Published online Dec 14, 2016. doi: 10.3748/wjg.v22.i46.10118
Peer-review started: August 24, 2016
First decision: September 12, 2016
Revised: September 27, 2016
Accepted: November 14, 2016
Article in press: November 16, 2016
Published online: December 14, 2016
Processing time: 111 Days and 22 Hours
Helicobacter pylori (H. pylori) is a gastric human pathogen associated with acute and chronic gastritis, 70% of all gastric ulcers, 85% of all duodenal ulcers, and both forms of stomach cancer, mucosal-associated lymphoid tissue (MALT) lymphoma and adenocarcinoma. Recently, attention has focused on possible relationship between presence of certain virulence factor and H. pylori-associated diseases. Some contradictory data between this bacterium and related disorders has been observed since not all the colonized individuals develop to severe disease. The reported diseases plausibility related to H. pylori specific virulence factors became an interesting story about this organism. Although a number of putative virulence factors have been identified including cytotoxin-associated gene a (cagA) and vacA, there are conflicting data about their actual participation as specific risk factor for H. pylori-related diseases. Duodenal ulcer promoting gene a (dupA) is a virulence factor of H. pylori that is highly associated with duodenal ulcer development and reduced risk of gastric cancer. The prevalence of dupA in H. pylori strains isolated from western countries is relatively higher than in H. pylori strains from Asian countries. Current confusing epidemiological reports will continue unless future sophisticated and molecular studies provide data on functional and complete dupA cluster in H. pylori infected individuals. This paper elucidates available knowledge concerning role of dupA in virulence of H. pylori after a decade of its discovery.
Core tip: Helicobacter pylori (H. pylori) is one of the most common bacterial infections worldwide. Ten years ago, virB4 homologue was identified as a new virulence factor, dupA “duodenal ulcer promoting gene A” by Lu and her colleagues. Nowadays, new genetical analysis using available sequences can help scientists to draw a better conclusion about dupA and its actual role in pathogenesis of H. pylori-related diseases. In this paper, we aim to draw a new shaped overview regarding H. pylori and its virulence factors with emphasis of dupA.