T22:39:21Z","timestamp":1780094361000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["Global epidemiology of\n                    <i>Helicobacter pylori iceA<\/i>\n                    genotypes: heterogeneity and virulence implications"],"prefix":"10.1128","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-7293-4941","authenticated-orcid":false,"given":"Yayi","family":"Ren","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, The Eighth Affiliated Hospital of Sun Yat-Sen University","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, The Eighth Affiliated Hospital of Sun Yat-Sen University","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Long","family":"Zhou","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0530pts50","id-type":"ROR","asserted-by":"publisher"}],"name":"School of Biology and Biological Engineering, South China University of Technology","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zelin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, The Eighth Affiliated Hospital of Sun Yat-Sen University","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingting","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, The Eighth Affiliated Hospital of Sun Yat-Sen University","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2063-7696","authenticated-orcid":false,"given":"Jie","family":"Ning","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, The Eighth Affiliated Hospital of Sun Yat-Sen University","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1331-2746","authenticated-orcid":true,"given":"Chao","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, The Eighth Affiliated Hospital of Sun Yat-Sen University","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2024.102399"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(84)91816-6"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-023-00431-8"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2020-322368"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1080\/19490976.2020.1762520"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2796.2003.01119.x"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1128\/IAI.00993-07"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/hel.12386"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41564-019-0441-6"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tim.2020.02.004"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-019-0934-z"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers16081476"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11033-023-09075-z"},{"key":"e_1_3_4_15_2","first-page":"531","article-title":"Adherence to gastric epithelial cells induces expression of a Helicobacter pylori gene, iceA, that is associated with clinical outcome","volume":"110","author":"Peek RM","year":"1998","unstructured":"Peek RM Jr, Thompson SA, Donahue JP, Tham KT, Atherton JC, Blaser MJ, Miller GG. 1998. 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