Published online before print July 8, 2002, doi: 10.1161/01.CIR.0000023894.10871.2F
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Circulation. 2002;106:580.)
© 2002 American Heart Association, Inc.
Clinical Investigation and Reports |
Cytotoxin-Associated Gene-A–Positive Helicobacter pylori Strains Are Associated With Atherosclerotic Stroke
From Medical Semiology and Methodology (A.P., M.V., A.G.), the Department of Neurological Sciences (M.D., M.L.C.), and Occupational Medicine (A.B., A.M.), Tor Vergata University, Rome, Italy; the Department of Bacteriology and Medical Mycology (I.L., M.J.G.-M.), Istituto Superiore di Sanità, Rome, Italy; Clinica San Raffaele (T.C.), Velletri, Italy; and Clinic of Neurology (M.S.), University of Ancona, Ancona, Italy.
Correspondence to Antonio Pietroiusti, MD, Dipartimento di Medicina Interna, University Tor Vergata, Via di Tor Vergata 135, 00133 Rome, Italy. E-mail pietroiusti{at}med.uniroma2.it
Background— It is uncertain whether Helicobacter pylori is associated with ischemic syndromes and whether this association is mediated by the induction of atherosclerosis. In this study, we tested the hypothesis that atherosclerotic stroke shows a selective association with virulent H pylori strains.
Methods and Results— The seroprevalence of infection by H pylori and by strains bearing the cytotoxin-associated gene-A (CagA), a strong virulence factor, was assessed by ELISA in 138 patients with large-vessel stroke (group A), in 61 patients with cardioembolic stroke (group B), and in 151 healthy control subjects. The 3 groups had a similar socioeconomic status. Serum levels of C-reactive protein were also measured by ELISA. The prevalence of infection was 71% in group A, 63.9% in group B, and 70.2% in the control group (P=NS), whereas the prevalence of CagA-positive strains was higher in group A than in group B (42.8% versus 19.7%, respectively; odds ratio 3.04, 95% CI 1.43 to 6.49; P<0.001) and higher in group A than in the control group (42.8% versus 17.9%, respectively; odds ratio 4.3, 95% CI 2.12 to 8.64; P<0.001), after adjusting for main cardiovascular risk factors and social class. A trend toward a difference in C-reactive protein was observed between CagA-positive (2.00±3.43 [mean±SD] mg/dL) and CagA-negative (1.31±1.72 [mean±SD] mg/dL) patients (P=0.072, Mann-Whitney U test).
Conclusions— The association between H pylori and acute cerebrovascular disease seems to be due to a higher prevalence of more virulent H pylori strains in patients with atherosclerotic stroke.
Key Words: infection • genes • stroke • proteins
This article has been cited by other articles:
 |
|
 |
|
  F. Megraud and P. Lehours Helicobacter pylori Detection and Antimicrobial Susceptibility Testing Clin. Microbiol. Rev., April 1, 2007; 20(2): 280 - 322. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Pietroiusti, M. Giuliano, A. Magrini, A. Bergamaschi, and A. Galante Cytotoxin-Associated Gene A Strains of Helicobacter Pylori Represent a Risk Factor for the Development of Microalbuminuria in Type 2 Diabetes. Diabetes Care, June 1, 2006; 29(6): 1399 - 1401. [Full Text] [PDF]
|
|
|
|
 |
|
 F.C. Gibson III, H. Yumoto, Y. Takahashi, H.-H. Chou, and C.A. Genco Innate Immune Signaling and Porphyromonas gingivalis-accelerated Atherosclerosis Journal of Dental Research, February 1, 2006; 85(2): 106 - 121. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Larizza, V. Calcaterra, M. Martinetti, R. Negrini, A. De Silvestri, M. Cisternino, A. M. Iannone, and E. Solcia Helicobacter pylori Infection and Autoimmune Thyroid Disease in Young Patients: The Disadvantage of Carrying the Human Leukocyte Antigen-DRB1*0301 Allele J. Clin. Endocrinol. Metab., January 1, 2006; 91(1): 176 - 179. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Diomedi, A. Pietroiusti, M. Silvestrini, B. Rizzato, L. M. Cupini, F. Ferrante, A. Magrini, A. Bergamaschi, A. Galante, and G. Bernardi CagA-positive Helicobacter pylori strains may influence the natural history of atherosclerotic stroke Neurology, September 14, 2004; 63(5): 800 - 804. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Ludewig, P. Krebs, and E. Scandella Immunopathogenesis of atherosclerosis J. Leukoc. Biol., August 1, 2004; 76(2): 300 - 306. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. R. Preusch, A. J. Grau, F. Buggle, C. Lichy, J. Bartel, C. Black, and J. Rudi Association Between Cerebral Ischemia and Cytotoxin-Associated Gene-A-Bearing Strains of Helicobacter pylori Stroke, August 1, 2004; 35(8): 1800 - 1804. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Gabrielli, A. Santoliquido, F. Cremonini, V. Cicconi, M. Candelli, M. Serricchio, P. Tondi, R. Pola, G. Gasbarrini, P. Pola, et al. CagA-positive cytotoxic H. pylori strains as a link between plaque instability and atherosclerotic stroke Eur. Heart J., January 1, 2004; 25(1): 64 - 68. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. J. Lindsberg and A. J. Grau Inflammation and Infections as Risk Factors for Ischemic Stroke Stroke, October 1, 2003; 34(10): 2518 - 2532. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Mayr, S. Kiechl, M. A. Mendall, J. Willeit, G. Wick, and Q. Xu Increased Risk of Atherosclerosis Is Confined to CagA-Positive Helicobacter pylori Strains: Prospective Results From the Bruneck Study Stroke, March 1, 2003; 34(3): 610 - 615. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Stroke and H. pylori: What's the Story? Journal Watch Infectious Diseases, August 23, 2002; 2002(823): 5 - 5. [Full Text]
|
|