Estudo do genótipo cagA da Helicobacter pylori e sua associação com os fatores socioeconômicos e as afecções gástricas no Oeste do Maranhão, Brasil

Detalhes bibliográficos
Autor(a) principal: LIMA, Victor Pereira
Data de Publicação: 2021
Tipo de documento: Dissertação
Idioma: por
Título da fonte: Biblioteca Digital de Teses e Dissertações da UFMA
Texto Completo: https://tedebc.ufma.br/jspui/handle/tede/tede/4144
Resumo: Approximately more than half of the world's population is infected with Helicobacter pylori. However, the prevalence of the infection varies between different regions, with higher rates in developing countries compared to developed ones. The mechanisms involved in the development of gastric diseases related to H. pylori infection depend on host genetics, environmental factors and bacterial virulence. Among the virulence factors, the cagA genotype stands out, being directly associated with the most severe gastric affections, due to the encoding of the CagA oncoprotein injected into the gastric epithelial cell through the type IV secretion system, which alters the transduction signals, mechanisms of apoptosis and the cytoskeleton of cells. Furthermore, other host factors can influence the pathogenesis of H. pylori infection, such as socioeconomic conditions and risk behaviors. Thus, the aim of this study was to identify cagA-positive strains of Helicobacter pylori in Maranhão, investigating associations between genotype, socioeconomic data and gastric disorders. Study conducted from October 2015 to February 2018, in a public endoscopy service, in Imperatriz, Maranhão. Information on socioeconomic factors was collected through a semi- structured form applied in the waiting room of the service. Clinical characteristics and endoscopic diagnoses were obtained from the patients' charts. The genotyping of the strains was performed by polymerase chain reaction (PCR) in gastric tissue samples, with a positive urease test for H. pylori. To verify the association between variables, Pearson's chi-square test was applied (significance level of p<0.05) and its effect was measured using the odds ratio. The study was approved by the Ethics Committee for Research with Human Beings of the Federal University of Maranhão. The study included 751 dyspeptic patients with a mean age of 43.8 years, 68.3% were women, 50.3% had less than 10 years of education, 66.7% married, 73.8% had income monthly less than the minimum wage, 83.5% lived with less than five people, 55.7% did not have a sewage system, 52.5% consumed untreated water, 67.5% did not drink and 82% did not smoke. The prevalence of H. pylori was 52.7%, with an association with income below the minimum wage (p < 0.0001; OR: 1.94; 95% CI: 1.39–2.70) and consumption of untreated water (p=0.03; OR: 1.37; 95% CI: 1.02–1.83). Men (p=0.01; OR=0.27; 95%CI=0.094-0.817) were less likely to develop gastritis. The prevalence of the cagA genotype was 25.5% of the strains. Low income was inversely associated with the presence of the cagA gene, even after adjustments. Untreated water was associated with the presence of the cagA genotype in univariate (OR = 2.55; 95% CI: 1.008-6.48; p = 0.03) and multivariate (OR = 2.89; 95% CI: 1.08-7.67; p = 0.03). There was no association between the cagA-positive strains with gastritis, peptic ulcer and esophagitis affections. The study showed that untreated water was associated with the presence of the Helicobacter pylori cagA genotype in southwestern Maranhão and was not associated with the investigated gastrointestinal diseases.
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spelling SERRA, Maria Aparecida Alves de Oliveirahttp://lattes.cnpq.br/3478049785850569SERRA, Maria Aparecida Alves de Oliveirahttp://lattes.cnpq.br/3478049785850569ARAÚJO, Márcio Flávio Moura dehttp://lattes.cnpq.br/3560955068874194SANTOS NETO, Marcelinohttp://lattes.cnpq.br/2762193275718620CHAVES, Marcelo Donizettihttp://lattes.cnpq.br/2032065080008349SANTOS, Leonardo Hunaldo doshttp://lattes.cnpq.br/7820773795322903http://lattes.cnpq.br/7081629884894846LIMA, Victor Pereira2022-10-11T13:34:18Z2021-09-28LIMA, Victor Pereira. Estudo do genótipo cagA da Helicobacter pylori e sua associação com os fatores socioeconômicos e as afecções gástricas no Oeste do Maranhão, Brasil. 2021. 56 f. Dissertação (Programa de Pós-Graduação em Saúde e Tecnologia) - Universidade Federal do Maranhão, Imperatriz.https://tedebc.ufma.br/jspui/handle/tede/tede/4144Approximately more than half of the world's population is infected with Helicobacter pylori. However, the prevalence of the infection varies between different regions, with higher rates in developing countries compared to developed ones. The mechanisms involved in the development of gastric diseases related to H. pylori infection depend on host genetics, environmental factors and bacterial virulence. Among the virulence factors, the cagA genotype stands out, being directly associated with the most severe gastric affections, due to the encoding of the CagA oncoprotein injected into the gastric epithelial cell through the type IV secretion system, which alters the transduction signals, mechanisms of apoptosis and the cytoskeleton of cells. Furthermore, other host factors can influence the pathogenesis of H. pylori infection, such as socioeconomic conditions and risk behaviors. Thus, the aim of this study was to identify cagA-positive strains of Helicobacter pylori in Maranhão, investigating associations between genotype, socioeconomic data and gastric disorders. Study conducted from October 2015 to February 2018, in a public endoscopy service, in Imperatriz, Maranhão. Information on socioeconomic factors was collected through a semi- structured form applied in the waiting room of the service. Clinical characteristics and endoscopic diagnoses were obtained from the patients' charts. The genotyping of the strains was performed by polymerase chain reaction (PCR) in gastric tissue samples, with a positive urease test for H. pylori. To verify the association between variables, Pearson's chi-square test was applied (significance level of p<0.05) and its effect was measured using the odds ratio. The study was approved by the Ethics Committee for Research with Human Beings of the Federal University of Maranhão. The study included 751 dyspeptic patients with a mean age of 43.8 years, 68.3% were women, 50.3% had less than 10 years of education, 66.7% married, 73.8% had income monthly less than the minimum wage, 83.5% lived with less than five people, 55.7% did not have a sewage system, 52.5% consumed untreated water, 67.5% did not drink and 82% did not smoke. The prevalence of H. pylori was 52.7%, with an association with income below the minimum wage (p < 0.0001; OR: 1.94; 95% CI: 1.39–2.70) and consumption of untreated water (p=0.03; OR: 1.37; 95% CI: 1.02–1.83). Men (p=0.01; OR=0.27; 95%CI=0.094-0.817) were less likely to develop gastritis. The prevalence of the cagA genotype was 25.5% of the strains. Low income was inversely associated with the presence of the cagA gene, even after adjustments. Untreated water was associated with the presence of the cagA genotype in univariate (OR = 2.55; 95% CI: 1.008-6.48; p = 0.03) and multivariate (OR = 2.89; 95% CI: 1.08-7.67; p = 0.03). There was no association between the cagA-positive strains with gastritis, peptic ulcer and esophagitis affections. The study showed that untreated water was associated with the presence of the Helicobacter pylori cagA genotype in southwestern Maranhão and was not associated with the investigated gastrointestinal diseases.Aproximadamente, mais da metade da população mundial esteja infectada pela Helicobacter pylori. No entanto, a prevalência da infecção varia entre diferentes regiões, com maiores taxas nos países em desenvolvimento, quando comparados aos desenvolvidos. Os mecanismos envolvidos no desenvolvimento das doenças gástricas relacionadas à infeção por H. pylori dependem da genética do hospedeiro, dos fatores ambientais e da virulência bacteriana. Entre os fatores de virulência, destaca-se o genótipo cagA, sendo diretamente associado com as afecções gástricas mais graves, devido à codificação da oncoproteína CagA, injetada na célula epitelial gástrica, por meio do sistema de secreção tipo IV, que altera os sinais de transdução, mecanismos de apoptose e citoesqueleto das células. Ademais, outros fatores do hospedeiro podem influenciar a patogênese da infecção por H. pylori, como condições socioeconômicas e comportamentos de risco. Desta forma, objetivou-se identificar cepas cagA-positivas da Helicobacter pylori, no Maranhão, de modo a investigar associações entre o genótipo, os dados socioeconômicos e as afecções gástricas. Estudo realizado de outubro de 2015 a fevereiro de 2018, em serviço público de endoscopia, em Imperatriz, Maranhão. Informações sobre fatores socioeconômicos foram coletadas por meio de formulário semiestruturado, aplicado na sala de espera do serviço. As características clínicas e diagnósticos endoscópicos foram obtidas nos prontuários dos pacientes. A genotipagem das cepas foi realizada por meio da reação em cadeia da polimerase (PCR), em amostras de tecido gástrico, com teste da urease positivo para H. pylori. Para verificar a associação entre as variáveis, aplicou-se o teste qui quadrado de Pearson (nível de significância de p<0,05), cujo efeito foi medido pela razão de chance. Estudo aprovado pelo Comitê de Ética em Pesquisa com Seres Humanos da Universidade Federal do Maranhão, conforme parecer no 1.304.308. Incluíram-se no estudo 751 pacientes dispépticos, com média de idade de 43,8 anos, destes, 68,3% eram mulheres, 50,3% tinham menos de 10 anos de estudo, 66,7% casados, 73,8% com renda mensal inferior a um salário mínimo, 83,5% viviam com menos de cinco pessoas, 55,7% não possuíam rede de esgoto, 52,5% consumiam água não tratada, 67,5% não etilista e 82% não fumante. A prevalência de H. pylori foi de 52,7%, apresentando associação com renda inferior a um salário mínimo (p <0,0001; OR: 1,94; IC 95%: 1,39–2,70) e consumo de água não tratada (p= 0,03; OR: 1,37; IC 95%: 1,02– 1,83). Os homens (p=0,01; RC=0,27; IC95%=0,094-0,817) apresentaram menor chance de desenvolverem gastrite. A prevalência do genótipo cagA foi de 25,5% das cepas. A baixa renda foi inversamente associada à presença do gene cagA, mesmo após ajustes. A água não tratada se mostrou associada à presença do genótipo cagA nas análises univariada (RC =2.55; IC 95%: 1.008-6.48; p= 0,03) e multivariada (RC = 2.89; IC 95%: 1.08-7.67; p = 0,03). Não houve associação entre as cepas cagA-positivas com as afecções gastrite, úlcera péptica e esofagite. O estudo mostrou que a água não tratada foi associada à presença do genótipo cagA da Helicobacter pylori, no sudoeste do Maranhão, e não estava associada às doenças gastrointestinais investigadas.Submitted by Jonathan Sousa de Almeida (jonathan.sousa@ufma.br) on 2022-10-11T13:34:18Z No. of bitstreams: 1 VICTORPEREIRALIMA.pdf: 2082795 bytes, checksum: 01646cc3f3113602cc19bde23e5d5ccb (MD5)Made available in DSpace on 2022-10-11T13:34:18Z (GMT). No. of bitstreams: 1 VICTORPEREIRALIMA.pdf: 2082795 bytes, checksum: 01646cc3f3113602cc19bde23e5d5ccb (MD5) Previous issue date: 2021-09-28FAPEMAapplication/pdfporUniversidade Federal do MaranhãoPROGRAMA DE PÓS-GRADUAÇÃO EM SAÚDE E TECNOLOGIAUFMABrasilCOORDENAÇÃO DO CURSO DE MEDICINA IMPERATRIZ/CCSSTHelicobacter pylori;gastropatias;gastrite;úlcera péptica;esofagite.helicobacter pylori;gastropathies;gastritis;peptic ulcer;esophagitis.GastroenterologiaCiências da SaúdeEstudo do genótipo cagA da Helicobacter pylori e sua associação com os fatores socioeconômicos e as afecções gástricas no Oeste do Maranhão, BrasilStudy of the Helicobacter pylori cagA genotype and association with socioeconomic factors and gastric disorders in southwestern Maranhão, Brazilinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UFMAinstname:Universidade Federal do Maranhão (UFMA)instacron:UFMAORIGINALVICTOR PEREIRA LIMA.pdfVICTOR PEREIRA LIMA.pdfapplication/pdf2139789http://tedebc.ufma.br:8080/bitstream/tede/4144/1/VICTOR+PEREIRA+LIMA.pdf6b733b93c5191fe4fc1ea8e091688954MD51tede/41442022-11-07 08:41:50.21oai:tede2:tede/4144Biblioteca Digital de Teses e Dissertaçõeshttps://tedebc.ufma.br/jspui/PUBhttp://tedebc.ufma.br:8080/oai/requestrepositorio@ufma.br||repositorio@ufma.bropendoar:21312022-11-07T11:41:50Biblioteca Digital de Teses e Dissertações da UFMA - Universidade Federal do Maranhão (UFMA)false
dc.title.por.fl_str_mv Estudo do genótipo cagA da Helicobacter pylori e sua associação com os fatores socioeconômicos e as afecções gástricas no Oeste do Maranhão, Brasil
dc.title.alternative.eng.fl_str_mv Study of the Helicobacter pylori cagA genotype and association with socioeconomic factors and gastric disorders in southwestern Maranhão, Brazil
title Estudo do genótipo cagA da Helicobacter pylori e sua associação com os fatores socioeconômicos e as afecções gástricas no Oeste do Maranhão, Brasil
spellingShingle Estudo do genótipo cagA da Helicobacter pylori e sua associação com os fatores socioeconômicos e as afecções gástricas no Oeste do Maranhão, Brasil
LIMA, Victor Pereira
Helicobacter pylori;
gastropatias;
gastrite;
úlcera péptica;
esofagite.
helicobacter pylori;
gastropathies;
gastritis;
peptic ulcer;
esophagitis.
Gastroenterologia
Ciências da Saúde
title_short Estudo do genótipo cagA da Helicobacter pylori e sua associação com os fatores socioeconômicos e as afecções gástricas no Oeste do Maranhão, Brasil
title_full Estudo do genótipo cagA da Helicobacter pylori e sua associação com os fatores socioeconômicos e as afecções gástricas no Oeste do Maranhão, Brasil
title_fullStr Estudo do genótipo cagA da Helicobacter pylori e sua associação com os fatores socioeconômicos e as afecções gástricas no Oeste do Maranhão, Brasil
title_full_unstemmed Estudo do genótipo cagA da Helicobacter pylori e sua associação com os fatores socioeconômicos e as afecções gástricas no Oeste do Maranhão, Brasil
title_sort Estudo do genótipo cagA da Helicobacter pylori e sua associação com os fatores socioeconômicos e as afecções gástricas no Oeste do Maranhão, Brasil
author LIMA, Victor Pereira
author_facet LIMA, Victor Pereira
author_role author
dc.contributor.advisor1.fl_str_mv SERRA, Maria Aparecida Alves de Oliveira
dc.contributor.advisor1Lattes.fl_str_mv http://lattes.cnpq.br/3478049785850569
dc.contributor.referee1.fl_str_mv SERRA, Maria Aparecida Alves de Oliveira
dc.contributor.referee1Lattes.fl_str_mv http://lattes.cnpq.br/3478049785850569
dc.contributor.referee2.fl_str_mv ARAÚJO, Márcio Flávio Moura de
dc.contributor.referee2Lattes.fl_str_mv http://lattes.cnpq.br/3560955068874194
dc.contributor.referee3.fl_str_mv SANTOS NETO, Marcelino
dc.contributor.referee3Lattes.fl_str_mv http://lattes.cnpq.br/2762193275718620
dc.contributor.referee4.fl_str_mv CHAVES, Marcelo Donizetti
dc.contributor.referee4Lattes.fl_str_mv http://lattes.cnpq.br/2032065080008349
dc.contributor.referee5.fl_str_mv SANTOS, Leonardo Hunaldo dos
dc.contributor.referee5Lattes.fl_str_mv http://lattes.cnpq.br/7820773795322903
dc.contributor.authorLattes.fl_str_mv http://lattes.cnpq.br/7081629884894846
dc.contributor.author.fl_str_mv LIMA, Victor Pereira
contributor_str_mv SERRA, Maria Aparecida Alves de Oliveira
SERRA, Maria Aparecida Alves de Oliveira
ARAÚJO, Márcio Flávio Moura de
SANTOS NETO, Marcelino
CHAVES, Marcelo Donizetti
SANTOS, Leonardo Hunaldo dos
dc.subject.por.fl_str_mv Helicobacter pylori;
gastropatias;
gastrite;
úlcera péptica;
esofagite.
topic Helicobacter pylori;
gastropatias;
gastrite;
úlcera péptica;
esofagite.
helicobacter pylori;
gastropathies;
gastritis;
peptic ulcer;
esophagitis.
Gastroenterologia
Ciências da Saúde
dc.subject.eng.fl_str_mv helicobacter pylori;
gastropathies;
gastritis;
peptic ulcer;
esophagitis.
dc.subject.cnpq.fl_str_mv Gastroenterologia
Ciências da Saúde
description Approximately more than half of the world's population is infected with Helicobacter pylori. However, the prevalence of the infection varies between different regions, with higher rates in developing countries compared to developed ones. The mechanisms involved in the development of gastric diseases related to H. pylori infection depend on host genetics, environmental factors and bacterial virulence. Among the virulence factors, the cagA genotype stands out, being directly associated with the most severe gastric affections, due to the encoding of the CagA oncoprotein injected into the gastric epithelial cell through the type IV secretion system, which alters the transduction signals, mechanisms of apoptosis and the cytoskeleton of cells. Furthermore, other host factors can influence the pathogenesis of H. pylori infection, such as socioeconomic conditions and risk behaviors. Thus, the aim of this study was to identify cagA-positive strains of Helicobacter pylori in Maranhão, investigating associations between genotype, socioeconomic data and gastric disorders. Study conducted from October 2015 to February 2018, in a public endoscopy service, in Imperatriz, Maranhão. Information on socioeconomic factors was collected through a semi- structured form applied in the waiting room of the service. Clinical characteristics and endoscopic diagnoses were obtained from the patients' charts. The genotyping of the strains was performed by polymerase chain reaction (PCR) in gastric tissue samples, with a positive urease test for H. pylori. To verify the association between variables, Pearson's chi-square test was applied (significance level of p<0.05) and its effect was measured using the odds ratio. The study was approved by the Ethics Committee for Research with Human Beings of the Federal University of Maranhão. The study included 751 dyspeptic patients with a mean age of 43.8 years, 68.3% were women, 50.3% had less than 10 years of education, 66.7% married, 73.8% had income monthly less than the minimum wage, 83.5% lived with less than five people, 55.7% did not have a sewage system, 52.5% consumed untreated water, 67.5% did not drink and 82% did not smoke. The prevalence of H. pylori was 52.7%, with an association with income below the minimum wage (p < 0.0001; OR: 1.94; 95% CI: 1.39–2.70) and consumption of untreated water (p=0.03; OR: 1.37; 95% CI: 1.02–1.83). Men (p=0.01; OR=0.27; 95%CI=0.094-0.817) were less likely to develop gastritis. The prevalence of the cagA genotype was 25.5% of the strains. Low income was inversely associated with the presence of the cagA gene, even after adjustments. Untreated water was associated with the presence of the cagA genotype in univariate (OR = 2.55; 95% CI: 1.008-6.48; p = 0.03) and multivariate (OR = 2.89; 95% CI: 1.08-7.67; p = 0.03). There was no association between the cagA-positive strains with gastritis, peptic ulcer and esophagitis affections. The study showed that untreated water was associated with the presence of the Helicobacter pylori cagA genotype in southwestern Maranhão and was not associated with the investigated gastrointestinal diseases.
publishDate 2021
dc.date.issued.fl_str_mv 2021-09-28
dc.date.accessioned.fl_str_mv 2022-10-11T13:34:18Z
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dc.type.driver.fl_str_mv info:eu-repo/semantics/masterThesis
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dc.identifier.citation.fl_str_mv LIMA, Victor Pereira. Estudo do genótipo cagA da Helicobacter pylori e sua associação com os fatores socioeconômicos e as afecções gástricas no Oeste do Maranhão, Brasil. 2021. 56 f. Dissertação (Programa de Pós-Graduação em Saúde e Tecnologia) - Universidade Federal do Maranhão, Imperatriz.
dc.identifier.uri.fl_str_mv https://tedebc.ufma.br/jspui/handle/tede/tede/4144
identifier_str_mv LIMA, Victor Pereira. Estudo do genótipo cagA da Helicobacter pylori e sua associação com os fatores socioeconômicos e as afecções gástricas no Oeste do Maranhão, Brasil. 2021. 56 f. Dissertação (Programa de Pós-Graduação em Saúde e Tecnologia) - Universidade Federal do Maranhão, Imperatriz.
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dc.publisher.department.fl_str_mv COORDENAÇÃO DO CURSO DE MEDICINA IMPERATRIZ/CCSST
publisher.none.fl_str_mv Universidade Federal do Maranhão
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