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<span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;"><strong><em>Background: </em></strong><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;"><em>Helicobacter pylori </em><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;">strains have two classical virulence genes, the cytotoxinassociated A (<span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;"><em>cagA</em><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;">) gene and the vacuolating cytotoxin A (<span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;"><em>vacA</em><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;">) gene, which are located in the<br /><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;"><em>cag </em><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;">pathogenicity island (<span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;"><em>cag</em><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;">PAI). Serum immunoglobulin G (IgG) antibodies to <span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;"><em>H. pylori</em><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;">,<br /><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;">especially, the CagA antigen may be a reliable marker for selection of dyspeptic patients for upper<br /><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;">endoscopy.<br /><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;"><strong><em>Methods</em></strong><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;"><strong>: </strong><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;">Serum sample of 129 dyspeptic patients with positive <span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;"><em>H. pylori</em><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;">, were tested for serum<br /><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;">IgG Anti-CagA antibody by ELISA. The presence of the <span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;"><em>cagA </em><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;">and <span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;"><em>vacA </em><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;">genotypes were<br /><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;">determined using polymerase chain reaction (PCR) on biopsy samples taken via endoscopy.<br /><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;"><strong><em>Results</em></strong><span style="font-family: Times New Roman,Bold; font-size: 10pt; color: #000000; font-style: normal; font-variant: normal;"><strong>: </strong><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;">Positive serum IgG anti-CagA antibodies in patients with <span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;"><em>cagA</em><span style="font-size: 6pt; color: #000000; font-style: normal; font-variant: normal;"><em>+</em><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;"><em>/vacA</em><span style="font-size: 6pt; color: #000000; font-style: normal; font-variant: normal;"><em>+ </em><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;">and <span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;"><em>cagA</em><span style="font-size: 6pt; color: #000000; font-style: normal; font-variant: normal;"><em>+</em><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;"><em>/vacA</em><span style="font-size: 6pt; color: #000000; font-style: normal; font-variant: normal;"><em>- </em><br /><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;">genotypes were 22/23 (95.6%) and 18/19 (94.7%), respectively. In addition, serum IgG anti-CagA<br /><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;">antibodies in patients with <span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;"><em>cagA</em><span style="font-size: 6pt; color: #000000; font-style: normal; font-variant: normal;"><em>-</em><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;"><em>/vacA</em><span style="font-size: 6pt; color: #000000; font-style: normal; font-variant: normal;">+ <span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;">and <span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;"><em>cagA</em><span style="font-size: 6pt; color: #000000; font-style: normal; font-variant: normal;"><em>-</em><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;"><em>/vacA</em><span style="font-size: 6pt; color: #000000; font-style: normal; font-variant: normal;"><em>- </em><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;">genotypes were 22/47 (46.8%) and 33/40<br /><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;">(82.5%), respectively.<br /><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;"><strong><em>Conclusions</em></strong><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;">: It can be concluded that the serum IgG anti-CagA antibody alone could select<br /><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;">patients with dyspepsia following upper endoscopy. The assessment of vacuolating cytotoxin<br /><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;">activity of <span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;"><em>H. Pylori </em><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;">is, therefore, not required, even when <span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;"><em>vacA </em><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;">gene is positive. This hypothesis<br /><span style="font-size: 9pt; color: #000000; font-style: normal; font-variant: normal;">needs to be studied in a large number of patients with dyspepsia.</span></span></span></span></span></span></span></span></span></span></span></span></span></span><br style="font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-align: -webkit-auto; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-size-adjust: auto; -webkit-text-stroke-width: 0px;" /><br class="Apple-interchange-newline" /></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span></span>