This article is available online at http://www.jlr.org of H. pylori outer membrane. The H. pylori LPS consists of a lipid A region, a core region, and an O-chain polysaccharide (also known as the O-antigen) ( 3 ). Lipid A, the hydrophobic moiety of LPS and a glucosamine-based saccharolipid, is the principal structural component responsible for the range of biological activities of LPS ( 4, 5 ).Generally, lipid A is a glucosamine disaccharide that carries phosphates at positions 1 and 4 ′ and usually has four primary (glucosamine-linked) hydroxyacyl chains and one or more secondary acyl chains ( 3, 6, 7 ). However, H. pylori lipid A is different from that of other bacterial species, including both phosphorylation and acylation patterns ( 8 ). The lipid A of H. pylori contains a phosphoethanolamine ( P Etn) group directly linked to the 1-position of the disaccharide backbone. This is in contrast to the P Etn groups found in other pathogenic Gram-negative bacteria, which are attached to the lipid A phosphate group to form a pyrophosphate linkage ( 9, 10 ). In addition, the predominant absence of ester-bound 4'-phosphate and the presence of tetraacyl lipid A with fatty acids of 16 to 18 carbons in length differentiate H. pylori lipid A from that of other Gram-negative bacteria. H. pylori synthesizes two types of lipid A molecules: hexaacyl-and tetraacyl-lipid A. Hexaacyllipid A has two phosphates or phosphoethanolamines on the lipid A disaccharide backbone, whereas tetraacyllipid A contains only one phosphate ( 8 ). It has also been reported that H. pylori does not survive long before it is deacylated at the 3 ′ position from hexaacyl structure to form the tetraacyl major lipid A species ( 11 ). The toxicity of H. pylori tetraacyl-lipid A on human monocytes is ف 4-fold lower than that of the hexaacyl form ( 12 ). It has been suggested that the phosphorylation and acylation patterns in lipid A of H. pylori LPS are responsible for its low biological activity ( 13,14 ).