Helicobacter pylori Strains from Duodenal Ulcer Patients Exhibit Mixed babA/B Genotypes with Low Levels of BabA Adhesin and Lewis b Binding.
BabA is a Helicobacter pylori cell surface adhesin, which binds to the ABO/Le(b) histo-blood group antigens (Le(b)) and serves as a virulence factor.



H. pylori single colonies were isolated from 156 [non-ulcer dyspepsia (NUD) = 97, duodenal ulcer (DU) = 34, gastric cancer (GC) = 25)] patients. babA and babB genes were evaluated by gene/locus-specific PCR. BabA protein expression and Le(b) binding activity were determined by immunoblotting and ELISA, respectively.



The combined categorization of H. pylori strains based on high, low or no levels of BabA expression and Le(b) binding, produced 4 groups: (I) BabA-high/Le(b)-high (36 %), (II) BabA-low/Le(b)-low (26 %), (III) BabA-neg/Le(b)-low (30 %) and (IV) BabA-neg/Le(b)-neg (8 %) strains. The majority (63 %) of the BabA-low/Le(b)-low strains exhibited mixed babA/B genotypes as compared to merely 18 % of the BabA-high/Le(b)-high, 15 % of the BabA-neg/Le(b)-neg and 11 % of the BabA-neg/Le(b)-low (P = 0.0001) strains. In contrast to NUD strains, the great majority (70 %) of DU strains were BabA-low/Le(b)-low (11 %, P = 0.0001), which compared to NUD strains, enhanced the risk of DU by 18.8-fold. In parallel, infection with babA/B mixed genotype strains amplified the risk of DU by 3.6-fold (vs. babA-positive: P = 0.01) to 6.9-fold (vs. babA-negative: P = 0.007).



Here, we show higher prevalence of mixed babA/B genotypes among BabA-low/Le(b)-low clinical strains. Recombination of babA and babB genes across their loci may yield lower BabA expression and lower Le(b) binding activity. We conclude that H. pylori strains with lower Le(b) binding activity are better adapted for colonization of the gastric metaplastic patches in the duodenum and enhance the risk of duodenal ulcers.
HPGC Group, Department of Medical Biotechnology, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, 1316943551, Iran.
Samaneh
S
Saberi
Department of Medical Biosciences and Pathology, Umeå University, 901 85, Umeå, Sweden.
Alexej
A
Schmidt
Research Center for Modeling in Health, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, 7618747653, Iran.
Sana
S
Eybpoosh
HPGC Group, Department of Medical Biotechnology, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, 1316943551, Iran.
Maryam
M
Esmaili
HPGC Group, Department of Medical Biotechnology, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, 1316943551, Iran.
Yeganeh
Y
Talebkhan
HPGC Group, Department of Medical Biotechnology, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, 1316943551, Iran.
Nazanin
N
Mohajerani
HPGC Group, Department of Medical Biotechnology, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, 1316943551, Iran.
Akbar
A
Oghalaie
Department of Gastroenterology, Amiralam Hospital, Tehran University of Medical Sciences, Tehran, 1145765111, Iran.
Mahmoud
M
Eshagh Hosseini
Cancer Research Center, Tehran University of Medical Sciences, Tehran, 141979733141, Iran.
Mohammad Ali
MA
Mohagheghi
Department of Medical Biochemistry and Biophysics, Umeå University, 901 87, Umeå, Sweden.
Jeanna
J
Bugaytova
Department of Medical Biochemistry and Biophysics, Umeå University, 901 87, Umeå, Sweden. thomas.boren@umu.se.
Thomas
T
Borén
HPGC Group, Department of Medical Biotechnology, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, 1316943551, Iran. marjan.mohammadi@pasteur.ac.ir.
Marjan
M
Mohammadi
D018829:Adhesins, Bacterial / Q000235:genetics* / Q000378:metabolism; D000328:Adult; D000368:Aged; D001425:Bacterial Outer Membrane Proteins / Q000235:genetics*; D004381:Duodenal Ulcer / Q000382:microbiology*; D004415:Dyspepsia / Q000382:microbiology; D005260:Female; D005838:Genotype; D016481:Helicobacter Infections / Q000382:microbiology*; D016480:Helicobacter pylori / Q000235:genetics*; D006801:Humans; D007983:Lewis Blood Group Antigens; D008297:Male; D008875:Middle Aged; D009844:Oligosaccharides / Q000378:metabolism; D016133:Polymerase Chain Reaction; D013274:Stomach Neoplasms / Q000382:microbiology
D018829:Adhesins, Bacterial; C400429:BabA protein, Helicobacter pylori; C451032:BabB protein, Helicobacter pylori; D001425:Bacterial Outer Membrane Proteins; D007983:Lewis Blood Group Antigens; D009844:Oligosaccharides
Adhesin; BabA; Duodenal ulcer; Helicobacter pylori; Mixed babA/B genotypes