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The Helicobacter pylori VacA toxin is a urea permease that promotes urea diffusion across epithelia
Francesco Tombola, Laura Morbiato, Giuseppe Del Giudice, Rino Rappuoli, Mario Zoratti, Emanuele Papini
Francesco Tombola, Laura Morbiato, Giuseppe Del Giudice, Rino Rappuoli, Mario Zoratti, Emanuele Papini
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Article

The Helicobacter pylori VacA toxin is a urea permease that promotes urea diffusion across epithelia

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Abstract

Urease and the cytotoxin VacA are two major virulence factors of the human pathogen Helicobacter pylori, which is responsible for severe gastroduodenal diseases. Diffusion of urea, the substrate of urease, into the stomach is critically required for the survival of infecting H. pylori. We now show that VacA increases the transepithelial flux of urea across model epithelia by inducing an unsaturable permeation pathway. This transcellular pathway is selective, as it conducts thiourea, but not glycerol and mannitol, demonstrating that it is not due to a loosening of intercellular junctions. Experiments performed with different cell lines, grown in a nonpolarized state, confirm that VacA permeabilizes the cell plasma membrane to urea. Inhibition studies indicate that transmembrane pores formed by VacA act as passive urea transporters. Thus, their inhibition by the anion channel blocker 5-nitro-2-(3-phenylpropylamino) benzoic acid significantly decreases toxin-induced urea fluxes in both polarized and nonpolarized cells. Moreover, phloretin, a well-known inhibitor of eukaryotic urea transporters, blocks VacA-mediated urea and ion transport and the toxin’s main biologic effects. These data show that VacA behaves as a low-pH activated, passive urea transporter potentially capable of permeabilizing the gastric epithelium to urea. This opens the novel possibility that in vivo VacA may favor H. pylori infectivity by optimizing urease activity.

Authors

Francesco Tombola, Laura Morbiato, Giuseppe Del Giudice, Rino Rappuoli, Mario Zoratti, Emanuele Papini

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Figure 2

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Dose response, kinetics, and unsaturability of VacA-induced urea transep...
Dose response, kinetics, and unsaturability of VacA-induced urea transepithelial flux. Cell monolayers of MDCK I (a) and MDCK II (b) were apically treated with the indicated concentrations of activated VacA in DMEM, 10% FCS for 3 hours at 37°C. Transepithelial urea diffusion (open circles) and ion conductivity (filled circles) were determined. Values are the mean of four experiments in duplicate ± SE. (c) After the indicated intoxication times with activated (open circles) or nonactivated (filled circles) VacA (125 nM), transepithelial urea flux across MDCK II cell polarized monolayers was determined. The averages of two experiments run in duplicate are reported with average deviations. (d) After a 3-hour treatment with VacA, as above, 45 μM [14C]urea plus the indicated concentration of cold urea was placed in the basolateral chamber. The amount of radioactivity in the apical chamber was then measured, yielding plots analogous to those in Figure 1, c–e, whose slopes are plotted. The dotted line represents the theoretical linear correlation.

Copyright © 2025 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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