文章从GenBank中下载所有含有vacA和cagA基因的H. pylori菌株的VacA和CagA全长氨基酸序列, 利用ClastalX 2.0和MEGA 5.05软件构建VacA和CagA分子系统发育树, 探讨两基因之间的分子系统发育关系和不同聚类群的临床感染结果与基因型特征。结果显示, VacA和CagA具有高度相似的分子系统发育树, 并且所有H. pylori菌株在系统发育树中具有相同的分布特点, 分别聚类为东亚株群1、2和西方株群3个聚类群。其中东亚株群1患萎缩性胃炎比例较高, vacA基因型以s1c/m1b和s1a/m1b为主, cagA基因型以EPIYA-ABD为主; 东亚株群2患十二指肠溃疡的比例较高, vacA基因型以s1c/m2和s1a/m2为主, cagA基因型以EPIYA-AB'C为主; 西方株群患十二指肠溃疡和胃炎的比例相当, 萎缩性胃炎比例较低, vacA基因型以s1a/m1a和s1b/m1a为主, cagA基因型以EPIYA-AB/B'CC为主。这些结果说明, vacA和cagA基因可能具有共进化的遗传关系; 东亚株群1、2和西方株群分别具有不同的vacA和cagA基因亚型, 这可能与其临床感染结果密切相关, 因此, 在进行H. pylori相关性疾病分析时, 有必要结合vacA和cagA基因型的亚型做深入分析。
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