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1Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands 2Department of Gastroenterology, VU University Medical Center, Amsterdam, the Netherlands 3Division of Bacteriology, National Institute for Biological Standards and Control, Potters Bar, UK
Correspondence Johannes G. Kusters j.g.kusters{at}erasmusmc.nl
Received November 25, 2003
Accepted January 22, 2004
The human gastric pathogen Helicobacter pylori expresses several putative outer-membrane proteins (OMPs), but the role of individual OMPs in colonization of the stomach by H. pylori is still poorly understood. The role of four such OMPs (AlpA, AlpB, OipA and HopZ) in a guinea pig model of H. pylori infection has been investigated. Single alpA, alpB, hopZ and oipA isogenic mutants were constructed in the guinea pig-adapted, wild-type H. pylori strain GP15. Guinea pigs were inoculated intragastrically with the wild-type strain, single mutants or a mixture of the wild-type and a single mutant in a 1 : 1 ratio. Three weeks after infection, H. pylori could be isolated from stomach sections of all animals that were infected with the wild-type, the hopZ mutant or the oipA mutant, but from only five of nine (P = 0.18) and one of seven (P = 0.02) animals that were infected with the alpA or alpB mutants, respectively. The hopZ and oipA mutants colonized the majority of animals that were inoculated with the strain mixture, whereas alpA and alpB mutants could not be isolated from animals that were infected with the strain mixture (P < 0.01). Specific IgG antibody responses were observed in all animals that were infected with either the wild-type or a mutant, but IgG levels were lower in animals that were infected with either the alpA or the alpB mutants, compared to the wild-type strain (P < 0.05). In conclusion, absence of AlpA or AlpB is a serious disadvantage for colonization of the stomach by H. pylori.
| INTRODUCTION |
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It appears that mucosal adhesion of H. pylori is associated directly with mucosal damage (Hessey et al., 1990; Guruge et al., 1998). Adhesion of H. pylori is mediated in part via specific adhesins, such as the sialyl Lewisx-binding protein SabA (Mahdavi et al., 2002) and the Lewisb blood group antigen-binding protein BabA (Boren et al., 1993; Ilver et al., 1998). However, the H. pylori genome also encodes several other outer-membrane proteins (OMPs) that have been associated with adhesion, including OipA, HopZ, AlpA and AlpB (Alm et al., 1999; Evans & Evans, 2000; Tomb et al., 1997). The role of these individual OMPs in adhesion of H. pylori is still relatively poorly understood. H. pylori strains with reduced expression of OipA, SabA, SabB and HopZ displayed limited colonization of the murine stomach when two or more of these OMPs were not expressed, due to phase variation (Yamaoka et al., 2002). AlpA and AlpB may function as adhesins, as isogenic alpA and alpB mutants displayed reduced adherence to human gastric tissue and gastric epithelial cells when tested in vitro (Odenbreit et al., 1999, 2002a).
Several animal models have been employed for study of H. pylori infection, using non-human primates, gerbils, mice and guinea pigs (Marchetti et al., 1995; Dubois et al., 1996; Hirayama et al., 1996; Guruge et al., 1998; Shomer et al., 1998). The guinea pig model for H. pylori infection has some attractive features, such as ease of husbandry and animal size. The guinea pig stomach has several features in common with the human stomach that are lacking in the mouse model, such as sterility and the production of IL8 (Shomer et al., 1998; Sturegard et al., 1998).
In this study, we have employed the guinea pig model of H. pylori infection to characterize the role of the OMPs AlpA, AlpB, OipA and HopZ in colonization of the stomach by H. pylori. Isogenic mutants in the alpA, alpB, oipA and hopZ genes were created in the guinea pig-adapted H. pylori strain GP15 and used to infect guinea pigs with either single mutants or 1 : 1 mixtures of the wild-type strain and a single mutant. Three weeks after inoculation, colonization efficiency and local and systemic antibody responses were measured. We thus observed that both AlpA and AlpB make important contributions to gastric colonization by H. pylori.
| METHODS |
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Construction of site-directed mutants and recombinant DNA techniques.
Standard recombinant DNA techniques were performed as described by Sambrook et al. (1989). Plasmid pJMK30 (van Vliet et al., 1998) was used as the source of the kanamycin-resistance (KanR) cassette. PCR fragments that contained an internal part of the alpA, alpB, oipA or hopZ genes were amplified by PCR using the primers listed in Table 1 and were subsequently cloned into pGEM-T Easy vector (Promega). The KanR cassette was inserted into the unique Eco47III, SmaI, HindIII and SmaI sites in the alpA, alpB, oipA and hopZ genes, respectively. The resulting plasmids were used to transform H. pylori strain GP15 by natural transformation, as described previously (Bijlsma et al., 1999). Correct integration of the KanR cassette was verified by restriction analysis and PCR amplification, using primers located outside the amplified region that was used for creation of the respective mutants (Table 1).
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Animal experiments and serology.
Infection experiments were performed essentially as described previously (Rijpkema et al., 2001). Female DunkinHartley guinea pigs (200300 g) were housed on grids and fed with water and food ad libitum. All animal experiments were performed according to the guidelines of the Home Office (1986) and were approved by the local ethics committee. Guinea pigs were fasted overnight before being given an intragastric dose of either wild-type H. pylori strain GP15, its isogenic mutants or a mixture of both at a ratio of 1 : 1. Either two or three doses of approximately 109 c.f.u. H. pylori per dose were given to animals intragastrically on alternate days (Rijpkema et al., 2001). Animals were dissected 21 days after inoculation and serum, bile and gastric mucosa of the antral region were collected. The stomach was rinsed briefly with PBS and a small section of the gastric antrum was streaked out on Dent plates to detect wild-type H. pylori, and on kanamycin-supplemented Dent plates to detect H. pylori mutants. Colonies were identified as H. pylori by morphology and urease activity. Antibodies were extracted from antral tissue as described previously (Bergquist et al., 2000). Specific IgG and IgA were detected by ELISA, using plates that were coated with H. pylori GP15 outer-membrane fraction, as described previously (Rijpkema et al., 2001; Durrani & Rijpkema, 2003).
Statistical analysis.
The MannWhitney U test for non-parametric data was used to compare differences between experimental groups. All data are presented as mean ± SD. P values of < 0.05 were considered to be significant.
| RESULTS AND DISCUSSION |
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Effect of OMP gene mutation on gastric colonization by H. pylori in guinea pigs
The role of the AlpA, AlpB, OipA and HopZ proteins in gastric colonization in vivo was evaluated by using the guinea pig model for H. pylori infection (Rijpkema et al., 2001; Durrani & Rijpkema, 2003). Ability to colonize was first assessed by comparing single infections with the wild-type strain GP15 and single isogenic mutants in two independent infection experiments. The results of these experiments are shown in Fig. 1a. Wild-type H. pylori GP15 and the oipA and hopZ mutants colonized all inoculated guinea pigs, confirming previous observations made by using a mouse model of H. pylori infection (Yamaoka et al., 2002). The alpA mutant could only be isolated from five of nine inoculated guinea pigs, but this difference was not significant (P = 0.18). In contrast, the alpB mutant could only be isolated from one of seven inoculated animals (P = 0.02).
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The attenuating effect of the OMP mutations was further defined by using competitive infection experiments with wild-type GP15 and each of the single OMP mutants in a 1 : 1 ratio. Wild-type and OMP mutants could be distinguished by the kanamycin resistance of mutant cells. The wild-type strain was isolated from all inoculated animals, irrespective of the OMP mutant included in the 1 : 1 mixture (Fig. 1b). The hopZ and oipA mutants could also be isolated from more than half of the inoculated animals, indicating that neither mutant had a major selective disadvantage when compared to the wild-type strain. In contrast, the alpA and alpB mutants could only be isolated from one of six (P = 0.01) and none of three (P = 0.03) infected guinea pigs, respectively.
Antibody responses to infection by OMP mutants
Differential effects of the OMP mutations were apparent in the antibody response in serum, as well as in locally produced antral mucosa IgG and bile IgA (Fig. 2). Serum IgG and antral IgG antibody responses were significantly lower in animals that were inoculated with the alpB mutant, compared to the wild-type strain (P = 0.01 in both cases). Serum IgG, but not antral mucosal IgG, was also decreased in animals that were inoculated with the alpA mutant (P = 0.01). This finding may be due to incomplete colonization (56 %) of animals that were inoculated with the alpA mutant (Fig. 1). There was no difference between the levels of specific IgG antibodies in animals that were inoculated with wild-type GP15 and the oipA and hopZ mutants. Interestingly, bile IgA levels were significantly lower in animals that were inoculated with the alpB, oipA and hopZ mutants (P values of 0.01, 0.03 and 0.03, respectively), but not with the alpA mutant (P = 0.12) (Fig. 2). We currently have no explanation for this unexpected difference between the IgG and IgA responses with the oipA and hopZ mutants. Antibody responses in animals that were infected with 1 : 1 ratios of wild-type and single OMP mutants were similar to those infected with the wild-type GP15 strain (data not shown), which is not surprising in view of the total colonization by the wild-type strain.
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| DISCUSSION |
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The alpA gene is transcribed in vivo in human gastric tissues, as well as in murine gastric tissues, in the first 3 months of infection (Rokbi et al., 2001), indicating that the Alp proteins play an active role in establishing and maintaining gastric colonization. Transcription of alpA was tenfold higher 1 h post-infection than 1 week post-infection; by comparison, transcription of ureA and 16S rRNA varied much less over time (Rokbi et al., 2001). The role of AlpA and AlpB in the early stages of infection may make them important candidates for a prophylactic vaccine. Indeed, vaccination studies in mice have indicated that an AlpA vaccine reduced bacterial load significantly when given as a prophylaxis, but was ineffective when given as a therapeutic treatment (Sanchez et al., 2001).
Conclusion
In this study, it is demonstrated that the H. pylori OMPs AlpB and, to a lesser extent, AlpA, are required for gastric colonization of the guinea pig stomach, most probably by mediating adherence to gastric epithelial cells. Further work is required to determine whether alpA or alpB mutants may serve as an attenuated live vaccine. Characterization of the receptors and functions of individual H. pylori OMP molecules may provide further insights into mechanisms that are essential for H. pylori colonization of human gastric mucosa.
| ACKNOWLEDGEMENTS |
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| REFERENCES |
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