Electron Microscopic Evaluation of Adhesion of Helicobacter pylori to the Gastric Epithelial Cells in Chronic Gastritis

Abstract

BackgroundThe adhesion of H. pylori to the gastric epithelial cells may be an essential step for the pathophysiology of various H. pylori-induced gastrointestinal diseases. The purpose of this study was to investigate the ultrastructural relation of H. pylori and gastric epithelial cells in their adhesion.MethodsEndoscopic biopsy of gastric antrum and body was performed from 15 patients (9 men, 6 women) with chronic gastritis and H. pylori infection. The specimens were processed for electron microscopy and observed with a transmission electron microscope (Hitachi H-600).ResultsOn the basis of morphological appearances, the adhesions of H. pylori to the gastric epithelial cells were categorized into three types; filamentous connection, adhesion pedestals and membrane fusion. Coccoid and undetermined forms adhered mainly by the filamentous connection, whereas the bacillary forms adhered primarily by the adhesion pedestals and membrane fusion.ConclusionVarious types of adhesion were associated with H. pylori and gastric epithelium. Further studies are needed to evaluate the influence of different types of adhesion to the pathophysiology of H. pylori.

Helicobacter pylori Endemic and Gastric Disease

“…The lack of an association between cagA and peptic ulcerations in this population could possibly be due to medication usage (data that was not collected). Although, these findings are consistent with the results from some of the studies conducted in Asia (17)(18)(19)(20)(21) and from the United States (22,23). There are conflicting reports regarding the association of vacA and cagA with duodenal ulcer disease (8, 11,2 4).…”

An ultrastructural study of the association between Helicobacter pylori and the gastric mucosa

“…The spiral form is known to be active in the pathogenesis of various gastric diseases (Chun et al, 2002), whereas the infectivity of the coccoid form remains controversial (Saito et al, 2012). Reports have mentioned that under stressful environmental conditions, the spiral form can transform into a coccoid one, where the coccoid structure enables the survival of the organism by minimizing its surface area to face the unfavorable external conditions (Ozbek et al, 2010;Saito et al, 2012).…”

“…The undetermined category is believed to include a considerable number of intermediate forms not only in morphology but also in behavior between the other two forms as well as some obliquely sectioned spiral forms. The possibility that undetermined forms may represent a group changing their shapes from the bacillary into the coccoid form still needs to be investigated (Chun et al, 2002).…”

“…The prevailing concept is that H. pylori is an extracellular pathogen that is present only in the mucus layer immediately overlaying the gastric epithelial cells or adherent to the cell surface (Tan et al, 2009(Tan et al, , 2011. In fact, some researchers have failed to demonstrate intracellular bacteria (Rautelin et al, 1995;Chun et al, 2002). In contrast, others have hinted at the invasive potential of this organism (Papadogiannakis et al, 2000;Saito et al, 2012).…”

“…In animal models of H. pylori infection, neutrophilic response or ulcer in the mucosa may not be induced (Lozniewski et al, 1999). Only a few studies have included biopsies from patients with gastritis, gastric, or duodenal ulcers as test materials (Papadogiannakis et al, 2000;Chun et al, 2002).…”