What exists beyond cag A and vacA? Helicobacter pylori genes in gastric diseases

Helicobacter pylori(H. pylori) infection is present in more than half the world’s population and has been associated with several gastric disorders, such as gastritis, peptic ulceration, and gastric adenocarcinoma.The clinical outcome of this infection depends on host and bacterial factors where H. pylori virulence genes seem to play a relevant role. Studies of cag A and vac A genes established that they were determining factors in gastric pathogenesis. However, there are gastric cancer cases that are cag A-negative. Several other virulence genes have been searched for, but these genes remain less well known that cag A and vac A. Thus, this review aimed to establish which genes have been suggested as potentially relevant virulence factors for H. pylori-associated gastrointestinal diseases. We focused on the cag-pathogenicity island, genes with adherence and motility functions, and ice A based on the relevance shown in several studies in the literature.