Vacuolating cytotoxin production by Helicobacter pylori isolates from peptic ulcer, atrophic gastritis and gastric carcinoma patients.

OBJECTIVE: We investigated the production of vacuolating cytotoxin by Helicobacter pylori isolates from patients with peptic ulcer, atrophic gastritis or gastric carcinoma in order to examine the pathophysiological significance of vacuolating cytotoxin in these diseases.
METHODS: H. pylori was isolated from 18 patients (five with peptic ulcers, seven with atrophic gastritis and six with gastric carcinoma). Culture supernatants of H. pylori isolates, concentrated 20-fold, were serially diluted and then analyzed for cytotoxin activity semi-quantitatively using A431 cells as indicator cells. The relative activity of vacuolating cytotoxin was defined according to the maximum dilution.
RESULTS: Cytotoxin production was observed in two out of five, six out of seven and six out of six isolates from peptic ulcer, atrophic gastritis and gastric carcinoma patients, respectively. The mean relative activity was calculated as 0.80, 2.71 and 2.50 in
CONCLUSION: These results suggest that vacuolating cytotoxin-producing H. pylori is strongly associated with both atrophic gastritis and gastric carcinoma.