InlP, a New Virulence Factor with Strong Placental Tropism.

Intrauterine infection is a major detriment for maternal-child health and occurs despite local mechanisms that protect the maternal-fetal interface from a wide variety of pathogens. The bacterial pathogen Listeria monocytogenes causes spontaneous abortion, stillbirth, and preterm labor in humans and serves as a model for placental pathogenesis. Given the unique immunological environment of the maternal-fetal interface, we hypothesized that virulence determinants with placental tropism are required for infection of this tissue. We performed a genomic screen in pregnant guinea pigs that led to the identification of 201 listerial genes important for infection of the placenta but not maternal liver. Among these genes was lmrg1778 (lmo2470), here named inlP, predicted to encode a secreted protein that belongs to the internalin family. InlP is conserved in virulent L. monocytogenes strains but absent in Listeria species that are nonpathogenic for humans. The intracellular life cycle of L. monocytogenes deficient in inlP (ΔinlP) was not impaired. In guinea pigs and mice, InlP increased the placental bacterial burden by a factor of 3 log10 while having only a minor role in other maternal organs. Furthermore, the ΔinlP strain was attenuated in intracellular growth in primary human placental organ cultures and trophoblasts. InlP is a novel virulence factor for listeriosis with a strong tropism for the placenta. This virulence factor represents a tool for the development of new modalities to prevent and treat infection-related pregnancy complications.

The Serum Immunoglobulin G Glycosylation Signature of Gastric Cancer.

Biomarkers may facilitate detection of gastric cancer at an earlier stage and reduce mortality. Here we sought to determine if the glycosylation profile of serum immunoglobulin G (IgG) could distinguish patients with non-atrophic gastritis (NAG), duodenal ulcer (DU) and gastric cancer (GC). Serum IgG was released and analyzed using nano-LC-TOF mass spectrometry. Statistically significant false discovery rate (FDR)-adjusted p-values were observed for 18 glycans, eight that differed significantly between NAG and GC, three that distinguished NAG from DU, and eight that differed between DU and GC. The IgG glycosylation signature may be useful as a predictive marker for gastric cancer.

Serum glycan signatures of gastric cancer.

Glycomics, a comprehensive study of glycans expressed in biologic systems, is emerging as a simple yet highly sensitive diagnostic tool for disease onset and progression. This study aimed to use glycomics to investigate glycan markers that would differentiate patients with gastric cancer from those with nonatrophic gastritis. Patients with duodenal ulcer were also included because they are thought to represent a biologically different response to infection with Helicobacter pylori, a bacterial infection that can cause either gastric cancer or duodenal ulcer. We collected 72 serum samples from patients in Mexico City that presented with nonatrophic gastritis, duodenal ulcer, or gastric cancer. N-glycans were released from serum samples using the generic method with PNGase F and were analyzed by matrix-assisted laser desorption/ionization Fourier transform-ion cyclotron resonance mass spectrometry. The corresponding glycan compositions were calculated based on accurate mass. ANOVA-based statistical analysis was performed to identify potential markers for each subgroup. Nineteen glycans were significantly different among the diagnostic groups. Generally, decreased levels of high-mannose-type glycans, glycans with one complex type antenna, bigalactosylated biantennary glycans, and increased levels of nongalactosylated biantennary glycans were observed in gastric cancer cases. Altered levels of serum glycans were also observed in duodenal ulcer, but differences were generally in the same direction as gastric cancer. Serum glycan profiles may provide biomarkers to differentiate gastric cancer cases from controls with nonatrophic gastritis. Further studies will be needed to validate these findings as biomarkers and identify the role of protein glycosylation in gastric cancer pathology.

Biomarkers of Helicobacter pylori-associated gastric cancer.

Helicobacter pylori-associated gastric cancer is a major cause of morbidity and mortality worldwide, and is predicted to become even more common in developing countries as the population ages. Since gastric cancer develops slowly over years to decades, and typically progresses though a series of well-defined histologic stages, cancer biomarkers have potential to identify asymptomatic individuals in whom surgery might be curative, or even those for whom antibiotics to eradicate H. pylori could prevent neoplastic transformation. Here we describe some of the challenges of biomarker discovery, summarize current approaches to biomarkers of gastric cancer, and explore some recent novel strategies.

Functional plasticity in the type IV secretion system of Helicobacter pylori.

Helicobacter pylori causes clinical disease primarily in those individuals infected with a strain that carries the cytotoxin associated gene pathogenicity island (cagPAI). The cagPAI encodes a type IV secretion system (T4SS) that injects the CagA oncoprotein into epithelial cells and is required for induction of the pro-inflammatory cytokine, interleukin-8 (IL-8). CagY is an essential component of the H. pylori T4SS that has an unusual sequence structure, in which an extraordinary number of direct DNA repeats is predicted to cause rearrangements that invariably yield in-frame insertions or deletions. Here we demonstrate in murine and non-human primate models that immune-driven host selection of rearrangements in CagY is sufficient to cause gain or loss of function in the H. pylori T4SS. We propose that CagY functions as a sort of molecular switch or perhaps a rheostat that alters the function of the T4SS and "tunes" the host inflammatory response so as to maximize persistent infection.

Expression of the BabA adhesin during experimental infection with Helicobacter pylori.

The Helicobacter pylori babA gene encodes an outer membrane protein that mediates binding to fucosylated ABH antigens of the ABO blood group. We recently demonstrated that BabA expression is lost during experimental infection of rhesus macaques with H. pylori J166. We sought to test the generality of this observation by comparison of different H. pylori strains and different animal hosts. Challenge of macaques with H. pylori J99 yielded output strains that lost BabA expression, either by selection and then expansion of a subpopulation of J99 that had a single-base-pair mutation that encoded a stop codon or by gene conversion of babA with a duplicate copy of babB, a paralog of unknown function. Challenge of mice with H. pylori J166, which unlike J99, has 5' CT repeats in babA, resulted in loss of BabA expression due to phase variation. In the gerbil, Leb binding was lost by replacement of the babA gene that encoded Leb binding with a nonbinding allele that differed at six amino acid residues. Complementation experiments confirmed that change in these six amino acids of BabA was sufficient to eliminate binding to Leb and to gastric tissue. These results demonstrate that BabA expression in vivo is highly dynamic, and the findings implicate specific amino acid residues as critical for binding to fucosylated ABH antigens. We hypothesize that modification of BabA expression during H. pylori infection is a mechanism to adapt to changing conditions of inflammation and glycan expression at the epithelial surface.

Modification of gastric mucin oligosaccharide expression in rhesus macaques after infection with Helicobacter pylori.

BACKGROUND & AIMS: Helicobacter pylori attaches to mucin oligosaccharides that are expressed on host gastric epithelium. We used the rhesus macaque model to characterize the effect of H. pylori infection on gastric mucin oligosaccharides during acute and chronic infection. METHODS: Specific pathogen (H. pylori)-free rhesus macaques were inoculated with H. pylori J166. Biopsy specimens of the gastric antrum were obtained 2 and 4 weeks before and 2, 8, and 24 weeks after infection with H. pylori. O-linked mucin oligosaccharides were released from gastric biopsy samples by beta-elimination and profiled by matrix-assisted laser desorption/ionization mass spectrometry. Similar studies were performed on gastric biopsy samples from H. pylori-infected and uninfected humans. Formalin-fixed, paraffin-embedded sections of rhesus antrum biopsy samples were stained with H&E, periodic acid-Schiff stain, and antibody to MUC5AC, the predominant mucin expressed in the stomach. RESULTS: H. pylori-induced gastritis was accompanied by an acute and dramatic decrease in diversity and relative abundance of O-linked mucin oligosaccharides in the rhesus stomach, which largely recovered during the 24-week observation period. These variations in oligosaccharide abundance detected by mass spectrometry were reflected by changes in periodic acid-Schiff-positive material and expression of MUC5AC over time. Relatively few differences were seen in gastric mucin oligosaccharide composition between H. pylori-infected and uninfected patients, which is consistent with the results in rhesus macaques because infection occurs in childhood. CONCLUSIONS: Acute H. pylori infection is accompanied by a dramatic but transient loss in mucin oligosaccharides that may promote colonization and persistence.

Method for profiling mucin oligosaccharides from gastric biopsies of rhesus monkeys with and without Helicobacter pylori infection.

A method for in vivo analysis of gastric mucin oligosaccharides was developed and applied to rhesus monkeys with and without Helicobacter pylori infection. Mucin-type O-linked oligosaccharides were directly released by reductive beta-elimination from gastric biopsies from rhesus monkeys. The released oligosaccharides were structurally characterized by matrix-assisted laser desorption/ionozation and electrospray ionization Fourier transform ion cyclotron resonance mass spectrometry. A diverse profile of neutral and acidic oligosaccharides was observed with these techniques. The most predominant core structure detected in all of the samples at relatively high abundance corresponded to core 2 (2HexNAc-1Hex, m/z = 611.227). The spectra generated from H. pylori-infected monkey samples showed fewer oligosaccharides collectively. Peaks corresponding to 1HexNAc-1Hex (m/z = 408.148) and 2HexNAc (m/z = 449.174), which most likely represent core structures, were absent in all infected monkeys studied, although present in all uninfected monkeys. Unsupervised cluster analysis demonstrated clear differences between the peaks detected in uninfected and naturally infected monkey samples. The results suggest that H. pylori infection is associated with lower relative abundance of oligosaccharides and loss of mucin-type core structures. This method can be applied to characterize the glycans associated with the mucin lining of live animals and allows for repeated analysis of the same animal over the course of infection.

Use of pooled samples for the detection of Salmonella in feces by polymerase chain reaction.

Many epidemiological studies of Salmonella rely on conventional bacteriological culture methods to detect Salmonella in fecal samples. These culture-based methods are inefficient for epidemiological studies in populations with a low prevalence of Salmonella. The objective of this study was to optimize a protocol that uses pooled Salmonella enrichment broth cultures of bovine feces and polymerase chain reaction (PCR) for the detection of the invA gene of Salmonella in feces. In one field trial, 196 animals were sampled, and all samples were tested by culture, invA PCR on individual samples, invA PCR on pools of 5 samples, and BAX PCR on individual samples. All assays showed a high agreement on individual samples (kappa > or = 0.75). The invA PCR was run on each of 40 pools and detected 19 of 22 culture-positive pools. In another field trial, 152 samples were taken from 4 dairies, and the invA PCR was performed on pools of 5 samples in addition to bacteriological culture of individual samples. Salmonella was detected in 5 of the 32 pools (7 total positive samples) by both PCR and culture. One pool was PCR-positive but culture-negative. Pooling did not dramatically affect the performance of the invA PCR; most of the culture-positive samples were detected, including all of the samples when there were 4 or more Salmonella colonies on the agar plate. Based on these field trials, invA PCR on pooled samples appears to be an efficient method of Salmonella detection as long as Salmonella loads are not extremely low.

The role of genome diversity and immune evasion in persistent infection with Helicobacter pylori.

Helicobacter pylori is an important human pathogen that chronically colonizes the stomach of half the world's population. Infection typically occurs in childhood and persists for decades, if not for the lifetime of the host. How is bacterial persistence possible despite a vigorous innate and adaptive immune response? Here we describe the complex role of bacterial diversity and specific mechanisms to avoid or subvert host immunity in bacterial persistence. We suggest that H. pylori finely modulates the extent to which it interacts with the host in order to promote chronic infection, and that it uses diverse mechanisms to do so.

Enrofloxacin resistance in Escherichia coli isolated from dogs with urinary tract infections.

OBJECTIVE: To assess the strain heterogeneity of enrofloxacin-resistant Escherichia coli associated with urinary tract infections in dogs at a veterinary medical teaching hospital (VMTH). In addition, strains from other veterinary hospitals in California were compared with the VMTH strains to assess the geographic distribution of specific enrofloxacin-resistant E. coli isolates. DESIGN: Bacteriologic study. SAMPLE POPULATION: 56 isolates of E. coli from urine samples (43 isolates from dogs at the VMTH, 13 isolates from dogs from other veterinary clinics in California). PROCEDURES: Pulsed field gel electrophoresis was performed on 56 isolates of E. coli from urine samples from 56 dogs. All 56 isolates were tested for susceptibility to amoxicillin, chloramphenicol, enrofloxacin, tetracycline, trimethoprim-sulphamethoxazole, cephalexin, and ampicillin. Enrofloxacin usage data from 1994 to 1998 were obtained from the VMTH pharmacy. RESULTS: Several strains of enrofloxacin-resistant E. coli were collected from urine samples from the VMTH, and strains identical to those from the VMTH were collected from other veterinary clinics in California. For the isolates that did share similar DNA banding patterns, variable antibiotic resistance profiles were observed. CONCLUSIONS AND CLINICAL RELEVANCE: The increased occurrence of enrofloxacin-resistant E. coli from urine samples from dogs at the VMTH was not likely attributable to a single enrofloxacin-resistant clone but may be attributed to a collective increase in enrofloxacin resistance among uropathogenic E. coli in dogs in general.