B-cell monoclonality in Helicobacter pylori-associated chronic atrophic gastritis

Incidência e aspectos histopatológicos da infecção por Helicobacter spp. em gatos da Cidade de Recife, Pernambuco, Brasil

O presente trabalho objetivou investigar a prevalência da bactéria Helicobacter spp. em gatos da Cidade do Recife, Pernambuco. As amostras de estômagos analisadas foram colhidas de 119 gatos sem raça e idade definida, sendo 56 machos e 63 fêmeas. Para pesquisa de Helicobacter spp., foram realizados os métodos de teste rápido da urease e exames histopatológicos. As análises pelo teste rápido da urease mostraram que em 82,35% das amostras foi detectada reação positiva para Helicobacter. Na análise histopatológica, verificou-se que em 59,66% das amostras (71/119) apresentaram lesões. Essas lesões consistiram em infiltrado linfoplasmocitário com folículo linfoide, microabcessos, necrose, hipotrofia; em 40,34% das amostras (48/119) não foram observadas alterações histológicas. Conclui-se que gatos oriundos da Cidade de Recife, Pernambuco< apresentam alta incidência de infecção por Helicobacter spp. Infiltrado difuso de células linfoplasmocitárias foram as alterações histopatológicas mais frequentes observadas na mucosa gástrica de gatos infectados por Helicobacter spp.

Effects of lactose as an inducer on expression of Helicobacter pylori rUreB and rHpaA, and Escherichia coli rLTKA63 and rLTB

AIM: To demonstrate the effect of lactose as an inducer on expression of the recombinant proteins encoded by Helicobacter pylori ureB and hpaA, and Escherichia coli LTB and LTKA63 genes and to determine the optimal expression parameters.

METHODS: By using SDS-PAGE and BIO-RAD gel image analysis system, the outputs of the target recombinant proteins expressed by pET32a-ureB-E.coliBL21, pET32a-hpaA-E.coliBL21, pET32a-LTKA63-E.coliBL21 and pET32a-LTB-E.coliBL21 were measured when using lactose as inducer at different dosages, original bacterial concentrations, various inducing temperatures and times. The results of the target protein expression induced by lactose were compared to those by isopropyl-β-D-thiogalactoside (IPTG). The proteins were expressed in E.coli.

RESULTS: Lactose showed higher efficiency of inducing the expression of rHpaA, rUreB, rLTB and rLTKA63 than IPTG. The expression outputs of the target recombinant proteins induced at 37 °C were remarkably higher than those at 28 °C. Other optimal expression parameters for the original bacterial concentrations, dosages of lactose and inducing time were 0.8, 50 g/L and 4 h for rHpaA; 0.8, 100 g/L and 4 h for rLTKA63; 1.2, 100 g/L and 5 h for both rUreB and rLTB, respectively.

CONCLUSION: Lactose, a sugar with non-toxicity and low cost, is able to induce the recombinant genes to express the target proteins with higher efficiency than IPTG. The results in this study establish a beneficial foundation for industrial production of H pylori genetic engineering vaccine.

Construction of prokaryotic expression system of ureB gene from a clinical Helicobacter pylori strain and identification of the recombinant protein immunity

AIM: To clone ureB gene from a clinical isolate of Helicobacter pylori and construct a prokaryotic expression system of the gene and identify immunity of the expressed recombinant protein.

METHODS: ureB gene from a clinical H pylori strain Y06 was amplified by the high fidelity polymerase chain reaction technique. The target DNA fragment amplified from ureB gene was sequenced after T-A cloning. Prokaryotic recombinant expression vector pET32a inserted with ureB gene (pET32a-ureB) was constructed. The expression of recombinant UreB protein (rUreB) in E. coli BL21DE3 induced by isopropylthio-β-D-galactoside (IPTG) at different concentrations was examined by SDS-PAGE. Western blot using commercial antibodies against whole cell of H pylori and an immunodiffusion assay using a self-prepared rabbit anti-rUreB antibody were applied to determine immunity of the target recombinant protein. ELISA was used to detect the antibody against rUreB in sera of 125 H pylori infected patients and to examine rUreB expression in 109 H pylori isolates.

RESULTS: In comparison with the reported corresponding sequences, the nucleotide sequence homology of the cloned ureB gene was from 96.88-97.82% while the homology of its putative amino acid sequence was as high as 99.65-99.82%. The rUreB output expressed by pET32a-ureB-BL21DE3 was approximate 30% of the total bacterial proteins. rUreB specifically combined with the commercial antibodies against whole cell of H pylori and strongly induced rabbits to produce antibody with a 1:8 immunodiffusion titer after the animals were immunized with the recombinant protein. Serum samples from all H pylori infected patients were positive for UreB antibody and UreB expression were detectable in all tested H pylori isolates.

CONCLUSION: A prokaryotic expression system with high expression efficiency of H pylori ureB gene was successfully established. The expressed rUreB showed qualified immunoreactivity and antigenicity. High frequencies of UreB expression in different H pylori isolates and specific antibody against UreB in sera of H pylori infected patients indicate that UreB is an excellent antigen candidate for developing H pylori vaccine.

Construction of a prokaryotic expression system of vacA gene and detection of vacA gene, VacA protein in Helicobacter pylori isolates and ant-VacA antibody in patients’ sera

AIM: To construct a recombinant prokaryotic expression vector inserted with Helicobacter pylori vacA gene and identify the immunity of the expressed recombinant protein, and to determine prevalence of vacA-carrying/VacA expressing H pylori isolates and seroprevalence of specific ant-VacA antibody in H pylori infected patients.

METHODS: Polymerase chain reaction technique was used to amplify complete vacA gene of H pylori strain NCTC11637 and to detect vacA gene in 109 H pylori isolates. The amplification product of the complete vacA gene was sequenced after T-A cloning. A recombinant expression vector inserted with a complete vacA gene fragment, named as pET32a-vacA, was constructed. Expression of the target recombinant protein VacA (rVacA) was examined by SDS-PAGE. Western blot using commercial antibodies against whole cell of H pylori and an immunodiffusion assay using self-prepared rabbit anti-rVacA antibody were applied to determine immunoreaction and antigenicity of rVacA. Two ELISA methods were established to detect VacA expression in H pylori isolates and the specific anti-VacA antibody in sera from 125 patients infected with H pylori.

RESULTS: In comparison with the reported corresponding sequences, homologies of nucleotide and putative amino acid sequences of the cloned vacA gene were 99.82% and 100%, respectively. The constructed recombinant prokaryotic expression system efficiently produced rVacA. rVacA was able to combine with the commercial antibodies against whole cell of H pylori and to induce the immunized rabbit to produce specific antibody with an immunodiffusion titer of 1:4. All tested H pylori isolates carried vacA gene, but only 66.1% expressed VacA protein. Of the serum samples tested, 42.4% were positive for specific anti-VacA antibody.

CONCLUSION: A prokaryotic expression system of H pylori vacA gene was successfully constructed. The expressed rVacA can be used to detect specific anti-VacA antibody in human and to prepare antiserum in animals. The high frequency of vacA gene in H pylori isolates, but with a low frequency of VacA expression and specific anti-VacA antibody in H pylori infected patients implies that VacA is not an ideal antigen for H pylori vaccine.

Establishment of Helicobacter pylori infection model in Mongolian gerbils

AIM: To establish a stable and reliable model of Helicobacter pylori infection model in Mongolian gerbils and to observe pathological changes in gastric mucosa in infected animals.

METHODS: Mongolian gerbils were randomly divided into 18 groups; 6 groups were infected with H pylori clinical strain Y06 (n = 6, groups Y), 6 groups were infected with H pylori strain NCTC11637 (n = 6, groups N), and 6 uninfected groups as negative controls (n = 4, groups C). H pylori suspensions at the concentrations of 2 × 10⁸ and 2 × 10⁹ CFU/mL of strain NCTC11637 and strain Y06 were prepared. The animals in three groups N and in three groups Y were orally challenged once with 0.5 mL of the low concentration of the bacterial suspension. The animals in another three groups N and in another three groups Y were orally challenged with 0.5 mL of the high concentration of the bacterial suspension for 3 times at the intervals of 24 h, respectively. For the negative controls, the animals in six groups C were orally given with the same volume of Brucella broth at the corresponding inoculating time. The animals were killed after 2nd, 4^th and 6^th week after the last challenge and the gastric mucosal specimens were taken for urease test, bacterial isolation, pathological and immunohistochemical examinations.

RESULTS: Positive isolation rates of H pylori in the animals of groups Y at the 2nd, 4^th and 6^th week after one challenge were 0%, 16.7% and 66.7%, while in the animals of groups N were 0%, 0% and 16.7%, respectively. Positive isolation rates of H pylori in the animals of groups Y at the 2nd, 4^th and 6^th week after three challenges were 66.7%, 100% and 100%, while in the animals of groups N were 66.7%, 66.7% and 100%, respectively. In animals with positive isolation of H pylori, the bacterium was found to colonized on the surface of gastric mucosal cells and in the gastric pits, and the gastric mucosal lamina propria was infiltrated with inflammatory cells.

CONCLUSION: By using H pylori suspension at high concentration of 2 × 10⁹ CFU/mL for multiple times, the orally challenged Mongolian gerbils can be used as a stable and reliable H pylori infection model. The 2 strains of H pylori can colonize in gastric mucosa of the infected animals and cause mild inflammation reaction.

Effects of H. pylori eradication with liaowei decoction on pathology of H. pylori-associated chronic gastritis in rats

AIM: To evaluate the effects of H. pylori eradication with liaowei decoction on pathologic changes and COX-2 expression of H. pylori-associated chronic gastritis in rats.

METHODS: A total of 80 grade-II male Wister rats weighing 80-100 g were given H. pylori and MNNG to prepare H. pylori-associated chronic gastritis model with 4 mice dead. Among them, 54 rats with H. pylori serum antibody positive were randomly divided into 4 groups: H. pylori eradication with liaowei decoction (14 rats); H. pylori eradication with Maizilin (positive control, 14 rats); spontaneous recovery (negative control, 13 rats); and simple H. pylori eradication therapy (13 rats). After treatment, both Gram staining of gastric antrum mucosal smear and rapid urease testing were made to detect the H. pylori colonization of the gastric mucosa and to assess the histological indexes of gastric antrum mucosa. Immunohistochemical staining was also performed to detect COX-2 expression.

RESULTS: The colonization of gastric mucosa by H. pylori was found in rats from spontaneous recovery group, as an indication of long-term continuous H. pylori infection, while no colonization was found in rats from other groups. Pathological changes of gastric antrum mucosa included moderate gastric mucosal atrophy in rats from spontaneous recovery group (pathologic integration 2.0±0.20 points), associatded with moderate acute or chronic gastric mucosal inflammation (pathologic integrations were 2.0±0.20 points and 1.90±0.39 points, respectively). In comparison with spontaneous recovery group, treatment effectiveness in the group of H. pylori eradication with liaowei decoction was remarkably different (P < 0.05). The gastric mucosal atrophy in the combination group (pathologic integration 1.25±0.44 points) was less severe, while acute gastric mucosal inflammation (pathologic integration 0.3±0.47 points) was extincted, and chronic inflammation (pathologic integration 1.05±0.22 points) was less severe; For the group of H. pylori eradication and "Maizilin", pathologic integration of gastric mucosal atrophy was 2.0±0.43 points. In comparison with spontaneous recovery group, there was no remarkable difference, however, acute inflammation was extincted and chronic inflammation was the same as before. Gastric mucosal atrophy and chronic inflammation were more severe in simple H. pylori eradication group than those in spontaneous recovery group, while active inflammatory changes extincted. COX-2 expression of gastric antrum mucosa in the group of simple H. pylori eradication, group of H. pylori eradication with liaowei decoction, group of H. pylori eradication and Maizilin as well as spontaneous recovery group were 14%±3.7%, 10%±3.8%, 13%±4.0% and 19%±10.2%, respectively. In comparison with spontaneous recovery group, COX-2 expression of the treatment groups were greatly decreased as an indication of remarkable difference (P < 0.05).

CONCLUSION: COX-2 expression and acute inflammation can be greatly decreased by applying H. pylori eradication therapy in the treatment of H. pylori-associated chronic gastritis, but the therapy cannot do much to chronic pathologic changes, especially to atrophic changes. Application of the combined therapy of H. pylori eradication with "liaowei decoction" for 12 weeks will have better treatment effectiveness on chronic pathologic changes, especially atrophic changes.

Construction of expression systems for flaA and flaB genes of Helicobacter pylori and determination of immunoreactivity and antigenicity of recombinant proteins

AIM: To clone flagellin genes A (flaA) and B (flaB) from a clinical strain of Helicobacter pylori (H pylori) and to construct prokaryotic expression systems of the genes and identify immunity of the fusion proteins.

METHODS: The flaA and flaB genes from a clinical H pylori isolate Y06 were amplified by high fidelity PCR. The nucleotide sequences of target DNA amplification fragments from the two genes were sequenced after T-A cloning. The recombinant expression vector pET32a inserted with flaA and flaB genes was constructed, respectively. The expressions of FlaA and FlaB fusion proteins in E. coli BL21DE3 induced by isopropylthio-β-D-galactoside (IPTG) at different concentrations were examined by SDS-PAGE. Western blot using commercial antibodies against whole cell of H pylori and immunodiffusion assay using self-prepared rabbit antiserum against FlaA (rFlaA) or FlaB (rFlaB) recombinant proteins were applied to the determination of the fusion proteins immunity. ELISA was used to detect the antibodies against rFlaA and rFlaB in sera of 125 H pylori infected patients and to examine rFlaA and rFlaB expression in 98 clinical isolates of H pylori, respectively.

RESULTS: In comparison with the reported corresponding sequences, the nucleotide sequence homologies of the cloned flaA and flaB genes were from 96.28%-97.13% and 96.31%-97.73%, and their putative amino acid sequence homologies were 99.61%-99.80% and 99.41%-100% for the two genes, respectively. The output of rFlaA and rFlaB expressed by pET32a-flaA-BL21DE3 and pET32a-flaB-BL21DE3 systems was as high as 40%-50% of the total bacterial proteins. Both rFlaA and rFlaB were able to combine with the commercial antibodies against whole cell of H pylori and to induce rabbits to produce specific antibodies with the same 1:2 immunodiffusion titers after the animals were immunized with the two recombinant proteins. Ninety-eight and zero point 4 and 92.80% of the serum samples from 125 patients infected with H pylori were positive for rFlaA and rFlaB antibodies, respectively. One hundred percent and 98.98% of the 98 tested isolates of H pylori were detectable for rFlaA and rFlaB epitopes, respectively.

CONCLUSION: Two prokaryotic expression systems with high efficiency of H pylori flaA and flaB genes were successfully established. The expressed rFlaA and rFlaB showed satisfactory immunoreactivity and antigenicity. High frequencies of FlaA and FlaB expression in different H pylori clinical strains and the general existence of specific antibodies against FlaA and FlaB in H pylori infected patients strongly indicate that FlaA and FlaB are excellent antigen candidates for developing H pylori vaccine.

p53 expression, K-ras gene mutation and microsatellite instability in gastric B-cell lymphomas

BACKGROUND AND AIMS

Genetic mechanisms involved in the development of gastric B-cell lymphomas remain unclear. The aim of the present study was to clarify the roles of mutations of the p53 and K-ras genes, and microsatellite instability (MSI) in the development of gastric B-cell lymphomas.

METHODS

We investigated p53 immunoreactivity, mutations of the K-ras gene, and MSI in 27 gastric marginal zone B-cell lymphomas of mucosa-associated lymphoid tissue type (MZBCL) and 24 diffuse large B-cell lymphomas (DLBCL). p53 immunoreactivity was examined using a monoclonal antibody, DO-7. Mutation of the K-ras gene was detected by polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) analysis. MSI was examined at five microsatellite loci with a microsatellite assay. Cases were classified as having high-frequency MSI (MSI-H) (>/= 2 loci showing instability), low-frequency MSI (MSI-L) (only one locus showing instability), or as microsatellite stable.

RESULTS

p53 immunoreactivity was detected in 1 of 16 (6%) MZBCL and 8 of 19 (42%) DLBCL. Frequency of p53 immunoreactivity in DLBCL was significantly higher than that in MZBCL (P = 0.018). MSI-H was detected only in 1 of 20 (5%) DLBCL. None of the cases examined showed mutation of the K-ras gene.

CONCLUSIONS

These data suggest that mutations of the p53 gene may play an important role in the development of gastric DLBCL, and that mutations of the K-ras gene and MSI may be involved in little part of the development of gastric B-cell lymphomas.

Construction of hpaA gene from a clinical isolate of Helicobacter pylori and identification of fusion protein

AIM: To clone hpaA gene from a clinical strain of Helicobacter pylori and to construct the expression vector of the gene and to identify immunity of the fusion protein.

METHODS: The hpaA gene from a clinical isolate Y06 of H. pylori was amplified by high fidelity PCR. The nucleotide sequence of the target DNA amplification fragment was sequenced after T-A cloning. The recombinant expression vector inserted with hpaA gene was constructed. The expression of HpaA fusion protein in E.coli BL21(DE3) induced by IPTG at different dosages was examined by SDS-PAGE. Western blot with commercial antibody against whole cell of H. pylori as well as immunodiffusion assay with self-prepared rabbit antiserum against HpaA fusion protein were applied to determine immunity of the fusion protein. ELISA was used to detect the antibody against HpaA in sera of 125 patients infected with H. pylori and to examine HpaA expression of 109 clinical isolates of H. pylori.

RESULTS: In comparison with the reported corresponding sequences, the homologies of nucleotide and putative amino acid sequences of the cloned hpaA gene were from 94.25%-97.32% and 95.38%-98.46%, respectively. The output of HpaA fusion protein in its expression system of pET32a-hpaA-BL21(DE3) was approximately 40% of the total bacterial proteins. HpaA fusion protein was able to combine with the commercial antibody against whole cell of H. pylori and to induce rabbit producing specific antiserum with 1:4 immunodiffusion titer after the animal was immunized with the fusion protein. 81.6% of the serum samples from 125 patients infected with H. pylori (102/125) were positive for HpaA antibody and all of the tested isolates of H. pylori (109/109) were detectable for HpaA.

CONCLUSION: A prokaryotic expression system with high efficiency of H. pylorihpaA gene was successfully established. The HpaA expressing fusion protein showed satisfactory immunoreactivity and antigenicity. High frequencies of HpaA expression in different H. pylori clinical strains and specific antibody production in H. pylori infected patients indicate that HpaA is an excellent and ideal antigen for developing H. pylori vaccine.

B-cell monoclonality is associated with lymphoid follicles in gastritis

The gold standard for diagnosis of gastric MALT lymphoma is histopathology. Polymerase chain reaction-based assays to detect the expansion of monoclonal B cells have also been used to corroborate the diagnosis. However, there are conflicting data on monoclonal B-cell expansion in gastritis. We asked about its frequency in graded gastritis cases. Lymphocytic infiltration in gastric biopsies was graded according to Wotherspoon in 129 cases. The histologic diagnosis ranged from normal gastric mucosa to suspicious for gastric MALT lymphoma. To search for a monoclonal B-cell population, a semi-nested polymerase chain reaction strategy was used for amplification of rearranged VDJ sequences of the immunoglobulin heavy chain gene. Of 106 evaluable samples, 18 were found to be monoclonal. The detection of a monoclonal B-cell population was strongly associated with the presence of lymphoid follicles. In cases with lymphoid follicles, detection of monoclonality was independent of Wotherspoon grading; there is no significant difference between cases being suspicious for lymphoma and those not. We found B-cell monoclonality to be a more frequent than expected finding in gastritis and to be strongly associated with the presence of lymphoid follicles; thus, its presence is of little significance in patient management.

Non-Hodgkin's lymphoma developing in a pacemaker pocket

A 29-year-old man developed diffuse large B-cell lymphoma in a subpectoral pacemaker pocket that 6 years previously had been created in the chest for a titanium-covered pulse generator. The patient had an 8-cm-diameter dark red tumor with necrotic tissue on a keloidal surgical scar in the left side of the chest. Left axillary lymphadenopathy also was present. Laboratory studies showed an increased level of soluble interleukin 2 receptor and a normal level of lactose dehydrogenase. A biopsy specimen showed a diffuse large B-cell phenotype and monoclonal immunoglobulin H gene rearrangement. A gallium scintigraphy study showed abnormal accumulation in the left chest and left axilla. On the basis of these findings, we diagnosed diffuse large B-cell lymphoma, stage II. The patient received THP-COP chemotherapy (pirarubicin, cyclophosphamide, vincristine, and prednisolone) and radiotherapy, achieved complete remission, and was free of disease for 16 months after treatment. This case suggests that there was a relationship between the development of non-Hodgkin's lymphoma and the presence of chronic inflammation in the pulse generator pocket.

The Relationship Between Primary Gastric B-cell Lymphoma and Immunoglobulin Heavy Chain (IgH) Gene Rearrangement – A Histopathological Study of Primary Gastric Lymphomas

The aim of this study was to review our primary gastric lymphoma cases according to the new WHO classifications and to investigate the histopathological features of B-cell lymphomas. In addition, B-cell monoclonality was analyzed for immunoglobulin heavy chain (IgH) gene rearrangement using the polymerase chain reaction at the site of the lymphoma lesion, transitional lesion, and the non-lymphoma lesion. Specimens resected from 31 primary gastric lymphomas were examined. There were 28 cases (90.3%) of B-cell lymphoma and three cases (9.7%) of T-cell lymphoma. The B-cell lymphomas were classified as low-grade mucosa-associated lymphoid tissue (MALT) lymphoma (LGML) (9%), high-grade MALT lymphoma (HGML) (42%), and diffuse large B-cell lymphoma (DLBCL) (29%). Histopathologically, lymphoepithelial lesions (LEL) were higher in LGML (100%) than in DLBCL (22%), with statistical significance (p < 0.05). A monoclonal pattern of IgH rearrangement was detected in LGML (50.0%), HGML (60.0%), and DLBCL (80.6%), with a statistically significant difference between LGML and DLBCL (p < 0.01). The IgH monoclonal pattern may reflect the gross appearance of lymphoma or the lymphoma infiltration depth. Superficial spreading and shallow growth in LGML may correspond to an oligoclonal pattern, and mass-forming and deep invasive growth in DLBCL may correspond to a more monoclonal pattern.

PELA microspheres loaded H. pylori lysates and their mucosal immune response

AIM: To prepare poly (D,L-lactide)-polyethylene glycol copolymer (PELA) microspheres loaded H.pylori lysates or Cystografin and observe their targeting in gastrointestinal mucous membrane or analyze the mucosal immune responses by oral administration.

METHODS: PELA microspheres loaded H.pylori lysates or Cystografin were prepared by double emulsion evaporation method. Their distribution in gastrointestinal mucous membrane was observed by CT.Balb/c mice orally immunized in mucosal immune responses, whose antibody production in salivary and gut washing and antibody secreting cells in Peyer’s patches (PP) were estimated by ELISA and ELISPOT, respectively. The microspheres’ physical properties, such as particle size, protein level and morphology were investigated.

RESULTS: All prepared microspheres were found to have a smooth surface morphology from 3.20-4.05 μm in diameter and high encapsulation efficiency from 74.9%-82.2%. No significant correlation in their physical properties was shown, depending on their molecular weight at the similar composition ratio. Immunization with all types of PELA-Hp microspheres elevated the saliva sIgA level at week 3 by approximately 3-4 times that with soluble antigen, which was greatly enhanced after boosting. At one week after last immunization with all types of PELA-Hp microspheres (week 8), the specific sIgA-ASCs, IgG-ASCs and sIgA in salivary rose obviously. In intestinal Peyer’s patches, the specific sIgA-ASCs were 5.92-6.98 × 10⁴/mL cell and IgG-ASCs were 3.47-4.02 × 10⁴/mL cell, about 5-9 times higher than those with soluble antigen (P < 0.01). ASCs in intestine were more than those in stomach and the majority of the ASCs were sIgA-ASCs. The sIgA in gut washing fluid was 1.62-1.85 OD, about 3-6 times tthat of those with soluble antigen. There were significant differences of the ASCs and sIgA in gut washing fluid as compared with those of PBS and MS-0 (P < 0.05). There appeared to be good correlation between sIgA level in gut washing fluid and sIgA-ASCs in intestinal Peyer’s patches.

CONCLUSION: PELA microspheres may be used as vehicle to delivery antigen and adjuvant in designing oral vaccination.