TheHelicobacter pyloriimmunodominant protein, CagA, is associated with severe gastritis and carcinoma. Injection of CagA into gastric epithelial cells by type IV secretion leads to actin-cytoskeletal rearrangements and cell scattering. CagA has been reported to have no role in the induction of transcription factor NF-κB and IL-8, which are crucial determinants for chronic inflammation. Here, we provide several lines of evidence showing that CagA is able to induce IL-8 in a time- and strain-dependent manner. We also show that by exchanging specificcagAgenes, high IL-8-inducingH. pyloristrains could be converted into low inducing strains and vice versa. Our results suggest that IL-8 release induced by CagA occurs via a Ras→Raf→Mek→Erk→NF-κB signaling pathway in a Shp-2- and c-Met-independent manner. Thus, CagA is a multifunctional protein capable of effecting both actin remodeling and potentiation of chemokine release.

More than fifty percent of the world’s population is infected with Helicobacter pylori. Chronic infection with the Gram-negative pathogen is associated with the development of peptic ulcers and is linked to an increased risk of gastric cancer. H. pylori secrete many proteinaceous factors that are important for initial colonization and subsequent persistence in the host stomach. One of the major protein toxins secreted by H. pylori is the bipartite toxin, Vacuolating cytotoxin A (VacA). After secretion from the bacteria via a type V autotransport secretion system, the two VacA subunits (p33 and p55) enter host cells and cause severe “vacuolation”. This is the accumulation of large vesicles that possess hallmarks of both late endosomes and early lysosomes. The development of “vacuoles” has been attributed to the formation of VacA anion selective channels in membranes. Apart from its vacuolating effects, it has recently become clear that VacA also directly affects mitochondrial function. Earlier studies suggested that the p33 subunit, but not the p55 subunit of VacA, could enter mitochondria to modulate organelle function. This raised the possibility that a mechanism separate from pore formation may be responsible for the effects of VacA on mitochondria, as crystallography studies and structural modeling predict that both subunits are required for a physiologically stable pore. It has also been suggested that the mitochondrial effects observed are due to indirect effects on pro-apoptotic proteins and more direct effects on mitochondrial morphology related processes. Other studies have shown that both the p55 and p33 subunits can indeed be efficiently imported into mammalian derived mitochondria raising the possibility that they could re-assemble to form a pore. Our review summarizes and consolidates the recent advances in VacA toxin research, with focus on the outstanding controversies in the field and the key remaining questions that need to be addressed.

AlthoughHelicobacter pylorihas generally been considered an extracellular pathogen, a number of in vitro infection experiments and biopsy examinations have shown that it is capable of occasionally entering mammalian host cells. Here, we characterized this entry process by using AGS cells as a host cell model. In gentamicin protection-invasion assays, the number ofH. pyloricolonies recovered was lower than that forSalmonella entericaserovar Typhimurium X22,Escherichia coliexpressing InvA, andYersinia enterocoliticaYO:9 grown at 25°C but higher than that forNeisseria gonorrhoeaeVP1 andY. enterocoliticaYO:9 grown at 37°C. At the ultrastructural level, the entry process was observed to occur via a zipper-like mechanism. InternalizedH. pyloriwas bound in tight LAMP-1-containing vacuoles in close association with condensed filamentous actin and tyrosine phosphorylation signals. Wortmannin, a potent inhibitor of phosphatidylinositol 3-kinase, and calphostin C, an inhibitor of protein kinase C, both inhibited the entry ofH. pyloriin a sensitive and dose-dependent manner; however, the level of entry was enhanced by sodium vanadate, an inhibitor of tyrosine phosphatases and ATPases. Furthermore, the cytokine tumor necrosis factor alpha antagonized the entry ofH. pyloriinto AGS cells. Collectively, these results demonstrate that the entry ofH. pyloriinto AGS cells occurs via a zipper-like mechanism which involves various host signal transduction events.

Significance: Bacteria can obtain genes from other bacteria, or the surrounding environment, by horizontal gene transfer (HGT). While it is clear that HGT is very important for microbial populations, it is not understood how HGT changes the rate or mechanisms of adaptation. In this study, we evolve populations of the bacteria Helicobacter pylori and use DNA sequencing to track the movement of HGT genes as they spread through the population. We show that HGT can help antibiotic resistance genes establish at a low frequency in a population, even in the absence of the antibiotic. We find that these HGT treatment populations flourish when treated with antibiotics, showing how HGT can potentiate adaptation to future environmental change.

Many host-adapted bacterial pathogens contain DNA methyltransferases (mod genes) that are subject to phase-variable expression (high-frequency reversible ON/OFF switching of gene expression). In Haemophilus influenzae and pathogenic Neisseria, the random switching of the modA gene, associated with a phase-variable type III restriction modification (R-M) system, controls expression of a phase-variable regulon of genes (a “phasevarion”), via differential methylation of the genome in the modA ON and OFF states. Phase-variable type III R-M systems are also found in Helicobacter pylori, suggesting that phasevarions may also exist in this key human pathogen. Phylogenetic studies on the phase-variable type III modH gene revealed that there are 17 distinct alleles in H. pylori, which differ only in their DNA recognition domain. One of the most commonly found alleles was modH5 (16% of isolates). Microarray analysis comparing the wild-type P12modH5 ON strain to a P12ΔmodH5 mutant revealed that six genes were either up- or down-regulated, and some were virulence-associated. These included flaA, which encodes a flagella protein important in motility and hopG, an outer membrane protein essential for colonization and associated with gastric cancer. This study provides the first evidence of this epigenetic mechanism of gene expression in H. pylori. Characterisation of H. pylori modH phasevarions to define stable immunological targets will be essential for vaccine development and may also contribute to understanding H. pylori pathogenesis.