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Background and Aims:  The 3′ region of the cagA gene, the most well‐known virulence factor of Helicobacter pylori, contains Glu‐Pro‐Ile‐Tyr‐Ala (EPIYA) motifs. Four segments flanking the EPIYA motifs, EPIYA‐A, ‐B, ‐C, or ‐D, were reported to play important roles in H. pylori‐related gastroduodenal pathogenesis. The aim was to determine the roles of EPIYA segments in gastroduodenal pathogenesis in an Iranian population.

Methods:  A total of 92 cagA‐positive Iranian strains isolated from dyspepsia patients with non‐ulcer dyspepsia (n = 77), peptic ulcer (n = 11) and gastric cancer (n = 4) were studied. The EPIYA motif genotyping was determined by polymerase chain reaction and sequencing.

Results:  A total of 86 (93.5%) strains had three copies of EPIYA (ABC type), three (3.3%) had four copies (ABCC type) and three (3.3%) had two copies (AB type). The alignment of the deduced protein …