While it is well-known that H. pylori induces inflammation, this inflammatory response is insufficient to clear the organism from the gastric mucosa and the organism overcomes the immune response to cause chronic infections that can last for decades in untreated patients. Paradoxically, H. pylori may have both pro-inflammatory as well as anti-inflammatory mechanisms. These opposing forces must operate in such a fashion as to achieve a delicate balance that involves complex interactions between bacterial virulence factors and host innate and adaptive immune system factors.
How does arginase in wild type
H. pylori act as an anti-inflammatory mediator? While the underlying mechanisms are still not well understood, the depletion of arginine by this enzyme from the extracellular environment may be one factor that triggers altered gene expression in the gastric epithelial cell. Precedence for this idea comes from prior work showing that arginine depletion leads to altered T cell receptor zeta chain expression (CD3ζ) [
16]. Another possibility is that the products of arginine hydrolysis, namely, ornithine and urea, could also be playing a role in altering transcriptional responses by the gastric epithelial cells. A third possibility is that the arginase mutant, through disruption of the bacterial metabolic balance of arginine, ornithine, or urea levels, could have altered gene transcriptional profiles leading to modified expression of other bacterial virulence factors that interplay with the host immune system.
A fourth possibility is that the increase in IL-8 production induced by the
H. pylori rocF- mutant is through altered spermine produced by the AGS cells. Previous reports have shown that
H. pylori infection induces ornithine decarboxylase (ODC) in macrophages [
15,
18]. ODC degrades L-ornithine into putrescine and this is later converted into spermidine and finally spermine. Although we did not find differences in the level of mRNA for the spermine synthase (
SMS), we did find that ornithine decarboxylase (
ODC) and spermidine synthase mRNA (
SRM), two key enzymes in the production of spermine, were 20% and 41%, respectively, reduced in the
rocF-mutant
-infected AGS cells (data not shown). It has also been shown that spermine can reduce the inflammatory response by post-transcriptional inhibition of the production of pro-inflammatory cytokines, including TNFα, IL6, MIP-1α, and MIP-1β [
19], and even though IL-8 was not included in this study, it is possible that it is regulated by spermine as well. Thus, in the interaction of wild type
H. pylori with AGS cells, spermine levels may be elevated in the AGS cells, leading to a dampening of the chemokine/cytokine pro-inflammatory response. These possibilities await further in depth analyses.
We performed pair-wise comparison of transcriptome on the human adenocarcinoma gastric cell line AGS after infection with 26695 wild type, its isogenic
rocF- knockout mutant, and a
rocF- complemented (
rocF+)
H. pylori strain, with uninfected AGS cells as a control. The first observation with the microarray analysis was an overall increase in the number of genes that participate in several signaling pathways previously investigated with
H. pylori infection, notably with
NFKB and
AP-1 activation and mitogen-activated protein kinase (especially
ERKs,
JNKs,
SAPKs) [
20], along with
JUN-mediated signaling. From this activation cascade, the induction of
IL-8 marked the greatest difference between the
rocF- mutant
H. pylori versus either the WT or the
rocF+ complemented strain. Our results show a significant increase of mRNA and protein levels of
IL-8 in AGS cells infected with the
rocF- mutant strain, suggesting that WT bacteria may be able to control the inflammatory infiltration of immune cells by controlling the production of IL-8, which is a potent chemotactic factor for inflammatory cells, especially neutrophils [
21-
24].
While many
H. pylori factors have been suggested to stimulate IL-8 expression, including peptidoglycan, LPS, CagA, VacA, PicB, IceA, urease (and even ammonia) [
25-
28], less is known about bacterial factors involved in suppression of cytokine production, especially in epithelial cells. Mechanisms for immune evasion by
H. pylori have been demonstrated, including the presence of a less potent LPS and cholesterol glycosylation [
29]; however, fewer studies dealt with reduced host cytokine production as an immune suppressive mechanism, including effects on IL-12 [
30-
32]. While an increased amount of cytokines can result in histologically more intense gastritis [
33], the limitation of this cytokine induction could be an advantage to the bacteria so that it can stay under the radar of the immune system. However, due to the complexity of the
H. pylori-gastric cell interaction, and the complexity of the lesions induced by the infection, it is expected that multiple pathways are activated and the balance of those pathways may determine the presence or the evolution of the gastric lesions.
Efforts to determine the effect of the infection with
H. pylori rocF- strains in the cellular infiltration of the gastric mucosa are currently underway. To the best of our knowledge, there is only one published work trying to measure the levels of
H. pylori arginase in gastric biopsies of patients with gastritis and its correlation with disease [
34]. That work showed that there is a lot of variability on the levels of
H. pylori arginase in biopsies but the authors were not able to establish a correlation with the degree of gastritis. The reason for the increased number of genes modulated by the
rocF-
H. pylori, when compared to the WT and the
rocF+ bacteria, is not known; however, our results, rather than suggesting the existence of
H. pylori arginase mutants in human gastric lesions, highlights the importance that this enzyme may have in the interaction of the bacteria with cells in the human gastric mucosa, and through them, with the immune system. Taken together our results suggest that
H. pylori arginase, by modulating the production of IL-8 may play a significant role in the survival of
H. pylori in the gastric environment. By preventing an over-zealous immune response,
H. pylori can achieve its chronicity through the production of arginase and probably other bacterial factors that contribute to the overall global success of this important and highly-adapted gastric human pathogen.