Full Text PDF - 感染症学雑誌 ONLINE JOURNAL

1027
In
Vitro Cytotoxic
Effects
by Clinical
of Vacuolating
Isolates
Cytotoxin
of Helicobacter
Produced
pylori
Kaoru KODAMA1), Toshio FUJIOKA1), Akira ITO1),
Akira NISHIZONO2) and Masaru NASU1)
SecondDepartmentof Internal Medicine1),
Departmentof InfectiousDiseasesControl2),
Oita MedicalUniversity
(Receiced:February16,1998)
(Accepted:June 15,1998)
Key
words:
Helicobacter
rabbit
pylori,
gastric
vacuolating
epithelial
cytotoxin,
MTT
assay,
cells
Abstract
The
factor
vacuolating
causing
induction
of
of
MTT
clinically
strains
duodenal
but
H.
incidence
of
different
Pylori
epithelium
ulcers
duodenal
there
was
no
of
patients
with
the
patient
Similar
our
of
pylon
pylori
or
(p<
observed
regard
to
indicate
manifestations,
induce
H.
ulcers
also
with
not
(63%)
gastritis
were
may
by
57
supernatants
with
results
data
of
gastric
H.
in
culture
activity
36
incidence
patients
clinical
particularly
used
of
in patients
between
and
may
the
of
than
Although
cytotoxin
cytotoxin
gastric
higher
virulence
cytotoxic
gastritis,
activity
differences
We
presence
in
with
supernatants.
significant
vacuolating
differences
one
cytotoxin
(RGECs).
in the
patients
cytotoxic
isolates.
vacuolating
no
significantly
ulcer
were
prevalance
harboring
in
that
cytotoxin-negative
between
H.
to
however,
vacuolating
correlation
that
not
showed
gastric
were
be
vacuolating
quantitated
observed
among
to
of
cells
and
was
there
considered
activity
epithelial
cytotoxin
(Tox+)
is
the
gastric
RGECs
However,
assay
with
of
pylon
examined
vacuolating
cytotoxin
MTT
patients
of
we
rabbit
vacuolation
strains.
Helicobacter
study,
of
vacuolating
The
isolates,
by
this
a source
pylon
positive
was
Tox+
as
isolated
from
0.01),
pylon
Intracellular
ulcers.
obtained
in
H.
In
vacuolation
method.
with
produced
ulceration.
intracellular
supernatants
the
cytotoxin
peptic
a
they
damage
to
the
clear
suggest
the
gastric
ulcers.
Introduction
Helicobacter
and
mucosal
ed
Pylori
peptic
by
the
have
vacA
gene,
associated
with
the
hybridizes
with
vacA
vacuolating
vacuolating
cytotoxin
MTT
to:
Department
平成10年10月20日
of
and
assay
Kaoru
in
gene.
In
development
using
cultured
of
H.
of
peptic
rabbit
pylon
in
clarify
the
cells
pylori
isolates
fail
cytotoxic
we
epithelial
and
in
isolates
vitro
to
have
the
Medicine,
Oita Medical
University,
ascribed
vitro
activity
of
vacuolating
role
cells.
Hasama-machi,
closely
gene
KODAMA
of Internal
in
encod-
Oita 879-5593,
that
detectable
been
in
is
a
produce
the
is
and
contain
beteeen
investigated
gastric
damage
which
activity
relationship
ulcers,
gastric
H.
including
cytotoxin,
eukaryotic
most
Differences
to
diseaes
inflammation
Vacuolating
of
While
50%
order
enhance
identified4)•`9).
ulcers.
vitro10)•`12)
gastroduodenal
may
vacuolation
peptic
approximately
activity
with
that
and
intracellular
probes,
vacA
associated
factors
investigated
induces
cytotoxin
by
Correspondence
Second
been
in
closely
virulence
development
cytotoxin
divergence
is
Several
epithelium
sequence
infection
ulcers1)•`3).
Japan
to
of
Kaoru
1028
KODAMA
et al
Methods
Strains
Strain
types
NCTC11673,
vacuolating
cytotoxin-producing
consecutive
dyspeptic
14-78
years]
April
1988
gastric
to
March
with
deformity,
only
biopsy
agar,
cultured
under
Systems)
at
confirmed
Preparation
of
Stored
bacterial
for
cells
number
of
The
of
isolated,
Assay
of
and
of
fresh
dilutions
of
control.
After
20%
RGECs
from
plates
the
scar
To
or
obtain
medium:
H.
heart
medium,
BBL
used
presence
solution
study.
ulcer
(basic
System;
pylori
with
received
the
including
Belo-Horizonte
H.
in
of
and
Microbiology
this
study
urease,
were
catalase
and
at -80•Ž.
of
107CFU/ml
bovine
and
optical
(FBS;
1011CFU/ml,
were
sterilized
of
each
cells
with
were
in brucella
broth
Grand
Island,
Gibco,
conditions.
density
than
cultured
serum
microaerophilic
supernatants
approved
provided
FBS,
by
rabbit
a
The
culture
were
stored
at
— 80•Ž
density
medium.
centrifuged
the
1,000•~g,
filter
until
of
When
at
0.45-um-pore-size
0.2%
in
per
cells
ml,
were
cells
for
(Millipore
use.
on
E.
day
The
Nippon
a
of
modified
100
frozen
24
units
humidified
by
Experithe
method
Briefly,
Shinyaku
Co.14).
The
stomachs
epithelial
cells
were
Medium
G sodium
atomosphere
and
Animal
gestation.
Eagle
penicilin
at -80•Ž
for
prepared
dispersed
Dulbecco's
in
Committee
(RGECs)
Laboratories,
Pronase
kanamycin,
Tokyo)
Review
removed
subcultured
5, the
Ethics
epithelial
Research
were
100ƒÊg
the
gastric
by
rabbits
and
level
were
24-well
allowed
10%,
to
hours
under
MTT
were
thawed
adhere
30%,
of
for
24
40%
hours.
10%
and
50%.
incubation
at
(tetrazoliurn)
assay
96-well
37•Ž
at
of
At
Lincoin
After
with
microscope
into
cultured.
Dickinson,
a light
seeded
and
(Becton
supplemented
20%,
24
first
plates
DMEM
visually
Colorirnetric
those
had
examination.
agar
of
fetal
under
the
more
with
flasks
cells
into
ml,
excluded
between
(DMEM;
(GIBCO)
of
were
seeded
5%
and
CO2
in
GIBCO)
50
in
units
air.
At
stored.
vacuolation
frozen
distributed
10%
shaker
These
kindly
white
SHUSEI,
RGEC
were
and
and
milk
a density
measuring
to
was
digested
doubling
The
at
with
Cultured
were
culture
(GODO
population
scored
al13)
with
Dispase-I
1ml
protocol
and
supplemented
who
(Campypak
stain
skim
groups;
57
range
hospital
three
blood
known
from
(•}SD),
our
Patients
histological
strains
Gram
10%
rotary
UK).
JW/NIBS
tissue
using
sterile
supernatants
institution.
everted
75-cm2
All
into
ulceration,
MD)
jars
days.
of
in
ulcers.
time
sheep
years
biopsy
a
obtained
culture
our
et
fetuses
a
grew
Bedford,
on
7%
aerobic
4
thawed
by
pylon
experimental
of
on
cell-free
cell
Matsuoka
per
the
of
mentation
the
H.
of
is
were
50.9•}14.8
antral
duodenal
Cockeyville,
for
age,
evidence
mucosa
in
supplemented
hours
no
NCTC11637
strains
classified
or
period
onto
study.
supernatants
were
determined
Division,
Conditions
of
was
and
Products
24
cultured
minutes
culture
isolates
Systems)
37•Ž
gastric
identification
in
mean
gastric
long
smeared
37•Ž
stored
pylon
pylon
Microbiology
at
the
this
isolated
and
showed
Systems,
and
were
H.
H.
a
conditions
humidity
in
endoscopically
of
for
Microbiology
strains
were
in
microaerobic
used
clinically
16 females;
evidence
were
bacteriological
All
and
endoscopy
changes
BBL
by
oxidase.
no
whom
were
The
gastroduodenoscopy
patients
or
specimens
high
males
agents
in
showed
gastric
NY)
The
ulcers
gastritis,
infusion
15
1995.
11639
(Tox+).
by
anti-inflammatory
Patients
pylori
[41
examined
duodenal
non-steroid
(BBL
were
and
strain
patients
who
ulcers,
11916
FBS
confluence,
Park,
adherence,
media
containing
H.
Uninoculated
with
5%
RGECs
NJ)
at
was
pylori
brucella
CO2,
a magnification
were
trypsinized
concentrations
removed
cultured
broth
intracellular
of
and
and
1•~105cells
replaced
with
supernatants
was
used
vacuolation
as
to
a
give
negative
of
RGECs
was
at
a concentra-
of •~200.
RGECs
microtiter
plates
(Nunc
A/S,
Roskilde,
Denmark)
感 染 症 学雑 誌
第72巻
第10号
Cytotoxic Effect of H. pylori Supernatants
tion
of
of
5•~103cells
fresh
per
DMEM-10%
After
24
hours
bromide,
some
added
to
was
temperature,
photometers
broth
at
did
not
have
shown).
(NOD)
the
of
each
a
wells
optical
quadruplicate.
Percent
The
NOD(%)=[NOD
The
were
expressed
determined
in
Statistical
of
the
by
the
media,
added
to
products.
in
of
each
H.
20%
of
using
spectrobrucella
assay
(data
optical
density
optical
manner.
experimental
dissolution
MTT
net
of
sulfoxide
pylon-free
The
same
method
scanning
background
the
the
15 minutes
plate.
the
in
well.
All
density
of
assays
supernatant
were
was
expres-
20
clinical
equation:
control
H.
brucella
pylori
the
broth]•~100
supernatants
supernatants
a modification
of
subtracting
each
dimethyl
multi-well
that
every
measured
to
of
After
by
confirmed
control
by
and
in
according
measured
100ƒÊl
tetrazolium
150ƒÊl
a concentration
a
cytotoxicity
in
was
performed
was
at
as
following
ammonia
of
supernatant
experiments
RGECs
alone
concentration
of
well
used
sample/NOD
ammonia
concentrations
isolates
by
removal
acid-isopropanol,
determined
index
calculated
of
was
After
culture
formazan
each
on
medium
hours.
was
of
Initial
was
well
in
pylori
MTT
effects
24
assay
of
540nm.
medium
incubated
H.
for
[3-(4,5-Dimethyl-2-thiazolyl)-2,5-diphenyl-2H
dissolve
of
this
of
Japan]
density
cytotoxic
37•Ž
Instead
to
wavelength
percentage
Measurement
of
the
of
method
three
of
control
Okuda
et
strains
al16).
and
The
concentration
was
mM.
analysis
The
was
the
at
MTT
Osaka,
the
experimental
in
as
20ƒÊl
37•Ž,
Co.,
any
well
performed
at
modifications.
Therefore,
cell-free
sed
a test
cultured
containing
Junyaku
with
at
and
incubation
Wako
(DMSO)
not
FBS
of
Mossmann15)
room
well
1029
frequency
of
compared
in
statistical
the
patients
with
significance
SEM,
and
expression
was
compared
by
of
vacuolating
gastritis,
set
at
gastric
p<0.05.
Fisher's
cytotoxin
and
The
PLSD
activity
duodenal
results
in
ulcers
of
MTT
by
H.
the
assay
pylon
clinical
chi-squared
were
isolates
test,
and
as
mean•}
expressed
the
test.
Results
In
vitro
activity
Since
the
sensitivity
cells
cells,
(Tox+
of
a half
vacuolation
strain
NCTC11637
volume
of
induced
vacuolation
even
RGECs
isolate
the
volume
the
presence
of
considered
to
Toxa half
Table
Although
of
was
volume
the
of
平 成10年10月20日
these
of
of
the
unconcentrated
of
isolates
of
H.
H.
Pylori
(63%)
the
RGECs
Pylon
produced
H.
NCTC11639
cell
culture
intracellular
cells
of
the
cells
there
strain,
not
in
cytotoxin
vacuolation
no
a
Thus,
cytotoxin.
Figure
H.
RGECs
Therefore,
culture
in
57
clinical
of
RGECs,
pylori
even
in
intracel-
vacuolation
RGECs
10%
vacuola-
different
exhibited
was
NCTC11916,
exhibit
of
medium.
the
of
of
supernatant.
of
in
supernatants
by
presence
supernatant
vacuolating
HeLa
vacuolation
in
20%
Centriplus-
of
presence
did
induced
the
intracellular
than
NCTC11637
culture
vacuolation
in
of
the
pylon
RGECs
the
gastric
using
However,
in
tested
rat
by
culture
even
Another
supernaton
harboring
medium.
However,
apparent
more
vacuolation
we
RGM1
supernatant
Unconcentrated
formation
concentrated
when
The
medium.
assay
lines17),
cells,
concentration
culture
concentrated
show
positive
the
of
vacuole
not
10-fold
frequency
clinical
for
with
did
considered
a hlaf
36
suitable
strains
in
conditions.
cell
HeLa
induced
conditions.
of
lines,
a 10-fold
process
culture
same
volume
RGECs
volume
1 shows
the
a half
be
same
in the
under
of
This
vacuolation
supernatant
RGECs
percentages
vacuolation
the
different
cell
experiments.
to
supernatant
under
cells
between
different
50min
MA).
intracellular
of
the
of
for
Beverly,
cells
three
preliminary
3,000•~g
concentrated
induced
were
presence
presence
of
RGM1
supernatants.
lular
Inc.,
of
cultured
varies
using
a series
at
unconcentrated
in
1 shows
in
various
cytotoxin
activity
centrifuged
of
against
vacuolating
cytotoxin
(Amicon,
visible
cytotoxin
RGECs,
was
concentrator
tion
of
to
and
strain)
presence
vacuolating
activity
of
mucosal
100
of
in
the
medium.
isolates.
there
were
Kaoru
1030
KODAMA
et al
Fig. 1 Percentage of RGECs with intracellular vacuolation produced by H.
pylori isolate supernatants.
After 24 hours of incubation with the H. pylon isolate supernatants at a
concentration of 50%, intracellular vacuolation of RGECs was scored visually
under a light microscope. A positive cytotoxic effect was considered when wells
contained more than 20% of vacuolated cells. Twenty-one isolates had no
vacuolating cytotoxic activity (Tox-) while 36 isolates were considered Tox+
isolates.
Table 1
Number (percentage)
producing vacuolating
isolates
no
significant
differences
no
significant
difference
of
RGECs
GU
from
no
and
showing
DU,
Cytotoxic
activity
by
was
MTT
assay.
significantly
difference
between
H.
lower
than
isolates
NOD
in patients
from
the
patients
in the
percentage
of
isolates
between
male
supernatants
73•}30%,
be
activity
of
of
with
Tox+
cytotoxic
among
the
Tox+
isolates.
and
three
groups
The
obtained
Although
than
There
female.
isolates
respectively.
from
Tox+
those
with
was
gastritis,
isolates
obtained
gastritis,
(Fisher's
also
percentages
there
PLSD
was
test).
RGECs
supernatants
supernatants
gastritis
with
of
more
against
activities
percent
Tox+
to
supernatants
cytotoxic
mean
tended
vacuolyzing
pylori
the
The
by
and
ulceration
in
of
2 shows
groups
of
75•}23%
peptic
difference
Figure
three
induced
60•}29%,
with
significant
the
frequency
vacuolation
were
patients
among
in the
of H. pylon isolates
cytotoxin among 57 clinical
duodenal
of
from
(90•}3.8;
ulcer
H.
pylon
patients
p<0.01),
(72•}5.0)
against
with
RGECs
gastric
but
and
there
determined
ulcer
was
isolats
感染 症 学 雑誌
no
(66•}6.6)
significant
from
第72巻
gastritis
第10号
Cytotoxic
Fig.
2
Cytotoxic
The
percent
of
20%
the
optical
in
8.7,
In
Tox+
Gastritis
three
disease
Gastritis
groups
of
ammonia
Urease
is
gastric
H.
pylori
on
control
isolates
and
Each
were
were
value
were
DU
70•}6.8),
but
with
RGECs
(MTT
was
at
classified
further
represents
assay).
evaluated
broth
as
into
into
Solid
bars:
three
seen
among
in
groups
Tox+
significant
by
isolates,
*P<0.01.
the
Tox-
groups
two
mean•}SEM(%),
whereas
the
a concentration
divided
activity.
also
no
on
RGECs
brucella
cytotoxic
results
seen,
The
tions
of
1.49mM,
we
cytotoxic
various
effect
ammonia
the
of
three
isolates,
differences
(GU
of
sulfate
of
that
RGECs
was
cytotoxin
cytotoxicity
against
平成10年10月20日
rather
mucosal
than
cell
low
produced
pylori-free
disease
groups
(GU
a similar
trend
among
85•}5.8,
DU
55•}
the
75•}7.7,
survival
urea
concentrations
the
cells
and
was
pylori
were
not
to
vaculoes
concentrations
in
exceeding
were
might
too
play
24
was
30mM.
low
an
hours
to
important
in
Since
while
the
direct
role
in
of
To
and
10
isolates
10
isolates
examine
a
of
cytotoxic
concentration
of
cytotoxicity,
mediating
the
containing
concentration
20mM
induce
vitro.
concentra-
a medium
minimal
injury7).
1.25mM,
that
t-test).
acidic
cytotoxic
in
the
from
from
The
RGECs
injury
mM.
1.30mM,
Student's
in
be
cell
obtained
different
for
may
cellular
32•~10-2
were
100mM).
organism
mucosal
supernatants
incubated
10
the
and
on
was
p=0.79,
supernatants
ammonia
H.
11916cells
of
(range,
of
gastric
broth
(1.12•}0.26mM,
injury.
cytotoxicity
in
by
11639
sulfate
at
cellular
role
brucella
concentration
visually-evident
noted
on
(1.15•}0.24mM)
RGECs,
culture
at
NCTC11637,
ammonium
caused
conventional
vacuolating
on
urease
ammonia
activity
ammonia
pylori
important
neutrophillic-dependent
ammonia
activity
cytotoxin
effect
of
H.
an
by
in H.
mean
cytotoxin
concentrations
in
effect
ammonia
The
vacuolating
by
play
enhance
supernatants
respectively.
against
and/or
of
in
may
synthesized
evaluated
ammonia
produced
pylori
cells
concentration
ammonum
H.
catalytically
vacuolating
without
by
epithelial
Therefore,
with
isolates.
concentration
produced
Ammonia
to
Clinical
vacuolating
similar
was
of
diagnosis
the
p<0.01,
of
supernatant
1031
98•}7.5).
Effects
pH.
medium.
Tox-
isolates,
87•}4.3,
each
(NOD)
endoscopic
of
bars:
supernatants
of
density
the
to
expression
open
of
effect
net
according
patients.
effect
cytotoxic
Effect of H. pylori Supernatants
the
bacterial
Kaoru
1032
KODAMA
et al
Discussion
The
of
H.
results
pylori
causing
of
peptic
Several
groups
appear
produce
detectable
The
the
of
genes21).
of
was
due
the
present
was
of
a
activity
Therefore
results
of
that
the
showed
low
isolates
(DU
of
factors
and
severity
most
likely
factors
the
from
patients
such
that
is less
in
the
GU
the
exert
assay,
other
effects
the
may
obtained
influenced
on
the
. We
RGECs
were
a
higher
cytotoxin,
it
that
cause
low
On
in
the
with
and
the
other
of
other
in
yet
contaminated
,
ulcers
NOD
as
three
hand
duodenal
percent
is
in
irritation
was
factor.
have
. The
had
epithelial
that
super-
ulceration
compounds
mean
was
pylori
supernatants
vacuolating
postulate
might
vacuolating
H.
gastric
patients
to
cytotoxin
assay
of
ammonia
from
oral
a similar
organisms
virulence
region
epithelial
ulcers,
pylon
cause
of
important
98•}7.5)
H.
with
cytotoxic
that
an
which
Gastritis
as
middle
vacuolation
Tox+
concentration
to be
isolates
cytotoxic
well
contain
mean
likely
MTT
85•}5.8,
As
the
and
process.
gastric
of
patients
of
Schmitt
following
cytotoxity
addition,
compound
non-producing
values
assay.
in
to
showed
toxin-induced
RGEC
the
pylori
fail
mechanism
vacuolating
and
H.
gene
by
with
The
In
the
activity,
cytotoxity
gastritis.
and
cytotoxin
isolates
from
vacA
inflammatory
or
the
obtained
the
epithelium
that
duodenal
quantify
may
showed
indirect
supernatant.
MTT
one
gastric
all
isolates
postulated
showed
cytotoxin
with
in
is
ammonia
may
to
supernatants
cytotoxin
which
pylori
the
of
of
and
pylon
sequences
vacuolating
gastritis,
isolates
isolates
results
75•}7.7,
H.
to
and
frequency
vacuolating
asay
that
Ammonia
that
the
H.
system,
related
an
of
analysis
was
of
than
gene18)•`20),
protease
mice,
showed
with
of
MTT
culture
our
NOD
substances
the
rather
each
showed
Tox-
pylon
vacuolating
in
activity
used
damage.
suggesting
three
different
IgA
is
in
isolates
patients
than
H.
clinical
among
those
However,
disease,
one
50%
supernatant
ulceration
cytotoxin
equal
than
cellular
damage.
vacA
the
Genetic
activity
effect
of
the
the
demonstrated
Although
assay
activity
vitro
al.20)
studies8,12,17).
we
MTT
cytotoxic
possible
of
vitro.
and
into
cytotoxin
cytotoxic
quantify
the
cytotoxic
virulence
is
approximately
in
cytotoxin
protein
vacuolating
63%
was
to
natant.
et
direct
almost
insufficient
more
between
cytotoxin
cloning
However,
activity
vacuolating
study,
other
molecular
87kDa
a purified
to
in
cytotoxic
correlation
vacuolating
gene.
cytotoxin
an
Telford
administration
activity
vacA
vacuolating
of
diversity
found
the
the
the
the
vacuolating
release
Haas19).
that
that
reported
possess
between
extracellular
In
examining
shown
have
to
a similarity
vacA
studies
have
ulcer.
isolates
injury
several
infection
Tox-
unknown
these
super-
natants.
The
in
sera
play
activity
of
a
vivo.
are
In
of
to
simple
and
cells.
Our
than
those
that
only
to
have
suggest
patiens
may
induce
damage
to
and
biochemical
the
of
quantitation
isolates
with
ulceration
of
gastric
in
gastric
the
of
RGECs
pylori.
Our
results
the
cytotoxity
of
patients
with
the
epithelium
H.
are
or
ultimately
detectable
cytotoxin
in
a highly
may
immunological
active
vacuolating
result
vacuolating
in
ulceration
cytotoxin
.
and
host
their
high
pylon.
for
cytotoxic
also
vacuolating
in
with
and
of
which
vacuolating
secretion
strains
of
from
that
the
acid
that
role
usefulness
antibodies
that
epithelium
pathogenic
H.
IgG
suggest
functions
of
and
also
gastric
obtained
gastritis
by
results
suggested
the
the
cytotoxin
for
neutralized
but
also
damage
understand
that
is
These
results
demonstrated
method
from
cell
the
vacuolating
easy
data
in
molecular
we
the
cytotoxin
subjects.
severe
necessary
summary,
sensitivity
not
cause
studies
response
vacuolating
Furthermore,
might
Further
the
pylori-infected
role
in
cytotoxin
factor
H.
direct
response
a
of
Tox+
H.
assay
showed
pylon
gastric
cytotoxin
that
due
the
to
MTT
supernatants
ulcers
is
an
are
on
more
important
assay
cultured
cytotoxic
virulence
vivo.
感 染 症 学雑 誌
第72巻
第10号
is
Cytotoxic
1033
Effect of H. pylori Supernatants
Acknowledgements
We thank
Dr. F. Ueda
for providing
RGECs.
We also thank
Miss.
M. Kimoto
for her technical
support.
References
1) Cover TL & Blaser MJ: Helicobacter pylon and gastroduodenal disease. Annu Rev Med 1992; 43: 135-145.
2) Forbes GM, Glaser ME, Cullen DJ et al.: Duodenal ulcer treated with Helicobacter pylon eradication: seven-year
follow-up. Lancet 1994; 343: 258-260.
3) Graham DY, Lew GM, Klein PD et al.: Effect of treatment of Helicobacter pylon infection on the long-term
recurrence of gastric or duodenal ulcer. A randomized, controlled study. Ann Intern Med 1992; 116: 705-708.
4) Cover TL & Blaser MJ: Helicobactor pylon infection, a paradigm for chronic mucosal inflammation: pathogenesis
and implications for eradication and prevention. Adv Intern Med 1996; 41: 85-117.
5) Boren T, Falk P, Roth KA et al.: Attachment of Helicobactor Pylori to human gastric epithelium mediated by blood
group antigens. Science 1993; 262: 1892-1895.
6) Covacci A, Censini S, Bugnoli M et al.: Molecular characterization of the 128-kDa immunodominant antigen of
Helicobacter pylon associated with cytotoxicity and duodenal ulcer. Proc Natl Acad Sci USA 1993; 90: 5791-5795.
7) Tsuda M, Karita M, Morshed MG et al.: A urease-negative mutant of Helicobacter pylori constructed by allelic
exchange mutagenesis lacks the ability to colonize the nude mouth stomach. Infect Immun 1994; 62: 3586-3589.
8) Xiang Z, Censini S, Bayeli PF et al.: Analysis of expression of CagA and VacA virulence factors in 43 strains of
Helicobacter pylori reveals that clinical isolates can be divided into two major types and that CagA is not necessary
for expression of the vacuolating cytotoxin. Infect Immun 1995; 63: 94-98.
9) Tummru MK, Sharma SA & Blaser MJ: Helicobacter pylon picB, a homologue of Bordetella pertussis toxin
secretion protein, is required for induction of IL-8 in gastric epithelial cells. Mol Microbiol 1995; 18: 867-876.
10) Cover TL & Blaser MJ: Purification and characterization of the vacuolating toxin from Helicobacter pylon. J Biol
Chem 1992; 267: 10570-10575.
11) Cover TL, Dooley CP & Blaser MJ: Characterization of human serologic response to proteins in Helicobacter pylon
broth culture supernatants with vacuolizing cytotoxin activity. Infect Immun 1990; 58: 603-610.
12) Cover TL, Cao P, Lind CD, Tham KT & Blaser MJ: Correlation between vacuolating cytotoxin production by
Helicobacter pylon isolates in vitro and in vivo. Infect Immun 1993; 61: 5008-5-12.
13) Matsuoka K, Tanaka M & Yamamoto M: Cultured rabbit gastric epithelial cells producing prostaglandin I2.
Gastroenterology 1983; 84: 498-505.
14) Ueda F, Kyoi T, Mimura K, Kimura K & Yamamoto M: Intercellular communication in cultured rabbit gastric
epithelial cells. Japan J Pharmacol 1991; 57: 321-328.
15) Mossman T: Rapid colorimetric assay for cellular growth and survival: application to proliferation and cytotoxicity assays. J Immunol Methods 1983; 65: 55-63.
16) Okuda H, Fujii S & Kawashima Y: A direct colorimetric determination of blood ammonia. J Clin Microbiol 1987;
25: 2378-2379.
17) Leunk RD, Johonson PT, David BC, Kraft WG & Morgan DR: Cytotoxic activity in broth-culture filtrates of
Campylobacter pylori. J Med Microbiol 1988; 26: 93-94.
18) Cover TL, Tummuru MKR, Cao P, Thompson SA & Blaser MJ: Divergence of genetic sequences for the
vacuolating cytotoxin among Helicobacter pylon strains. J Biol Chem 1994; 269: 10566-10573.
19) Schmitt W & Haas R: Genetic analysis of the Helicobacter pylori vacuolating cytotoxin: structural similarities with
the IgA protease type of exported protein. Mol Microbiol 1994; 12: 307-319.
20) Telford JL, Ghiara P, Dell'Orco M et al.: Gene structure of the Helicobacter pylon cytotoxin and evidence of its
key role in gastric disease. J Exp Med 1994; 179: 1653-1658.
21) Atherton JC, Cao P, Peek Jr RM, Tummuru MKR, Blaser MJ & Cover TL: Mosaicism in vacuolating cytotoxin
alleleas of Helicobacter pylon. J Biol Chem 1995; 270: 17771-17777.
平 成10年10月20日
1034
Kaoru
Helicobacter
pylori臨
KODAMA
et al
床 分離 株 の持 つ空胞 化毒 素 の産 生 と
細 胞 障害性 につ い ての検 討
1)大分医科大学第2内 科
,2)感染予防医学
要
Helicobacter
児玉
薫1)藤
岡
利 生1)伊
西園
晃2)那
須
勝1)
旨
伝 子 に コー ド され た 細 胞 外 分 泌 蛋 白(空
胞 化 毒 素)が
あ る.こ の 毒 素 の活 性 は全 て の菌 株
に は存 在 せ ず,こ
彰1)
る細 胞 障 害 度 の 定 量 化 を試 み た.
pyloriの 病 原 因子 の ひ とつ に,in
vitroで 上 皮 細 胞 に 空 胞 化 変 性 を 引 き起 こ す,
vacA遺
藤
の毒 素 を有 す る菌株 と消 化 性 潰
57株 の うち36株(63%)の
培養上 清が空胞化 毒
素 活 性 を有 して い た が,3疾
患群 での空胞化毒 素
陽 性 率 に有 意 差 は 認 め ら れ な か っ た(慢
二 指 腸 漬 瘍57%).一
性 胃炎
73%,胃
潰 瘍62%,十
方,
MTT法
で は 胃潰 瘍 患 者 由来 株 の 培 養 上 清 の 細 胞
瘍 との 関連 が 指 摘 さ れ て きた.空 胞 化 毒 素 と消 化
障 害 活 性 は慢 性 胃 炎 患 者 由 来 の それ よ り も有 意 に
性 胃漬 瘍 の 発 生 との 関連 につ い て,胃 粘 膜 上 皮 細
高 か った(p<0.01).空
胞 へ の障 害 性 を検 討 す る こ とに よっ て 明 らか に す
様 の傾 向 が 認 め られ た が(p<0.01),空
る こ とを本 研 究 の 目 的 と した.
陰 性 株 間 で は認 め られ な か っ た.
H.pylori感
染 を細 菌 学 的,組 織 学 的 に証 明 した
慢 性 胃炎 患 者(=15),胃
指 腸 漬 瘍 患 者(n=21)か
漬 瘍 患 者(n=21),十
二
ら得 られ たH.pylori臨
床 分 離 株57株 の 培 養 上 清 を用 い て,ウ サ ギ 胃粘 膜
上 皮 細 胞 の空 胞 化 の有 無 を検 討 し,MTT法
胞 化 毒 素 陽 性 株 間 で も同
胞 化毒素
以 上 の 結 果 よ り,空 胞 化 毒 素 は疾 患 特 異 性 を規
定 す る因 子 で は な い が,胃 潰 瘍 患 者 に お い て は そ
の 胃粘 膜 障 害 を担 う一つ の病 原 因 子 と して 重 要 な
役 割 を果 た し て い る可 能 性 が示 唆 され た.
によ
感 染 症 学雑 誌
第72巻
第10号