幽门螺杆菌感染时宿主免疫应答的特征

幽门螺杆菌感染可通过各种致黏膜炎症信号诱导宿主产生较强的免疫反应,但宿主免疫应答非但不能有效地清除感染,反而促进炎症反应而导致病情的加剧。本文综述了幽门螺杆菌感染所致宿主免疫应答以及该菌长期定居胃黏膜和致炎症的机制。     

幽门螺杆菌感染治疗的新靶位

抗生素治疗幽门螺杆菌感染面临着细菌耐药性的威胁,研究该细菌未知基因的功能,寻找新的抗菌靶,将为预防和治疗幽门螺杆菌感染开辟新途径。将机体适应性免疫应答运用于幽门螺杆菌感染的治疗,亦有广阔前景。     

氧化应激与幽门螺杆菌感染相关性胃炎

幽门螺杆菌(Helicobacter pylori,H.pylori)是一种选择性定植于胃上皮细胞的革兰氏阴性菌,是一种广泛传染的病原菌,也是诱导产生慢性胃炎的主要因素之一。近年来研究表明幽门螺杆菌感染诱导机体产生氧化应激反应,并通过各种逃逸机制避免被杀灭。幽门螺杆菌能不断刺激中性粒细胞和巨噬细胞表达活性氧和活性氮,导致体内活性氧和活性氮的过度积累,致使细胞的凋亡和胃粘膜损伤的加剧,这是导致胃炎发生及加重的重要因素。本文对幽门螺杆感染引起氧化应激反应的研究进展作简要综述。     

幽门螺杆菌逃逸宿主免疫应答机制

幽门螺杆菌(Helicobacter pylori,H.pylori)感染引起机体强的胃粘膜免疫应答,机体却无法对其进行完全根除,表明幽门螺杆菌具有逃避或破坏宿主免疫应答的特性。影响H.pylori逃避或破坏宿主免疫应答的因素或途径有很多,如肽聚糖的结构性修饰、H.pylori形态的改变、脂多糖抗原表位变化、IV型分泌系统、VacA和Treg细胞的免疫抑制作用、通过抑制吞噬细胞的吞噬作用和引起吞噬细胞的凋亡等等,本文就此作一综述,为以后对H.pylori的防御和治疗提供新的线索。     

幽门螺杆菌热休克蛋白A基因的克隆、表达及免疫原性研究

幽门螺杆菌的感染可诱发人体产生胃炎和消化性溃疡,其组成成分热休克蛋白Ａ（ＨｓｐＡ）可刺激机体产生保护性的免疫反应。用ＰＣＲ方法从幽门螺杆菌的染色体ＤＮＡ上扩增出ＨｓｐＡ基因片段,将其插入原核表达载体ｐＥＴ２２ｂ（＋）中,并在ＢＬ２１（ＤＥ３）大肠杆菌表达。经测序ＨｓｐＡ基因片段有３５４ｂｐ组成,可编码１１８个氨基酸残基的多肽。ＳＤＳＰＡＧＥ和免疫印迹分析检测发现,ＨｓｐＡ基因表达的蛋白质分子量约为１５ｋＤ,并证实该重组蛋白质可以被幽门螺杆菌感染阳性患者的血清所识别,同时将其免疫小鼠可刺激机体产生抗该重组蛋白质的抗体。ＨｓｐＡ有可能作为一种有效的蛋白质疫苗用于幽门螺杆菌感染的预防和治疗。     

表达HBHA和hIL-12融合蛋白的重组耻垢分枝杆菌在小鼠体内诱导的免疫应答及保护力

目的:测定表达肝素结合血凝素(HBHA)和人白细胞介素12(hIL-12)融合蛋白的重组耻垢分枝杆菌在小鼠体内诱导产生的免疫应答及对结核分枝杆菌感染的保护作用。方法:将表达HBHA和hIL-12融合蛋白的重组耻垢分枝杆菌采用同源加强免疫的方法免疫小鼠,检测小鼠外周血中IFN-γ、IL-2和IL-12的表达水平;用结核分枝杆菌感染免疫小鼠,检测小鼠肺部荷菌量和组织病理变化。结果:表达HBHA和hIL-12融合蛋白的重组耻垢分枝杆菌诱导小鼠产生以IFN-γ、IL-2分泌量增加为主的Th1型免疫应答,并能有效减少感染小鼠肺部结核分枝杆菌的荷菌量和病理损伤。结论:表达HBHA和hIL-12融合蛋白的重组耻垢分枝杆菌免疫小鼠可诱导产生与卡介苗相当的保护作用,可能成为控制结核病的有效疫苗。     

幽门螺杆菌疫苗诱导的免疫保护反应及临床试验研究进展

幽门螺杆菌(Helicobacter pylori,Hp)是一种微需氧、寄生于胃黏膜表面的革兰阴性致病菌,可导致各种不同的疾病,如慢性活动性胃炎、胃和十二指肠溃疡,甚至包括胃黏膜相关淋巴样组织(mucosa-associated lymphoid tissue,MALT)淋巴瘤和胃腺癌等恶性疾病。目前根除Hp主要依靠包括2种抗生素、铋剂和质子泵抑制剂(proton pumpinhibitors,PPI)在内的四联疗法。随着Hp耐药性的增强,研发Hp疫苗成为防治Hp感染的新途径。Hp疫苗能够诱导机体产生抗原特异性血清IgG和黏膜sIgA体液免疫反应以及抗原特异性CD4+T细胞免疫反应等的有效免疫保护反应。     

NKG2D免疫受体及其配体的作用

受到感染或损伤的细胞通过中间受体将信号传导至机体的免疫系统,NKG2D即是这样一种典型的具有较高免疫原性的免疫受体,它的主要作用是传导受损伤细胞产生的信号,诱导机体产生免疫应答。该文总结了近期关于NKG2D和其配体的多样性,以及NKG2D和其配体在信号传导,刺激免疫细胞产生,肿瘤细胞的监督和疾病预防方面的新发现。     

幽门螺杆菌感染免疫逃逸机制的研究

研制有效的幽门螺杆菌疫苗,是防治该菌感染的有效途径。本文综述幽门螺杆菌感染的免疫逃逸机制的研究进展,以便深入了解幽门螺杆菌慢性感染的机制,为研制疫苗提供新的思路。     

流感病毒感染的模式识别及下游相关信号通路

流感病毒(influenza virus)轻症感染可由机体免疫系统清除,但重症感染则诱发肺脏免疫损伤。流感病毒的病原体相关分子模式(pathogen-associated molecular patterns,PAMPs)可被位于细胞膜、细胞器膜及胞质内的重要模式识别受体(pattern recognition receptors,PRRs)介导识别,活化一系列激酶及转录因子,诱导促炎细胞因子和趋化因子的表达、成熟和分泌,进一步激活天然免疫及获得性免疫应答细胞,介导炎症反应和诱导免疫病理损伤。PRRs是研究天然免疫应答启动机制及抑制重症感染诱导免疫病理损伤的重要靶点。现就Toll样受体(toll-like receptors,TLRs)中的TLR3、TLR7/8、TLR4、RIG-I样受体(RIG-I like receptors,RLRs)和NOD样受体(NOD-like receptor,NLR)在流感病毒感染中的识别及下游信号通路在免疫病理损伤中的作用机制作一综述。     

Helicobacter pylori Immunology and Vaccines

Helicobacter pylori infection causes chronic gastritis, peptic ulcer, and gastric cancer. Colonization of H. pylori in the stomach activates Toll-like and Nod-like receptors to induce not only innate immunity but also adaptive Th1 responses against this organism. Adaptive Th1 response is not sufficient to clear this organism and, as a result, the infection persists. Insufficient adaptive immunity can be explained by poor activation of Toll-like receptors, suppressive effects of bacterial factors, and induction of regulatory T-cell responses. Significant progress in the understanding of innate and adaptive immunity against H. pylori was made during the past year. Recent findings in the fields of vaccines for H. pylori are also reviewed.     

Inflammation, immunity, and vaccine development for Helicobacter pylori

The immune response to Helicobacter pylori entails both innate effectors and a complex mix of Th1, Th17, and Treg adaptive immune responses. The clinical outcome of infection may well depend to a large degree on the relative balance of these responses. Vaccination with a wide range of antigens, adjuvants, and delivery routes can produce statistically significant reductions in H. pylori colonization levels in mice, though rarely sterilizing immunity. Whether similar reductions in bacterial load can be achieved in humans, and whether they would be clinically significant, is still unclear. However, progress in understanding the role of Th1, Th17, and most recently Treg cells in protection against H. pylori infection provides reason for optimism.     

Caspase-1 has both proinflammatory and regulatory properties in Helicobacter infections, which are differentially mediated by its substrates IL-1β and IL-18

The proinflammatory cysteine protease caspase-1 is autocatalytically activated upon cytosolic sensing of a variety of pathogen-associated molecular patterns by Nod-like receptors. Active caspase-1 processes pro-IL-1β and pro-IL-18 to generate the bioactive cytokines and to initiate pathogen-specific immune responses. Little information is available on caspase-1 and inflammasome activation during infection with the gastric bacterial pathogen Helicobacter pylori. In this study, we addressed a possible role for caspase-1 and its cytokine substrates in the spontaneous and vaccine-induced control of Helicobacter infection, as well as the development of gastritis and gastric cancer precursor lesions, using a variety of experimental infection, vaccine-induced protection, and gastric disease models. We show that caspase-1 is activated and IL-1β and IL-18 are processed in vitro and in vivo as a consequence of Helicobacter infection. Caspase-1 activation and IL-1 signaling are absolutely required for the efficient control of Helicobacter infection in vaccinated mice. IL-1R(-/-) mice fail to develop protective immunity but are protected against Helicobacter-associated gastritis and gastric preneoplasia as a result of their inability to generate Helicobacter-specific Th1 and Th17 responses. In contrast, IL-18 is dispensable for vaccine-induced protective immunity but essential for preventing excessive T cell-driven immunopathology. IL-18(-/-) animals develop strongly accelerated pathology that is accompanied by unrestricted Th17 responses. In conclusion, we show in this study that the processing and release of a regulatory caspase-1 substrate, IL-18, counteracts the proinflammatory activities of another caspase-1 substrate, IL-1β, thereby balancing control of the infection with the prevention of excessive gastric immunopathology.     

Importance of the host genetic background on immune responses to Helicobacter pylori infection and therapeutic vaccine efficacy

In order to investigate the role of host factors in Helicobacter pylori infection and immunity, two different strains of inbred mice, C57BL/6 and BALB/c, were infected with a standard H. pylori strain, SS1. A month later, infected mice were immunized orally with whole-cell lysates of H. pylori SS1 and cholera toxin on days 1, 3, 6, 30, and 54. Ten days after the last immunization, mice were sacrificed and the stomach was collected to assess H. pylori colonization density by quantitative culture. H. pylori SS1 colonization was significantly greater in C57BL/6 than in BALB/c (P<0.02 and P<0.003 at 2 and 13 weeks post-inoculation, respectively). Colonization in C57BL/6 persisted at equivalent levels for 13 weeks but the colonization density in BALB/c decreased significantly during this period. In contrast to the pattern of bacterial colonization, antibody responses following H. pylori SS1 infection were greater in BALB/c than in C57BL/6, suggesting that host factors may modulate the immune responses to H. pylori infection. Following therapeutic immunization, H. pylori colonization in BALB/c mice was also significantly reduced (P<0.03), while no significant differences in bacterial density were observed in C57BL/6. These observations collectively demonstrate the great importance of host factors in H. pylori infection and the development of effective immune responses.     

Evaluation of therapeutic efficacy of adjuvant Helicobacter pylori whole cell sonicate in mice with chronic H. pylori infection

Successful prophylactic administration of Helicobacter pylori whole cell sonicate (WCS) plus complete Freund's adjuvant (CFA) or aluminum hydroxide (ALM) against subsequent H. pylori infection was reported recently. Here we tested the effect of WCS plus TiterMax Gold (TMX) or ALM in mice with chronic H. pylori infection. Mice with chronic (18 weeks) H. pylori infection were injected intraperitoneally with H. pylori (Sydney strain) WCS plus ALM or TMX once weekly for three times. The number of colonizing H. pylori in the stomach, IgG1 and IgG2a levels, and local inflammatory status were determined after therapeutic immunization. H. pylori specific IgG1, but not IgG2a, was significantly induced in mice immunized with H. pylori WCS plus TMX or ALM. Immunization did not result in reduction of bacterial count or recruiting inflammatory cells to the stomach. Adjuvant H. pylori WCS resulted in induction of CD4+ Th2 cell-mediated immunity although it did not reduce bacterial density in mice with chronic H. pylori infection. Our results implied that CD4+ Th1 cell-mediated immunity, rather than Th2 cell dominant immunity, might play a role in reducing the number of bacteria in chronic H. pylori infection.     

Conventional, regulatory, and unconventional T cells in the immunologic response to Helicobacter pylori

Infection by the gastroduodenal pathogen Helicobacter pylori elicits a complex immunologic response in the mucosa involving neutrophils, plasma cells, eosinophils, and lymphocytes, of which T cells are the principal orchestrators of immunity. While so-called classical T cells (e.g. T-helper cells) that are activated by peptide fragments presented on antigen-presenting cells have received much attention in H. pylori infection, there exists a diverse array of other T cell populations that are potentially important for the outcome of the ensuing immune response, some of which have not been extensively studied in H. pylori infection. Pathogen-specific regulatory T cells that control and prevent the development of immunopathology associated with H. pylori infection have been investigated, but these cells can also benefit the bacterium in helping to prolong the chronicity of the infection by suppressing protective immune responses. An overlooked T cell population, the more recently described Th17 cells, may play a role in H. pylori-induced inflammation, due to triggering responses that ultimately lead to the recruitment of polymorphs, including neutrophils. The so-called innate or unconventional T cells, that include two conserved T cell subsets expressing invariant antigen-specific receptors, the CD1d-restricted natural killer T cells which are activated by glycolipids, and the mucosal-associated invariant T cells which play a role in defense against orally acquired pathogens in the intestinal mucosa, have only begun to receive attention. A greater knowledge of the range of T cell responses induced by H. pylori is required for a deeper understanding of the pathogenesis of this bacterium and its ability to perpetuate chronic infection, and could reveal new strategies for therapeutic exploitation.     

Negative selection of T cells by Helicobacter pylori as a model for bacterial strain selection by immune evasion.

The majority of humans infected with Helicobacter pylori maintain a lifelong infection with strains bearing the cag pathogenicity island (PAI). H. pylori inhibits T cell responses and evades immunity so the mechanism by which infection impairs responsiveness was investigated. H. pylori caused apoptotic T cell death, whereas Campylobacter jejuni did not. The induction of apoptosis by H. pylori was blocked by an anti-Fas Ab (ZB4) or a caspase 8 inhibitor. In addition, a T cell line with the Fas rendered nonfunctional by a frame shift mutation was resistant to H. pylori-induced death. H. pylori strains bearing the cag PAI preferentially induced the expression of Fas ligand (FasL) on T cells and T cell death, whereas isogenic mutants lacking these genes did not. Inhibiting protein synthesis blocked FasL expression and apoptosis of T cells. Preventing the cleavage of FasL with a metalloproteinase inhibitor increased H. pylori-mediated killing. Thus, H. pylori induced apoptosis in Fas-bearing T cells through the induction of FasL expression. Moreover, this effect was linked to bacterial products encoded by the cag PAI, suggesting that persistent infection with this strain may be favored through the negative selection of T cells encountering specific H. pylori Ags.     

Colonization of Helicobacter pylori in the gastric mucosa of Mongolian gerbils

Helicobacter pylori was orally inoculated into Mongolian gerbils. The organisms were able to colonize in the gastro-mucosal layer of the gerbils, especially in those gerbils which had mucosal lesions caused by indomethacin treatment. The pathological changes developed by H. pylori infection were restricted to the stomachs, and only slightly inflammatory cells were observed.     

Imunosuppression by a corticosteroid fails to exacerbate Helicobacter pylori infection in a mouse model of gastric colonization

Helicobacter pylori can colonize the human stomach for prolonged periods of time, and this colonization uniformly leads to the development of chronic active gastritis. In a small percentage of individuals, gastric pathology progresses to peptic ulceration or more rarely certain gastric cancers. In addition to non-specific inflammation, specific systemic and local immunity develops in response to gastric colonization by this pathogen. However, these responses combined appear inadequate for eliminating H. pylori from the gastric mucosa. This is also the case in a mouse model of gastric colonization by H. pylori. In the present study, we attempted to determine whether the mammalian host response to infection with H. pylori exerts any overt antibacterial effects. To this end we examined H. pylori colonization in normal mice, and mice immunosuppressed by treatment with a corticosteroid. Despite obvious suppression of the immune response in the latter mice, H. pylori burdens remained similar in both groups after three months of colonization. This suggests that the murine host response, at least, exerts little obvious protection against H. pylori colonization.     

Effect of Helicobacter pylori eradication on extent of duodenal gastric metaplasia and grade of gastritis

The extent of the regression of duodenal gastric metaplasia (DGM) after the eradication of Helicobacter pylori infection is controversial. Therefore, we decided to assess the degree of DGM before, sex weeks and one year after H. pylori eradication. 105 consecutive Helicobacter pylori positive patients with endoscopically proven duodenal ulcer, with DGM and Helicobacter pylori infection were recruited for this study. The diagnosis of Helicobacter pylori infection was based on CLO-test and histology, and DGM was assessed on four bulb biopsies taken before, sex weeks and one year after Helicobacter pylori eradication. Histological assessment of Helicobacter pylori associated gastritis was performed according to the Sydney classification. Follow up study on 98 patients before, six weeks and one year after the eradication of Helicobacter pylori showed that the mean extent of DGM did not change significantly after eradication and did not differ when compared with 14 patients with persisting infection. Our results show that the inflammatory process related to Helicobacter pylori does not play the main role in the development of DGM.