We previously reported that acute H. pylori infection of gastric epithelial (AGS) cells and human gastric biopsies causes H,K-ATPase α subunit (HKα) gene repression and inhibits acid secretion, events that may facilitate gastric H. pylori colonization and underlie transient clinical hypochlorhydria (Gastroenterology, 139:239, 2010; Gut, 59:874, 2010). In those studies, HKα repression was abrogated by infection with H. pylori isogenic mutant strains deficient in the cag pathogenicity island genes cagL, cagE or cagM, each of which fails to inject CagA into host cells or to induce interleukin-8 (IL-8) expression; HKα repression was partially abrogated by a cagA-deficient strain that induces IL-8. To test the hypothesis that bacterial factors other than those mediating CagA injection or IL-8 induction participate in HKα repression, AGS cells transfected with HKα promoter-Luc reporter constructs were infected (8 h, multiplicity of infection=50) with wild-type (WT) H. pylori strain 7.13 or isogenic mutants previously reported to be competent for CagA injection and IL-8 induction (cagζ, cage, cagN, cagZ or cagD), or competent only for IL-8 induction (cagβ [virD4]). AGS cell fractions were immunoblotted with anti-CagA antibodies, and IL-8 in cell-conditioned media was measured by ELISA. CagA was detected in cytoplasmic fractions of cells infected with WT H. pylori or cagζ, cage, cagN, cagZ or cagD mutants, but not with the virD4 mutant. AGS cell IL-8 secretion induced by the cagζ and cage mutants was comparable to WT; the virD4 mutant induced 22% less IL-8 than WT (P<0.01); and the cagN, cagZ and cagD mutants induced 32%, 68%, and 81% less IL-8 respectively than WT (all P<0.01). AGS cell infection by WT H. pylori inhibited HKα promoter activity (measured by luminometry) by 63% (P<0.01); the cagA-deficient mutant had minor effects on activity. The virD4 mutant inhibited HKα promoter activity by 23% (P<0.002), cagζ, cagN, cagZ and cagD mutants inhibited HKα by 40-50% (all P<0.01), and the cage mutant inhibited HKα by 87% (P<0.001). These data indicate that (i) CagA injection is associated with varying degrees of HKα repression, which is not abrogated by complete absence of CagA; (ii) HKα repression is poorly correlated with H. pylori-mediated induction of IL-8 gene expression; (iii) virD4, which encodes a cytoplasmic type IV secretion system nucleoside triphosphatase coupling protein, is necessary for bacterial signals culminating in HKα repression and consequent acid secretory inhibition; and (iv) neither CagA nor perturbation of signaling pathways leading to IL-8 induction are solely responsible for HKα repression. These findings are significant because hypochlorhydria is a predisposing factor for gastric epithelial progression to neoplasia, andH. pylori factors other than CagA and/or signaling to IL-8 are thus implicated in gastric carcinogenesis.
Read full abstract