Fox J G, Correa P, Taylor N S, Thompson N, Fontham E, Janney F, Sobhan M, Ruiz B, Hunter F
Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge.
Am J Gastroenterol. 1992 Nov;87(11):1554-60.
Helicobacter pylori is strongly associated with both chronic gastritis and duodenal ulcer. Certain strains of H. pylori produce a vacuolating cytotoxin in vitro. At New Orleans Charity Hospital, concentrated culture supernatants from 119 of 144 (83%) H. pylori strains isolated from 86 patients at high risk of developing gastric cancer, caused vacuolization in HeLa S3 cells. Cytotoxin activity was neutralized by acid (pH 4) and basic (pH 10) solutions and proteases, and was precipitable by (NH4)2SO4, which suggests that the cytotoxin is a protein. In 66 of 86 (76.7%) patients, the H. pylori strains isolated from single or multiple sequential gastric biopsies had a vacuolating cytotoxin. These cytotoxin-positive H. pylori strains were isolated from 69% of patients with diffuse antral gastritis and 89% of patients with chronic atrophic gastritis. The latter lesion is considered a precursor of gastric cancer. The cytotoxicity persisted in sequential biopsies over an interval of several months, indicating persistence of these strains in the gastric mucosa. Fifty-eight percent (7/12) of the sera from cytotoxin-positive H. pylori-infected patients neutralized cytotoxin activity, whereas 20% (1/5) of sera from patients with H. pylori cytotoxin-negative strains and none of five H. pylori-negative patients' sera neutralized cytotoxin activity. The relevance of this cytotoxin in the pathogenesis of H. pylori-induced gastritis requires further study.
幽门螺杆菌与慢性胃炎和十二指肠溃疡都密切相关。某些幽门螺杆菌菌株在体外可产生空泡毒素。在新奥尔良慈善医院，从86例胃癌高危患者中分离出的144株幽门螺杆菌中，有119株（83%）的浓缩培养上清液可使HeLa S3细胞发生空泡化。毒素活性可被酸性（pH 4）和碱性（pH 10）溶液以及蛋白酶中和，且可被硫酸铵沉淀，这表明该毒素是一种蛋白质。在86例患者中的66例（76.7%）中，从单次或多次连续胃活检中分离出的幽门螺杆菌菌株具有空泡毒素。这些产毒素阳性的幽门螺杆菌菌株分别从69%的弥漫性胃窦炎患者和89%的慢性萎缩性胃炎患者中分离得到。后一种病变被认为是胃癌的前驱病变。在数月的时间间隔内，连续活检中细胞毒性持续存在，表明这些菌株在胃黏膜中持续存在。产毒素阳性的幽门螺杆菌感染患者的血清中有58%（7/12）可中和毒素活性，而产毒素阴性的幽门螺杆菌菌株感染患者的血清中有20%（1/5）可中和毒素活性，5例幽门螺杆菌阴性患者的血清均无中和毒素活性。这种毒素在幽门螺杆菌诱导的胃炎发病机制中的相关性需要进一步研究。
