Novel virulence factor dupA of Helicobacter pylori as an important risk determinant for disease manifestation: An overview

Helicobacter pylori(H. pylori) is a microaerophilic, Gram-negative, human gastric pathogen found usually in the mucous lining of stomach. It infects more than 50% of the world's population and leads to gastroduodenal diseases. The outcome of disease depends on mainly three factors: Host genetics, environment and bacterial factors. Among these, bacterial virulence factors such ascagA,vacAare well known for their role in disease outcomes. However, based on the global epidemiological results, none of the bacterial virulence (gene) factors was found to be associated with particular diseases like duodenal ulcer (DU) in all populations. Hence, substantial importance has been provided for research in strain-specific genes outside thecagpathogenicity island, especially genes located within the plasticity regions.dupAfound within the plasticity regions was first demonstrated in 2005 and was proposed for duodenal ulcer development and reduced risk of gastric cancer in certain geographical regions. Due to the discrepancies in report from different parts of the world in DU development related toH. pylorivirulence factor,dupAbecame an interesting area of research in elucidating the role of this gene in the disease progression. In this review, we shed light on the detailed information available on the polymorphisms indupAand their clinical relevance. We have critically appraised several pertinent studies ondupAand discussed their merits and shortcomings. This review also highlightsdupAgene as an important biomarker for DU in certain populations.