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研究生:郭俊賢
研究生(外文):Chun-Hsien Kuo
論文名稱:幽門螺旋桿菌液胞毒素基因與功能之研究
論文名稱(外文):Genetic and Functional Studies of Helicobacter pylori Vacuolating Cytotoxin
指導教授:王雯靜
學位類別:博士
校院名稱:國立清華大學
系所名稱:生命科學系
學門:生命科學學門
學類:生物學類
論文種類:學術論文
論文出版年:2002
畢業學年度:90
語文別:英文
論文頁數:173
中文關鍵詞:幽門螺旋桿菌液胞毒素
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幽門螺旋桿菌(幽菌)為生長在人類胃黏膜之微需氧革蘭氏陰性菌,在流行病學上發現腸胃疾病與感染幽菌有密切關係。液胞毒素(VacA)是一個由幽菌分泌的細胞外毒素,亦是主要與病理相關的毒性因子。然而,液胞毒素對細胞毒害作用與致病機轉並不清楚。在第一章,我們從不同角度介紹幽菌的背景資料與其主要的毒性因子,並特別著重於液胞毒素之作用機制。
在第二章,我們首先比較取自55對台灣夫婦的臨床菌株之基因歧異度,以探討幽菌在配偶間傳染的情形。利用兩種核酸鑑定法發現25對夫妻中只有1對出現共同感染的情形。此外,比較40個病患胃內兩個部位的分離株發現9個病人胃內存有不同的菌株。感染相異菌株者有77.8%有腸胃道潰瘍的症狀,比例顯著高於感染同一菌株者(29%) (P = 0.025)。進一步以RAPD與核酸序列分析法對兩株取自同個病人且相當類近的菌株之檢驗結果支持如下假說:幽菌基因的變異性可能源自不同菌群在胃內長時間繁殖時所進行的橫向基因交換。
在第三章,為瞭解幽菌三種毒性因子在幽菌相關致癌機轉中所扮演的角色,我們從189株臨床病菌中分析比較cagA基因狀態、尿素酶的活性、以及液胞毒素的基因與功能特性。尿素酶活性在胃癌(GC)、消化性潰瘍(PU)、以及非潰瘍性消化不良(NUD)三種臨床菌株中並無出現統計上的顯著差異。此外,可能由於高達98 %的台灣菌株具有cagA基因與vacA s1a基因型,這兩者亦無法與臨床結果相關。然而,我們發現約45%的胃癌菌株為vacA m1T型,而消化性潰瘍菌株則主要為m2 (~72%),顯示胃癌與vacA m1T型之間的關聯性 (P < 0.01)。進一步分析m1T與m2液胞毒素的功能特性發現m1T菌株的液胞毒素活性顯著高於m2,但兩者液胞毒素產量卻無統計學上的差異。利用流式細胞儀分析液胞毒素對人類胃表皮細胞的附著能力發現m1型與m2型液胞毒素分別具有高以及中高的吸附活性。另一方面,比較不同臨床疾病菌株的液胞毒素功能特性發現:GC菌株相較於PU菌株顯然具有更高的液胞毒素活性,同時GC病人的m1T菌株液胞毒素活性與產量亦明顯高於PU的m1T菌株 (P < 0.05)。據此,我們確認液胞毒素與胃癌之間的關聯性,並且推測高活性的液胞毒素可能加深細胞退化性傷害而驅動病程往癌化的方向發展。感染m1型菌株或帶有高毒性液胞毒素之菌株可視為胃癌化的高風險指標。
儘管glycosylphosphatidylinositol-anchored proteins (GPI-APs)、與脂微單元(lipid microdomain 或簡稱 raft)被猜測在液胞毒素毒化作用中扮演一定角色,然而目前對相關機制之瞭解仍相當缺乏。在第四章,我們探討了液胞毒素、GPI-APs、以及脂微單元在液胞毒素毒化過程中的位置以及彼此互動關係,以瞭解液胞毒素之細胞作用機轉與生物性意義。表現fasciclin I (一種GPI-AP)的CHO細胞比正常CHO細胞對液胞毒素呈現更高的感度;以PI-PLC除去CHO細胞、AGS、與MDCK細胞表面的GPI-APs皆大幅降低液胞毒素的活性。利用流式細胞儀分析液胞毒素之細胞附著能力發現表現fasciclin I並不會增加液胞毒素之吸附活性;而藉由蛋白酶保護分析法與共軛焦顯微鏡觀察則發現液胞毒素進入細胞內的能力會因fasciclin I的存在而增加。進入細胞內的液胞毒素會被暫時送到細胞核周圍充滿fasciclin I的區域,該區域進一步被鑑定為高基氏體或者為recycling endosome (RE);在作用2-4小時後,接著液胞毒素會再分佈到液胞周圍,此時核周圍的fasciclin I會從原處散開然後重新聚集於液胞周圍而成點狀分佈。在毒化作用過程中,我們發現液胞毒素從開始進入細胞時即一直與fasciclin I的位置有所重疊。此外,將細胞的膽固醇去除後會造成fasciclin I部分流失並使液胞毒素之附著能力與毒性顯著降低。以介面活性劑差別萃取與蔗糖濃度梯度分離法發現液胞毒素與fasciclin I兩者皆主要分佈於脂微單元中,並且液胞毒素會促使更多的fasciclin I移到脂微單元。根據以上結果,我們認為GPI-APs並非液胞毒素的一級受體而液胞毒素乃經由GPI-APs之途徑進入細胞內;脂微單元提供液胞毒素黏附與後來液胞毒素及GPI-APs在胞內傳遞之平台。此外,液胞毒素可能藉由與脂微單元的互動來發揮其細胞作用以增進幽菌之存活能力。
Abstract
Helicobacter pylori (H. pylori) is a spiral microaerophilic Gram-negative bacterium which colonizes the gastric mucosa of the human stomach. Infection with H. pylori is epidemiologically associated with development of gastrointestinal diseases. Vacuolating cytotoxin (VacA) is the major disease-related virulence factor of H. pylori, whose molecular mechanisms in cellular damages and gastric diseases are obscure. In Chapter 1, the background regarding H. pylori in aspects of microbiology, epidemiology, and clinical investigations are described, followed by introduction of major virulence factors of H. pylori with emphasis on VacA.
In Chapter 2, H. pylori strain diversity was investigated in 55 couples in Taiwan. Only one of 25 couples had the same strain in both partners as characterized by two DNA typing methods. Comparison of isolates from the antrum and corpus in each of 40 patients showed that 9 pairs were distinct but might be related. Peptic ulcer occurred in 77.8% of these 9 patients compared with 29% of 31 patients with the same predominant strain in two biopsies (P = 0.025). RAPD and sequence analysis of two very closely related isolates from one patient supports the hypothesis that development of genetic diversity results from horizontal genetic exchange during long-term colonization of mixed bacterial populations.
In Chapter 3, we determined and analyzed cagA status, urease activities, and VacA genetic-functional properties from 189 clinical isolates to investigate the roles of virulence factors in H. pylori-involved carcinogenesis. Undifferentiated urease activities were detected among gastric cancer (GC), peptic ulcer (PU), and non-ulcer dyspepsia (NUD) groups. The presences of cagA gene and s1a genotype of vacA gene were regardless of clinical outcomes due to their extremely high prevalence (~ 98%), whereas GC isolates were significantly associated with higher frequency of vacA m1T genotype (44.7 %) as compared with 71.8 % of m2 strains in PU (P < 0.01). Extensive screening of VacA functional properties showed that m1T isolates displayed comparable production of exotoxins but apparently higher specific vacuolating activities as compared with m2 strains. Flow cytometric examination of VacA-binding on human gastric epithelial cells showed high and moderate-to-high binding competence for m1 and m2 form, respectively. Functional analyses of VacA in different clinical groups revealed that GC was associated with higher cytotoxicities as compared with PU; m1T isolates in GC group possessed significantly higher vacuolating activities and VacA productions than did those in PU (P < 0.05). We thus collectively verified the association of VacA with gastric carcinoma and suggested that high VacA activities might propel the pathogenic progress toward GC by worsening degenerative damages. Infection with either m1 strains or strains carrying high VacA cytotoxicity could both be regarded as the high-risk indicator for developing gastric malignancy.
Glycosylphosphatidylinositol (GPI)-anchored proteins (GPI-APs) and the lipid microdomain (lipid raft) are speculated to play roles in the process of VacA intoxication, despite that comprehension of the relevant mechanism is largely in absence. In Chapter 4, the interactions among VacA, GPI-APs, and the lipid raft were investigated with an aim to understand the molecular action and biological denotation of VacA. Transfected CHO cells expressing fasciclin I, a GPI-AP, displayed higher VacA sensitivity as compared with parental cells. PI-PLC removal of GPI-APs impaired vacuolating activities on AGS, MDCK, and both CHO cell lines. Flow cytometric binding analysis showed independence of VacA cell-binding from the presence of fasciclin I, whereas internalization of VacA was increased by fasciclin I-expression as detected by protease protection assay and confocal microscope. Internalized VacA was transiently delivered to fasciclin I-enriched perinuclear compartments identified as Golgi complex and/or recycling endosome (RE), followed by redistribution to the membrane of large vacuoles. Perinuclear fasciclin I dispersed from Golgi/RE and subsequently re-clustered around the vacuoles at 2-4 h after VacA intoxication. Colocalization of VacA with fasciclin I could be detected as internalization of VacA began. Cholesterol-depletion led to partial loss of fasciclin I and to significantly reduced VacA binding as well as impaired vacuolating activities. Differential detergent extraction and fractionation in sucrose density gradient showed both VacA and fasciclin I were mainly co-resided in the lipid microdomain and more fasciclin I was recruited to the raft after VacA treatment. We proposed that GPI-APs are not primary receptors of VacA and that VacA is internalized via the endocytosis pathway of GPI-APs. Lipid rafts serve as the platform for VacA binding and for further intracellular conveyance of GPI-APs and VacA. VacA may coordinate with lipid rafts to exert cellular functions for assisting H. pylori survivability.
摘要 1
ABSTRACT 3
誌謝 6
目錄 7
CHAPTER 1 9
INTRODUCTION 10
DISCOVERY OF HELICOBACTER PYLORI 10
MICROBIOLOGICAL BACKGROUND OF H. PYLORI 11
CLINICAL INVESTIGATIONS 12
Epidemiology 12
Histopathology of H. pylori Infection 13
Diagnosis of H. pylori infection 13
Therapy 14
Vaccine 15
VIRULENCE FACTORS 16
Urease 17
Neutrophil-activating protein 18
CagA and cag pathogenicity island 18
VacA 19
CHAPTER 2 25
ABSTRACT 26
INTRODUCTION 27
MATERIALS AND METHODS 28
RESULTS 30
DISCUSSION 33
CHAPTER 3 38
ABSTRACT 39
INTRODUCTION 41
MATERIALS AND METHODS 44
RESULTS 49
DISCUSSION 60
CHAPTER 4 73
ABSTRACT 74
INTRODUCTION 76
I. Review of the lipid microdomain 76
II. GPI—APs and fasciclin I 80
III. Specific aims in this study 82
MATERIALS AND METHODS 86
RESULTS 94
CHO cells expressing GPI-anchored proteins are more sensitive to VacA 94
CHO and CHO-f1 lines have comparable VacA binding activities 95
Fasciclin I distributes mainly in the cell surface and peri-nuclear compartments 96
Both fasciclin I and VacA are located in lipid rafts 97
More VacA is internalized in CHO-f1 cells as compared with parental cells 99
Internalized VacA initially reaches perinuclear compartments and is subsequently redistributed to the surrounding of vacuoles 100
Perinuclear fasciclin I is dramatically redistributed after VacA treatment 100
Raft-association of fasciclin I is more profound after VacA intoxication 101
Cholesterol depletion reduces raft formation and protects CHO cells from VacA intoxication 102
DISCUSSION 104
Summary of the results 104
Roles of GPI molecules in intoxication of VacA 105
Subcellular distributions of VacA 106
Roles of rafts in VacA intoxication 107
H. pylori survival and functions of VacA 107
Association between GPI-APs and sphingolipids 108
Pharmaceutical potential and application of VacA 109
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