C0274 - Low-Grade Duodenal Eosinophilia Is Associated With cag-A in Helicobacter pylori-Related Dyspepsia

Monday, October 24, 2022

3:00 PM – 5:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

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Fernando J. Barreyro, MD, PhD

Universidad Nacional de Misiones. Facultad de Ciencias Exactas Químicas y Naturales. Instituto de Biotecnología de Misiones “Dra. Maria Ebbe Reca” (InBioMis). CONICET. Argentina
Posadas, Misiones, Argentina

Fernando J. Barreyro, MD, PhD¹, Nicolas Sanchez, BSc², Virginia Caronia, MD², Karina Elizondo, MD², Graciela Jordá, PhD³, Adolfo Schneider, MD⁴, Pedro D. Zapata, PhD⁵
¹Universidad Nacional de Misiones. Facultad de Ciencias Exactas Químicas y Naturales. Instituto de Biotecnología de Misiones “Dra. Maria Ebbe Reca” (InBioMis). CONICET. Argentina, Posadas, Misiones, Argentina; ²Universidad Nacional de Misiones. Facultad de Ciencias Exactas Químicas y Naturales. Instituto de Biotecnología de Misiones “Dra. Maria Ebbe Reca” (InBioMis)., Posadas, Misiones, Argentina; ³Universidad Nacional de Misiones, Posadas, Misiones, Argentina; ⁴Fundación HA Barceló, Instituto Universitario en Ciencias de la Salud, Santo Tome, Corrientes, Argentina; ⁵Universidad Nacional de Misiones. Facultad de Ciencias Exactas Químicas y Naturales. Instituto de Biotecnología de Misiones “Dra. Maria Ebbe Reca” (InBioMis). Laboratorio de Biotecnología Molecular (BIOTECMOL). Misiones, Argentina, Posadas, Misiones, Argentina

Introduction: Functional dyspepsia (FD) is a multifactorial disorder. Helicobacter pylori (H. pylori) related dyspepsia (HpD) may be considered a separate entity. Duodenal eosinophilia is a potential pathogenic mechanism in FD. However, the impact of duodenal eosinophilia and H. pylori virulence genes in HpD was not explored. Thus, our aim was to evaluate the association of H. pylori virulence genes and low-grade duodenal eosinophilia in HpD.

Methods: A multi-center cross-sectional study was conducted. A total of 301 patients who meet Rome-III criteria were selected before upper endoscopy and 95 patients were included after normal endoscopy and positive H. pylori in gastric biopsies were assessed. Clinical parameters, H. pylori virulence genes (cagA, oipA and vacA) and duodenal histology were evaluated.

Results: 69 (72%) patients had epigastric pain syndrome (EPS), 17 (18%) post-prandial distress syndrome (PDS) and 9 (10%) EPS/PDS overlap. FD syndromes were not associated with cagA or oipA strains. A significantly trend of vacA s1/m1(78%) and s1/m2 (80%) positive strains in EPS was observed. Histological duodenal grading of chronic inflammation, low-grade duodenal eosinophilia and intra-epithelial lymphocytes showed no difference in oipA and vacA strains. Low-grade duodenal eosinophilia was significant in cagA positive strain (Table), the OR for low-grade duodenal eosinophilia with H. pylori cagA positive strain was 4.2 (95% CI, 1.77-9.93). Adjusting for age, gender, smoking, PPI and vacA s1/m1 the OR was 4.7 (95% CI, 1.66-13.3).

Discussion: Our findings suggest that low-grade duodenal eosinophilia is significantly associated with cagA strain in HpD.

	Low-grade duodenal eosinophilia
Variable	Positive (44)	Negative (51)
Age (SD)	44 (11.6)	51 (13)
Gender (Fem %)	22 (50%)	22 (43%)
PDS (%)	9 (20%)	8 (17%)
EPS (%)	32 (73%)	37 (72%)
EPS/PDS overlap (%)	3 (7%)	6 (11%)
BMI (SD)	26.6 (3.9)	27.6 (5.2)
*cagA* positive (%)	28 (64%) *	15 (29%)
*oipA* positive (%)	31 (70%)	34 (67%)
*vacA s1 m1* positive (%)	21 (48%)	20 (39%)
PPI (%)	14 (32%)	20 (39%)
NSAID (%)	17(39%)	19 (37%)
Diabetes (%)	9 (20%)	18 (35%)
Hypertension (%)	14 (32%)	13 (25%)
Smoking (%)	13 (29%)	20 (39%)

Table: Low-grade duodenal eosinophilia, H. pylori virulence genotypes and clinical variables

Disclosures:

Fernando Barreyro indicated no relevant financial relationships.

Nicolas Sanchez indicated no relevant financial relationships.

Virginia Caronia indicated no relevant financial relationships.

Karina Elizondo indicated no relevant financial relationships.

Graciela Jordá indicated no relevant financial relationships.

Adolfo Schneider indicated no relevant financial relationships.

Pedro Zapata indicated no relevant financial relationships.

Fernando J. Barreyro, MD, PhD¹, Nicolas Sanchez, BSc², Virginia Caronia, MD², Karina Elizondo, MD², Graciela Jordá, PhD³, Adolfo Schneider, MD⁴, Pedro D. Zapata, PhD⁵. C0274 - Low-Grade Duodenal Eosinophilia Is Associated With cag-A in Helicobacter pylori-Related Dyspepsia, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.