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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 7

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Effect of phloretin, thiourea, and urea on transmembrane current and tra...
Effect of phloretin, thiourea, and urea on transmembrane current and transepithelial [14C]urea flux induced by VacA. (a) Activated (pH 2.0) VacA (2–4 nM) was added to planar diphytanoyl-phosphatidylcholine membranes, and the transmembrane current was measured before and after addition of increasing concentrations of phloretin to the cis side. The remaining current is reported as percent of the initial value. Vcis: –40 mV. Each point represents the mean of three to six experiments ± SE. A modified Langmuir’s isotherm (38) was used for fitting; KD = 15 ± 1 μM. Inset: The effect of 50 μM phloretin on VacA-induced transmembrane current when added to the cis (filled column; n = 5) or the trans (open column; n = 6) side. (b) Inhibition of VacA-conducted current by 400 mM thiourea or 400 mM urea added to the cis (filled column; n = 4) or to the trans side (open column; n = 4) of the membrane. Gray columns represent the inhibitory effect of thiourea and urea on the increase of transepithelial diffusion of [14C]urea across polarized MDCK II cell monolayers, determined after a 3-hour intoxication by 125 nM VacA. Data are expressed as the percent of inhibition with respect to the control in the absence of cold thiourea and urea and are the mean of three experiments run in duplicate ± SE.

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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