Genetic Determination of H.Pylori Virulence Factors
Etiology, Diagnosis, Treatment and Prevention of Clinical Gastro Duodenal Diseases in the Caucasus Region
Tech Area / Field
- MED-DIS/Disease Surveillance/Medicine
- BIO-CGM/Cytology, Genetics and Molecular Biology/Biotechnology
- MED-DID/Diagnostics & Devices/Medicine
3 Approved without Funding
Center for Coordination and Implementation of Scientific, Technological and Socio-Economic Projects, Georgia, Tbilisi
- Georgian H.pylori Study Group, Georgia, Tbilisi\nTbilisi State Medical University / Pediatric Clinic, Georgia, Tbilisi
- New York University / School of Medicine, USA, New York
Project summaryThe aims of current project are: To study clinical features of H. pylori associated disease; to introduce the modern techniques for diagnosis and prevention; To provide epidemiological control and elaboration of standard regimens for treatment of above mentioned diseases in the Caucasus region.
It is known that 2/3 population of the Globe is infected with H. pylori. This bacterium colonizes the human gastric mucosa and represents the reason of chronic gastritis and Peptic ulcer diseases (in 80% cases they cause gastric ulcer while in 90% - duodenal ulcers). Besides, people infected with H. pylori have 2-6 times more risk of gastric cancer and MALT-lymphoma development compared to those not infected.
The role of H. pylori in the development of gastric and duodenal pathologies is one of the important matters for health cares and is widely studied in numerous countries in the World. There is a lack of information about the prevalence of mentioned infectious agent among the population of Caucasus region. In addition, there is not any data about prevalence of H. pylori by age. We also have not information on what are the most prevalent genotypes. Based on the high number of PUD and the increase in number of complicated cases that we have it is the reasonable to predict that the patients in our region are infected with H. pylori strains with high virulence.
Due to the complicated socio-economical conditions in the region and the lack of knowledge in the population, the intervention of the physician often is delayed. Therefore the hospital cases are very severe and complicated. The treatment is not possible at the early stages of diseases when it is more effective. Patients are becoming disabled, mortality rate is high and at the treatment of complications is not cost effective.
In this really difficult situation in the region there are not any elaborated standards of management; There is not defined application for the treatment; epidemiological control trends and there are not even one medical establishment that is able to diagnose and treat those mentioned diseases in the correct way.
The most frequent reasons for hospital admissions are complications such as: upper GI bleeding, ulcer perforation, pylorostenoses, maliginisation etc. This shows a trend of rise. For example, since 1993 up today annually 330 new cases of gastric malignancies are registered that represent the 8% of whole oncologic spectrum.
The most alarming issue is that the prevalence of H. pylori among children is relatively high. In the Pediatric Hospital of Tbilisi state Medical University; in the past 10 years more than 1000 children completed the treatment after a diagnosis of Peptic ulcer diseases. Approximately 1/3 of them applied the hospital due to the upper GI bleeding. In the same period, 6.000 children have been attended in the outpatient unit with gastric-dyspeptic complains. Data might be much time higher in adult population. Due to PUD complications, more than 850 cases of Radical Gastric Surgery are performed annually in Georgia. The presented data is sharply increasing.
At the very least, it is important to start the study of PUD and provide trainees and suggestion in this field in Georgia and in whole Caucasus Region as well.
In 1999, the Georgian H. pylori study Group has been established. The leading specialists of the country joined their efforts in H. pylori research. They are attended in the leading Hospitals and laboratories in the country. The work is providing the frames of fundamental research and elaboration of technologies for peaceful goals in the fields of Medicine and Molecular Microbiology that on the other hand represent the aims and goals of ISTC. We now are planning to study features of the Clinical manifestation associated with H.pylori, elaboration of early diagnosis methods, adequate and advanced treatment application and introduction of prophylactic measures among H. pylori associated diseases. We are also planning to provide epidemiological surveys and to introduce wide educational campaign in the country on H. pylori associated diseases.
The definite results of the project will allow obtaining new data on genotyping and prevalence of H. pylori infection and diseases associated with it in the Caucasus Region, that is very important in the global context and it will help in the understanding of this health problem.
Technical approach and methodology of our research includes randomized and crossectional evaluation of patients with symptoms of PUD diseases, dyspeptic patients, PUD and malignancies; evaluation of immunological status, detection of class specific and Ag-specific antibodies towards H. pylori. A critical part of the study is the culture of H.pylori for genotyping characterization. The genotype determination will be based on cagA, vacA, babA, iceA status and also the detection of other genes using genotyping by randomized PCR. We will be able to reveal the specific antibodies response to H. pylori by the regions. Correlated between antibody titer / Specific Antigen and risk factors for peptic ulcer diseases and gastric malignancy.
The International Science and Technology Center (ISTC) is an intergovernmental organization connecting scientists from Kazakhstan, Armenia, Tajikistan, Kyrgyzstan, and Georgia with their peers and research organizations in the EU, Japan, Republic of Korea, Norway and the United States.
ISTC facilitates international science projects and assists the global scientific and business community to source and engage with CIS and Georgian institutes that develop or possess an excellence of scientific know-how.