Comparison of the Virulence Factors of Helicobacter pylori Isolated in Stomach and Saliva in Iran

Introduction: Helicobacter pylori is a microaerophilic, spiral-shaped motile bacterium that is strongly associated with gastroduodenal diseases, but recently, dental plaque and saliva have been implicated as possible sources of H pylori infection. Two virulence factors that are expressed by the alleles of the cytotoxin genes, cagA and vacA, have been identified. The aim of this study was to compare cagA and vacA genotypes of H pylori between stomach and saliva in a same patient. Methods: This study was performed on antrum gastric biopsy specimens and saliva samples, which were obtained from 250 patients undergoing upper gastrointestinal tract endoscopy in Hagar Hospital of Shahrekord Township in Iran. Initially, H pylori strains were identified by rapid urease test; then, we applied polymerase chain reaction assay to analyze cagA and vacA genotypes of H pylori from both gastric and saliva specimens. Results: One hundred eighty-nine (75.6%) and 36 (14.4%) samples were H pylori positive in gastric and saliva samples, respectively. Evaluation of virulence factors in the 36 patients whose saliva and gastric samples were both positive for H pylori showed a great deal of cytotoxin genotypic diversity between stomach and saliva in the same patient; in fact, 14 patients (38.8%) had different H pylori strains in their saliva and gastric samples. Conclusions: The data suggest that >1 H pylori strain may exist in stomach and saliva in the same patient.