{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T22:05:53Z","timestamp":1766181953133,"version":"build-2065373602"},"reference-count":37,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2022,11,27]],"date-time":"2022-11-27T00:00:00Z","timestamp":1669507200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Istanbul Aydin University Scientific Research Projects Unit","award":["2018\/05"],"award-info":[{"award-number":["2018\/05"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Helicobacter pylori infection is associated with chronic gastritis, ulcers, and gastric cancer. The H. pylori Type 4 secretion system (T4SS) translocates the CagA protein into host cells and plays an essential role in initiating gastric carcinogenesis. The CagL protein is a component of the T4SS. CagL amino acid polymorphisms are correlated with clinical outcomes. We aimed to study the association between CagL amino acid polymorphisms and peptic ulcer disease (PUD) and non-ulcer dyspepsia (NUD). Materials and Methods: A total of 99 patients (PUD, 46; NUD, 53) were enrolled and screened for H. pylori by qPCR from antrum biopsy samples. The amino acid polymorphisms of CagL were analyzed using DNA sequencing, followed by the MAFFT sequence alignment program to match the amino acid sequences. Results: Antrum biopsy samples from 70 out of 99 (70.7%) patients were found to be H. pylori DNA-positive. A positive band for cagL was detected in 42 out of 70 samples (PUD, 23; NUD, 19), and following this, these 42 samples were sequenced. In total, 27 different polymorphisms were determined. We determined three CagL amino acid polymorphism combinations, which were determined to be associated with PUD and NUD. Pattern 1 (K35\/N122\/V134\/T175\/R194\/E210) was only detected in PUD patient samples and was related to a 1.35-fold risk (p = 0.02). Patterns 2 (V41\/I134) and 3 (V41\/K122\/A171\/I174) were found only in NUD patient samples and were linked to a 1.26-fold increased risk (p = 0.03). Conclusions: We observed three new patterns associated with PUD and NUD. Pattern 1 is related to PUD, and the other two patterns (Patterns 2 and 3) are related to NUD. The patterns that we identified include the remote polymorphisms of the CagL protein, which is a new approach. These patterns may help to understand the course of H. pylori infection.<\/jats:p>","DOI":"10.3390\/medicina58121738","type":"journal-article","created":{"date-parts":[[2022,11,28]],"date-time":"2022-11-28T03:28:49Z","timestamp":1669606129000},"page":"1738","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["New CagL Amino Acid Polymorphism Patterns of Helicobacter pylori in Peptic Ulcer and Non-Ulcer Dyspepsia"],"prefix":"10.3390","volume":"58","author":[{"given":"Reyhan","family":"Caliskan","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology, School of Medicine, Istanbul Aydin University, Istanbul 34295, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6985-0562","authenticated-orcid":false,"given":"Silva","family":"Polat Sari","sequence":"additional","affiliation":[{"name":"Vocational School of Health Services, Istanbul Aydin University, Istanbul 34295, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bahadir","family":"Ercan","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, School of Medicine, Istanbul Aydin University, Istanbul 34295, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kivanc Derya","family":"Peker","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Hisar Intercontinental Hospital, Istanbul 34768, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6975-0262","authenticated-orcid":false,"given":"Mehtap","family":"Omac Sonmez","sequence":"additional","affiliation":[{"name":"Faculty of Health Science, Kahramanmaras Sutcu Imam University, Kahramanmaras 46050, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ozer","family":"Akgul","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, School of Medicine, Istanbul Aydin University, Istanbul 34295, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Burcu","family":"Sapmaz","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, School of Medicine, Istanbul Aydin University, Istanbul 34295, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aliye","family":"Soylu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Bagcilar Medipol Mega University Hospital, Istanbul Medipol University, Istanbul 34810, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gokhan Tolga","family":"Adas","sequence":"additional","affiliation":[{"name":"Department of Surgery, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, University of Health Sciences, Istanbul 34147, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasar Ali","family":"Oner","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, School of Medicine, Istanbul Aydin University, Istanbul 34295, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pelin","family":"Yuksel Mayda","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy, Kocaeli Health and Technology University, Basiskele 41275, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.3349\/ymj.2014.55.6.1453","article-title":"Helicobacter Pylori: Bacterial Strategy for Incipient Stage and Persistent Colonization in Human Gastric Niches","volume":"55","author":"Rhee","year":"2014","journal-title":"Yonsei Med. 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