Evidence map›Paper›PMID 21859954›Full record

ArticleCancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology2011

Analysis of cagA in Helicobacter pylori strains from Colombian populations with contrasting gastric cancer risk reveals a biomarker for disease severity.

John T Loh, Carrie L Shaffer, M Blanca Piazuelo, Luis E Bravo, Mark S McClain, Pelayo Correa, Timothy L Cover

Open access · greenAbstract readComparative Study
In one paragraph

Article in Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed
4.7field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 53 citations in OpenAlex.

  1. Microbiology and molecular biology reviews : MMBR · 2026
    Review
  2. Methylation Dynamics inMicroorganisms · 2026
    Article
  3. World journal of gastrointestinal oncology · 2025
    Review
  4. Genomic epidemiology ofFrontiers in microbiology · 2025
    Article
  5. TheJournal of bacteriology · 2024
    Article
  6. Article
  7. International journal of molecular sciences · 2022
    Review
  8. International journal of molecular sciences · 2020
    Review
  9. Article
  10. Precancerous Gastric Lesions withBioMed research international · 2020
    Article
  11. Role of a Stem-Loop Structure inInfection and immunity · 2019
    Article
  12. Article
  13. Article
  14. Review
  15. Genetic populations and virulence factors of Helicobacter pylori.Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases · 2018
    Review
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 2 countries.

John T LohDivision of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA.
Carrie L Shaffer
M Blanca Piazuelo
Luis E Bravo
Mark S McClain
Pelayo Correa
Timothy L Cover
Vanderbilt University · USVA Tennessee Valley Healthcare System · USUniversidad del Valle · CO

Funding

Translational Analysis CoreP30DK058404 · NIDDK · VANDERBILT UNIVERSITY MEDICAL CENTER · PI RICHARD M. PEEK · 2002 to 2026
$29.9M
Role of Iron and B-Catenin Activation in Gastric CarcinogenesisP01CA116087 · NCI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI RICHARD M. PEEK · 2009 to 2026
$27.5M
Project 3 - Molecular Signatures of Gastric Carcinogenesis in the Host Response to H. pyloriP01CA028842 · NCI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI WILSON, KEITH T. · 1985 to 2019
$15.8M
Analysis of the H. Pylori cag pathogenicity islandR01AI068009 · NIAID · VANDERBILT UNIVERSITY · PI COVER, TIMOTHY L · 2008 to 2012
$1.9M
NCI NIH HHS P01 CA028842NCI NIH HHS P01 CA116087NIAID NIH HHS R01 AI068009NIDDK NIH HHS P30 DK058404NIDDK NIH HHS PD30DK058404
6 · The paper itself

Abstract

backgroundHelicobacter pylori infection is a risk factor for the development of gastric cancer, and the bacterial oncoprotein CagA contributes to gastric carcinogenesis.

methodsWe analyzed H. pylori isolates from persons in Colombia and observed that there was marked variation among strains in levels of CagA expression. To elucidate the basis for this variation, we analyzed sequences upstream from the CagA translational initiation site in each strain.

resultsA DNA motif (AATAAGATA) upstream of the translational initiation site of CagA was associated with high levels of CagA expression. Experimental studies showed that this motif was necessary but not sufficient for high-level CagA expression. H. pylori strains from a region of Colombia with high gastric cancer rates expressed higher levels of CagA than did strains from a region with lower gastric cancer rates, and Colombian strains of European phylogeographic origin expressed higher levels of CagA than did strains of African origin. Histopathologic analysis of gastric biopsy specimens revealed that strains expressing high levels of CagA or containing the AATAAGATA motif were associated with more advanced precancerous lesions than those found in persons infected with strains expressing low levels of CagA or lacking the AATAAGATA motif.

conclusionsCagA expression varies greatly among H. pylori strains. The DNA motif identified in this study is associated with high levels of CagA expression, and may be a useful biomarker to predict gastric cancer risk. IMPACT: These findings help to explain why some persons infected with cagA-positive H. pylori develop gastric cancer and others do not.

Indexed as

AdultAntigens, BacterialBacterial ProteinsBiomarkers, TumorBiopsyBlotting, WesternCase-Control StudiesCohort StudiesColombiaDNA, BacterialFemaleFollow-Up StudiesGastric MucosaHelicobacter InfectionsHelicobacter pyloriHumansAntigens, BacterialBacterial ProteinsBiomarkers, TumorcagA protein, Helicobacter pyloriDNA, Bacterial

Identifiers

PMID21859954
PMCPMC3189306
OpenAlexW1998359242

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.