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Division of Gastroenterology, Vanderbilt University School of Medicine, Nashville 37232; and Department of Veterans Affairs Medical Center, Nashville, Tennessee 37212
Helicobacter pylori strains that
possess the cag pathogenicity island induce more severe
gastritis and augment the risk of developing peptic ulcer disease and
distal gastric cancer. A specific mechanism by which
cag+ strains may enhance gastritis is
strain-selective regulation of interleukin (IL)-8 production. On
contact with gastric epithelial cells, H. pylori activates
multiple signal transduction cascades that regulate IL-8 secretion,
including nuclear factor-
B and mitogen-activated protein kinases,
and these events are dependent on genes within the cag
island. An independent effect of cag-mediated cellular
contact is translocation and phosphorylation of H. pylori proteins within the host epithelial cell. The redundancy of
intracellular signaling cascades activated by H. pylori and
the divergent epithelial cell responses induced by components of the
cag island may contribute to the ability of this organism to
persist for decades within the gastric niche.
interleukin-8; nuclear factor-
B; mitogen-activated protein
kinases
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