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Genetic Variation of Helicobacter pylori in the Oral Cavity and Stomach Detected Using Thymine Adenine Cloning in Children With Chronic Gastritis

Cai, Haifang MD; Li, Wei MD; Shu, Xiaoli MD; Peng, Kerong MD; Zhang, Yanyi BS; Jiang, Mizu MD, PhD

The Pediatric Infectious Disease Journal: January 2014 - Volume 33 - Issue 1 - p e1–e6
doi: 10.1097/INF.0000000000000017
Original Studies

Objectives: To investigate the DNA sequence variations of Helicobacter pylori in the oral cavities and stomachs of children with chronic gastritis.

Methods: Dental plaques and gargle on 235 patients were obtained before gastroscopy. Gastric H. pylori infection was diagnosed using rapid urease test or Giemsa staining. H. pylori 16S rDNA and CagA gene were analyzed using PCR methods. Thymine adenine cloning-based sequencing was performed in patients with CagA gene positive from oral cavities. The sequence alignments and V1 variable region were evaluated by comparison with the sequence of the standard H. pylori 26695 strain.

Results: Totally, 46 out of the 235 patients were positive for gastric H. pylori infection. Of the 46 patients, 26 cases had amplified H. pylori 16S rDNA in both oral (plaque and gargle) and gastric samples. Of the 26 cases, 12 patients (46.1%) were positive for the H. pylori CagA gene in the oral samples, which was significantly lower than that in the gastric mucosa (80.8%; P = 0.010). The homology of the complete sequence alignment ranged from 74.0% to 92.1% in the oral and gastric samples. The V1 region alleles (positions 75–99) had 7–22 polymorphisms (homology from 12.0% to 72.0%) in 11 patients between the oral and gastric samples, but had 100% homology in 1 patient.

Conclusions: Our study found that distinct H. pylori strains exist in the oral cavities of children, but we would not support the hypothesis that H. pylori in the oral cavities is an important reservoir of gastric H. pylori infections in children.

Department of Gastroenterology, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.

Haifang Cai, MD, is currently at the Lishui Central Hospital of Zhejiang Province, Lishui 323000, China

Wei Li is currently at the Department of Pediatrics, Jiaxing Maternity and Child Health Care Hospital of Zhejiang Province, Jiaxing, 314050, China.

Accepted for publication August 19, 2013.

H.C. and W.L. contributed equally for this article.

This study was supported by a grant from the National Natural Science Foundation of China (No. 81100268). The authors have no other funding or conflicts to disclose.

Address for correspondence: Mizu Jiang, Department of Gastroenterology, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China. E-mail:

© 2014 by Lippincott Williams & Wilkins, Inc.