title: Assessment of invasion frequencies of cultured HEp-2 cells by clinical isolates of Helicobacter pylori using an acridine orange assay.
abstract: OBJECTIVE
  Recent studies suggest that Helicobacter pylori is an invasive enteropathogen. However, the efficiency with which this pathogen invades mammalian cells remains unknown. Therefore, this study was designed to investigate the invasion frequencies of HEp-2 cells by clinical strains of H pylori.
  
  
  METHODS
  An acridine orange assay and cultured HEp-2 cell monolayers were used to determine the HEp-2 cell penetration frequencies of 17 clinical isolates and one American Type Culture Collection (ATCC) strain of H pylori, and single clinical strains of Yersinia enterocolitica, Shigella flexneri, and a non-invasive ATCC Escherichia coli strain.
  
  
  RESULTS
  The acridine orange assay demonstrated that invasion frequencies of HEp-2 cells by all H pylori isolates were significant and, in most instances, exceeded those for the S flexneri strain and equalled those for the Y enterocolitica strain. The assay also showed that internalised H pylori organisms remained viable for at least six hours, the maximum time that bacteria and HEp-2 cells were co-incubated.
  
  
  CONCLUSIONS
  These results may have important implications for treatment and prevention strategies for this gastric pathogen. Furthermore, the acridine orange assay may be useful for assessing, in vitro, the ability of conventional and newer antibiotics, alone or in combination, to kill intracellular H pylori organisms.
authors.affiliation: Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: Wilkinson
authors.forename: J R
authors.initials: JR
authors.lastname: Uhl
authors.forename: B C
authors.initials: BC
authors.lastname: Kline
authors.forename: F R
authors.initials: FR
authors.lastname: Cockerill
mesh_terms: D000165:Acridine Orange; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001422:Bacterial Adhesion; D002478:Cells, Cultured; D004381:Duodenal Ulcer / Q000382:microbiology*; D004847:Epithelial Cells / Q000382:microbiology* / Q000648:ultrastructure; D005456:Fluorescent Dyes; D005756:Gastritis / Q000382:microbiology*; D005839:Gentamicins / Q000494:pharmacology; D016480:Helicobacter pylori / Q000187:drug effects / Q000502:physiology* / Q000648:ultrastructure; D008858:Microscopy, Phase-Contrast
chemical_list: D000900:Anti-Bacterial Agents; D005456:Fluorescent Dyes; D005839:Gentamicins; D000165:Acridine Orange