幽门螺杆菌黏附素BabA的致病性

幽门螺杆菌在人群中感染非常普遍。全世界约有三分之二人口感染了幽门螺杆菌。长期慢性幽门螺杆菌感染能诱发炎症,如慢性胃炎和溃疡,甚至恶性肿瘤(如黏膜胃癌和相关淋巴组织淋巴瘤)。吸附在胃黏膜上是幽门螺旋杆菌定植宿主和诱发炎症的第一步,在此过程中,细菌很多外膜蛋白发挥了关键作用。本文将重点论述幽门螺杆菌外膜蛋白中的血型结合黏附素(blood-group-antigen-binding adhesin, BabA),并从宿主受体分子、黏附区域晶体结构和酸适应性等方面阐述其在幽门螺杆菌致病过程中的作用。     

幽门螺杆菌感染胃组织基因芯片生物信息学分析

为探讨幽门螺杆菌感染胃组织后差异基因变化,深入分析参与疾病发生、发展的分子机制。从GEO(Gene Expression Omnibus)数据库下载幽门螺杆菌感染胃组织基因芯片数据(GSE5081),根据胃粘膜组织是否受损分组,分别比较幽门螺杆菌感染者与阴性对照组,获得差异基因并进行功能分析包括GO分析、信号通路分析,基因相互作用及基因共表达,得到重要核心基因,并通过实时定量PCR方法进行验证。结果表明:得到参与幽门螺杆菌感染后上调的44个主要基因,主要涉及的GO分析及信号通路包括免疫反应、炎症反应、抗原提呈、细胞因子通路、因子受体关联,细胞粘附分子等。研究发现核心基因CXCR4,CCL20,JAK3,TNFAIP2,PLEK,HLA-DMA,PTPRC,CXCL13,BCL2A1,并通过实时定量PCR的方法进行部分验证,CXCR4,CXCL5,CXCL2在幽门螺杆菌感染后的胃黏膜组织表达高于对照组。幽门螺杆菌感染后胃粘膜组织引起免疫反应,炎症反应,抗原提呈,因子受体关联,细胞粘附分子通路的激活。同时发现一些主要的趋化因子相关基因CXCR4,CXCL5,CXCL2,CCL20,CXCL1等,涉及增殖,炎症,免疫,凋亡基因JAK3,TNFAIP2,PLEK,HLA-DMA,PTPRC,BCL2A1等的表达上调,并实时定量PCR验证部分相关基因的表达。这些结果为从分子网络机制层面上认识幽门螺杆菌感染提供分析思路及基础。     

iNOS基因与幽门螺杆菌相关胃癌关系的研究进展

幽门螺杆菌已被世界卫生组织列为胃癌的第一类致癌物。毒力因子、宿主遗传因素和环境因素共同影响着幽门螺杆菌的致胃癌作用。近年来的研究表明,宿主的iNOS基因多态性可能在胃癌的发生、发展中起到一定作用。文章将就该方面的研究进展进行综述。     

幽门螺杆菌

幽门螺杆菌是一种呈螺旋状或S形、微需氧的革兰阴性杆菌,专一性定居于人胃,是人类慢性胃炎、消化性溃疡、胃癌和胃MALT淋巴瘤的主要病因。幽门螺杆菌在人群中的感染率非常高,达40%~90%,通常在儿童期感染,而且一经感染,若不根除治疗,将终生携带,携带者是幽门螺杆菌的传染源。幽门螺杆菌感染的诊断有侵入性方法如细菌培养、快速脲酶试验等,亦有非侵入性方法如脲呼吸试验、抗体检测等。幽门螺杆菌感染引起胃-十二指肠疾病的机制涉及细菌本身毒力因子、细菌黏附与定植、宿主炎症/免疫反应、氧化应激、细胞的增殖与凋亡等,情况复杂。迄今,幽门螺杆菌的确切致病机制未有定论。幽门螺杆菌相关疾病的治疗普遍采用根除细菌的抗菌疗法。预防幽门螺杆菌感染以及治疗幽门螺杆菌相关疾病的疫苗正在研究中。     

关于幽门螺杆菌疫苗及其相关性研究的报告

幽门螺杆菌感染是慢性胃炎、消化性溃疡的主要致病因素,并且与胃癌的发生有关。本文报告了幽门螺杆菌疫苗及其相关性研究的成果,包括细菌的分离培养、毒力基因分型、抗原的纯化及单克隆抗体的研制、动物模型的建立及其基因工程株的构建等。     

幽门螺杆菌感染与胃癌相关基因的筛选及预后分析

目的通过分析幽门螺杆菌感染胃黏膜组织和胃癌细胞系后的差异基因变化,并在癌症基因组图谱(The Cancer Genome Atlas,TCGA)数据库和肿瘤基因芯片(Oncomine)数据库进行验证,探究幽门螺杆菌导致胃癌发生、发展的分子机制。方法分析基因表达汇编(Gene Expression Omnibus,GEO)数据库幽门螺杆菌感染相关芯片集GSE5081与GSE70394,绘制维恩图查找幽门螺杆菌感染后共同上调的差异基因。对共同上调的差异基因进行功能富集分析。通过TCGA和Oncomine数据库验证差异基因在胃癌中的表达。利用Kaplan-Meier Plotter数据库和GEPIA数据库分析差异基因表达高低与胃癌患者预后是否存在相关性。结果通过差异基因筛选和维恩分析,两个芯片集共有21个共同上调差异基因。GO分析发现共同上调差异基因主要富集在对细菌来源分子的反应、趋化因子CXCR受体结合、中性粒细胞趋化作用等相关的基因功能上;KEGG通路主要富集在癌症通路、TNF信号通路、趋化因子信号通路等。STRING以及PPI数据库分析发现21个基因中PRDM1、IL10、NRP1、BIRC3、GNG13、CXCL1、CXCL2、CXCL3、CXCL8基因存在有网络关系,属于关键枢纽基因。通过TCGA和Oncomine数据库筛选及验证,发现在胃癌组织中NRP1、CXCL1、CXCL8基因明显上调,结果差异有统计学意义(TCGA数据库中,三者P值均小于0.05,Oncomine数据库中,NRP1:t=4.607,P0.01;CXCL1:t=5.854,P0.01;CXCL8:t=5.316,P0.01)。在Kaplan-Meier Plotter数据库(210615-at芯片:P0.01;210510-s-at芯片:P0.01;212298-at芯片:P0.01)以及GEPIA数据库(P0.01)两个数据库中,NRP1的高表达均与胃癌的预后负相关。结论不同的数据库均显示NRP1、CXCL1、CXCL8三个基因与幽门螺杆菌感染相关,同时在胃癌中高表达,并且NRP1的高表达与胃癌的不良预后相关,这些结果为进一步探究幽门螺杆菌导致胃癌发生、发展的分子机制提供了重要基础。     

益生菌抑制幽门螺杆菌的作用机制及研究进展

幽门螺杆菌在胃部疾病的发病过程中起着重要作用,是导致胃炎、胃溃疡,甚至胃癌的关键因素之一。随着胃部疾病患者幽门螺杆菌阳性检出率的不断升高,人们对于胃病和幽门螺杆菌的相关性研究也有了一定进展。如今,对于幽门螺杆菌阳性患者根除治疗的必要性,以及抗生素治疗耐药性等问题已引起广泛关注。在这种情况下,益生菌作为相对安全的天然微生物,在抑制幽门螺杆菌并促进胃部健康的益生功能方面具有重要的研究潜力。本综述对幽门螺杆菌的致病机理、不同基因分型的致病程度等方面进行了总结,并对益生菌抑制幽门螺杆菌的机制进行了探讨。建议在治疗幽门螺杆菌感染时,应与常规的治疗手段结合应用,不仅会增加幽门螺杆菌的根除率,还能减少治疗相关的副作用。     

幽门螺杆菌与胃溃疡及胃癌的发病有关

幽门螺杆菌与胃溃疡及胃癌的发病有关１９８２年,Ｗａｒｒｅｎ和Ｍａｓｈａｌｌ首次从人胃粘膜中分离出幽门螺杆菌（ｈｅｌｉｃｏｂａｃｔｅｒｐｙｌｏｒｉ,ＨＰ）。目前人们已普遍认为幽门螺杆菌感染是引起胃和十二指肠粘膜炎症的重要原因之一,抗螺杆菌的药物也已普遍...     

全国中西医整合治疗幽门螺杆菌相关“病-证”共识

正幽门螺杆菌(Helicobacter pylori,H.pylori)与慢性胃炎、消化性溃疡、胃癌及胃黏膜相关淋巴组织(MALT)淋巴瘤的发生发展密切相关。1994年幽门螺杆菌被世界卫生组织列为胃癌发生的I类致癌因子,胃癌发生与幽门螺杆菌感染密切相关,根除幽门螺杆菌可降低胃癌的发生率。中国是幽门螺杆菌高感染率国家,同时也是胃癌高发国家,幽门螺杆菌感染不仅是一个临床问题,更是一个公     

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。     

Subtractive hybridization analysis of gastric diseases-associated Helicobacter pylori identifies peptidyl-prolyl isomerase as a potential marker for gastric cancer

Helicobacter pylori, a microaerophilic Gram-negative bacterium, is known to cause chronic gastritis, peptic ulcer and gastric cancer. Genes that are present in certain isolates may determine strain-specific traits such as disease association and drug resistance. In order to understand the pathogenic mechanisms of gastric diseases, identify molecular markers of the diseases associated with H. pylori strains and provide clues for target treatment of H. pylori-related diseases, a subtracted DNA library was constructed from a gastric cancer-associated H. pylori strain and a superficial gastritis-associated H. pylori strain by suppression subtractive hybridization. The presence of gastric cancer-specific genes was identified by dot blot hybridization, DNA sequencing and PCR-based screening. Twelve gastric cancer-specific high-copy genes and nine low-copy genes were found in gastric cancer compared with the superficial gastritis strain. These genes were confirmed by PCR analysis of H. pylori isolates. Notably, peptidyl-prolyl cis-trans isomerase (PPIase) was detected positively in 11 out of 22 (50%) gastric cancer-associated H. pylori strains. In contrast, <24% of the H. pylori strains from superficial gastritis showed positive results. Given the potential role of PPIases in cell growth, apoptosis and oncogenic transformation, our results suggest that PPIase may represent a novel marker and potential therapeutic target for gastric cancer.     

Helicobacter pylori as a class I carcinogen: physiopathology and management strategies

The gram-negative bacterium Helicobacter pylori is known as a persistent colonizer of the human stomach, and probably less known is that it is also involved in extraintestinal diseases. Public awareness of its contribution in the development of gastric cancer is less than 15 years old. The efficacy of the current therapies based on antibiotics against H. pylori has been limited by difficulties such as antibiotic resistance and recurrence. As a consequence, the development of promising vaccines was prompted as the best preventive measure. Unfortunately, so far vaccines failed the transition from animal models to human trials. This keynote presentation is to provide a bird's eye view of H. pylori-related gastric diseases, including gastric cancer, with a synthesis of the molecular mechanisms involved, and an exhaustive presentation and discussion of the current therapeutic guidelines and future strategies for prevention or therapy.     

Helicobacter pylori: Gastric Cancer and Extragastric Intestinal Malignancies

The greatest challenge in Helicobacter pylori-related diseases continues to remain prevention of gastric cancer. New evidence supports the beneficial effect of H.?pylori eradication not only on prevention of gastric cancer but also on the regression of preneoplastic conditions of the gastric mucosa. Concerning early detection of gastric cancer there are still no adequate means and there is urgent need to define appropriate markers, for example, by genome-wide research approaches. Currently, the best available method is the "serologic" biopsy based on pepsinogen I and the pepsinogen I/II ratio for identification of patients with severe gastric atrophy at increased risk for gastric cancer development. The treatment of early gastric cancer by endoscopic techniques can be performed safely and efficiently, but patients need meticulous follow-up for detection of metachronous lesions. In case of advanced disease, laparoscopically assisted surgical procedures are safe and favorable compared to open surgery. Two phase III trials support the role of adjuvant systemic treatment with different regimens. Unfortunately, there is still only slow progress in the development of palliative treatment regimens or modification of the existing therapy protocols. There is accumulating evidence for a role of H.?pylori infection also in colorectal carcinogenesis. Seropositive individuals are at higher risk for the development of colorectal adenomas and consequently adenocarcinomas of this anatomical region. This phenomenon can partly be attributed to the increase of serum gastrin as response to atrophic changes of the gastric mucosa.     

A distinctive set of genes is upregulated during the inflammation-carcinoma sequence in mouse stomach infected by Helicobacter felis.

Helicobacter pylori infects over half the population worldwide and is a leading cause of chronic gastritis and gastric cancer. However, the mechanism by which this organism induces inflammation and carcinogenesis is not fully understood. In the present study we used insulin-gastrin (INS-GAS) transgenic mice that fully develop gastric adenocarcinoma after infection of H. pylori-related Helicobacter felis. Histological examination revealed that more than half of those mice developed invasive adenocarcinoma after 8 months of infection. These carcinomas were stained by NCC-ST-439 and HECA-452 that recognize 6-sulfated and non-sulfated sialyl Lewis X. Lymphocytic infiltration predominantly to submucosa was observed in most H. felis-infected mice, and this was associated with the formation of peripheral lymph node addressin (PNAd) on high endothelial venule (HEV)-like vessels detected by MECA-79. Time-course analysis of gene expression by using gene microarray revealed upregulation of several inflammation-associated genes including chemokines, adhesion molecules, surfactant protein D (SP-D), and CD74 in the infected stomach. Immunohistochemical analysis demonstrated that SP-D is expressed in hyperplasia and adenocarcinoma whereas CD74 is expressed in adenocarcinoma in situ and invasive carcinoma. These results as a whole indicate that H. felis induces HEV-like vessels and inflammation-associated chemokines and chemokine receptors, followed by adenocarcinoma formation.     

Functional and intracellular signaling differences associated with the Helicobacter pylori AlpAB adhesin from Western and East Asian strains

Following adhesion of Helicobacter pylori to gastric epithelial cells, intracellular signaling leads to cytokine production, which causes H. pylori-related gastric injury. Two adjacent homologous genes (alpA and alpB), which encode H. pylori outer membrane proteins, are thought to be associated with adhesion and cytokine induction. We co-cultured gastric epithelial cells with wild type H. pylori strains and their corresponding alpA/alpB-deleted mutants (DeltaalpAB). Results were confirmed by complementation. Flow cytometry confirmed that AlpAB was involved in cellular adhesion. Deletion of alpAB reduced interleukin (IL)-6 induction in gastric epithelial cells. Deletion of alpAB reduced IL-8 induction with East Asian but not with Western strains. All AlpAB-positive strains tested activated the extracellular signal-regulated kinase, c-Fos, and cAMP-responsive element-binding protein. Activation of the Jun-N-terminal kinase, c-Jun, and NF-kappaB was exclusive to AlpAB from East Asian strains. DeltaalpAB mutants poorly colonized the stomachs of C57BL/6 mice and were associated with lower mucosal levels of KC and IL-6. Our results suggest that AlpAB may induce gastric injury by mediating adherence to gastric epithelial cells and by modulating proinflammatory intracellular signaling cascades. Known geographical differences in H. pylori-related clinical outcomes may relate to differential effects of East Asian and Western types of AlpAB on NF-kappaB-related proinflammatory signaling pathways.     

MDR1 C3435T polymorphism has no influence on developing Helicobacter pylori infection-related gastric cancer and peptic ulcer in Japanese

AIMS: P-glycoprotein, the gene product of multidrug-resistant transporter-1 (MDR1), confers multidrug resistance against antineoplastic agents but also affects the kinetic disposition of some drugs and carcinogens. MDR1 C3435T polymorphism influences the development of colon cancer and adult acute myeloid leukemia by the association with transporting carcinogen. The aim of this study was to clarify the association of MDR1 C3435T polymorphism with susceptibility to gastric cancer and peptic ulcers in patients with Japanese H. pylori infection. MAIN METHODS: We assessed the MDR1 C3435T polymorphism in H. pylori-positive gastritis alone patients (n=150), gastric cancer (n=292), gastric ulcer (n=215), and duodenal ulcer (n=163) and H. pylori-negative subjects (n=168) as control by a PCR-based method. KEY FINDINGS: No significant difference existed in frequencies of MDR1 C3435T polymorphisms between H. pylori-negative controls and H. pylori-positive gastritis alone patients. Moreover, MDR1-3435 T allele carriage didn't affect the risk of gastric cancer or peptic ulcer development. The age- and sex-adjusted odds ratios (ORs) of MDR1 3435 T allele carriers relative to the C/C genotype group for gastric cancer, gastric ulcer and duodenal ulcer risk were 0.96 (95%CI: 0.56-1.66), 1.16 (95%CI: 0.72-1.84) and 1.00 (95%CI: 0.61-1.62), respectively. SIGNIFICANCE: In this preliminary data, the association with MDR1 C3435T polymorphism and risk for developing H. pylori-related gastric cancer and peptic ulcer in Japanese was low. P-glycoprotein might not be involved in the carcinogenesis of H. pylori-related gastric cancer.     

胃黏膜菌群与幽门螺杆菌的相关性

除幽门螺杆菌之外,胃黏膜内还定居着大量细菌,占主导地位的是厚壁菌门、变形菌门、拟杆菌门、放线菌门和梭杆菌门。幽门螺杆菌和胃黏膜菌群之间可通过竞争营养和空间、扰乱抑菌肽的分泌以及改变宿主胃生理环境等直接或间接相互影响。本研究总结了胃内正常菌群的组成特征,分析了胃黏膜菌群与幽门螺杆菌之间的相互关系及其潜在机制,并进一步探讨了胃黏膜菌群对幽门螺杆菌相关胃部疾病的影响,有利于深入理解慢性胃病的发病机制,为疾病预防及治疗提供理论依据。     

Helicobacter pylori heat shock protein B (HspB) localizes in vivo in the gastric mucosa and MALT lymphoma

Heat shock protein B (HspB) is one of the dominant proteins recognized by most Helicobacter pylori-infected persons and is being considered as potential candidates for subunit vaccines. In the present study we describe the generation of an antibody against HspB and its use in immunohistochemical assays on gastric biopsies. We have demonstrated that our rabbit polyclonal antibody against HspB did not recognize any protein in lysates from a lung human epithelial cell (H1299) line and did not cross-react with the other members of human heat shock proteins. Secondly, we have observed that in gastric biopsies, HspB immunostaining was present inside the cytoplasm of human epithelial cells with a particular localization in the apical portion of gastric epithelial cells other than in the extracellular spaces among gastric cells of human stomach. Finally, we have demonstrated a cytoplasmic HspB immunostaining in groups of neoplastic cells of MALT lymphoma. In conclusion, our observations suggest a possible involvement of HspB in the pathogenesis of H. pylori-related pathologies such as gastritis, ulcer and gastric cancer.     

Almost all human gastric mucin O-glycans harbor blood group A, B or H antigens and are potential binding sites for Helicobacter pylori

Helicobacter pylori infects more than half of the world's population. Although most patients are asymptomatic, persistent infection may cause chronic gastritis and gastric cancer. Adhesion of the bacteria to the gastric mucosa is a necessary prerequisite for the pathogenesis of H. pylori-related diseases and is mediated by mucin O-glycans. In order to define which glycans may be implicated in the binding of the bacteria to the gastric mucosa in humans, we have characterized the exact pattern of glycosylation of gastric mucins. We have identified that the major component was always a core 2-based glycan carrying two blood group H antigens, whatever was the blood group of individuals. We have also demonstrated that around 80% of O-glycans carried blood group A, B or H antigens, suggesting that the variation of gastric mucin glycosylation between individuals is partly due to the blood group status. This study will help better understanding the role of O-glycans in the physiology and homeostasis of gastric mucosa. Overall, the results reported here give us the necessary background information to begin studies to determine whether individuals who express certain carbohydrate epitopes on specific mucins are predisposed to certain gastric diseases.     

Geographic pathology of Helicobacter pylori gastritis

BACKGROUND AND AIM: Helicobacter pylori is etiologically associated with gastritis and gastric cancer. There are significant geographical differences between the clinical manifestation of H. pylori infections. The aim of this study was to compare gastric mucosal histology in relation to age among H. pylori-infected patients from different geographical areas using the same grading system. The prevalence of atrophy and intestinal metaplasia were also compared with the respective gastric cancer incidence in the different countries. METHODS: A total of 1906 patients infected with H. pylori from seven countries were evaluated. Entry criteria included H. pylori positive cases with antral and corpus biopsies between the ages of 18 and 75 years. The minimum number of cases required from a country was 100. Hematoxylin-eosin stained biopsies from antrum and corpus were scored semiquantitatively using the parameters suggested by the Sydney Classification System. Statistical evaluation was performed using Kruskal-Wallis test and Spearman's rank correlation test. RESULTS: The severity of gastric atrophy varied among the different groups with the highest scores being present in Japan. The lowest scores were found in four European countries and in Thailand. The scores for intestinal metaplasia were low in general except for Xi-an, Japan, and Shanghai. For all the countries, the presence of atrophy in the antrum correlated well (r = 0.891) with the incidence of gastric cancer. CONCLUSION: Using a standardized grading system in a large study of H. pylori-related geographic pathology, we found major differences in the overall prevalence and severity of H. pylori gastritis in relation to age. These differences mirrored the respective incidences of gastric cancer in those geographical areas.