Genetic Manipulation of Helicobacter pylori Virulence Function by Host Carcinogenic Phenotypes

is the strongest risk factor for gastric adenocarcinoma, yet only a minority of infected persons ever develop this malignancy. One cancer-linked locus is the type 4 secretion system ( T4SS), which translocates an oncoprotein into host cells. A structural component of the T4SS is CagY, which becomes rapidly altered during adaptation in mice and rhesus monkeys, rendering the T4SS nonfunctional; however, these models rarely develop gastric cancer. We previously demonstrated that the strain 7.13 rapidly induces gastric cancer in Mongolian gerbils. We now use this model, in conjunction with samples from patients with premalignant lesions, to define the effects of a carcinogenic host environment on the virulence phenotype of to understand how only a subset of infected individuals develop cancer. sequence differences and T4SS function were directly related to the severity of inflammation in human gastric mucosa in either a synchronous or metachronous manner. Serial infections of Mongolian gerbils with strain 7.13 identified an oscillating pattern of T4SS function. The development of dysplasia or cancer selected for attenuated virulence phenotypes, but robust T4SS function could be restored upon infection of new hosts. Changes in the genetic composition of mirrored T4SS function, although the mechanisms of alterations differed in human isolates (mutations) versus gerbil isolates (addition/deletion of motifs). These results indicate that host carcinogenic phenotypes modify T4SS function via altering allowing the bacteria to persist and induce carcinogenic consequences in the gastric niche. .