“…Tipa directly induces TNF-a gene expression in gastric epithelial cells (Suganuma et al 2005(Suganuma et al , 2006(Suganuma et al , 2008. The unique features of Tipa protein are as follows: (1) H. pylori lacking Tipa gene reduced the colonization levels of H. pylori in the stomach of mice (Godlewska et al 2008); (2) Vaccination with Tipa significantly reduced colonization of H. pylori in mice associated with high levels of Tipa-specific antibody (Inoue et al 2009); (3) Tipa protein is secreted from H. pylori but not mediated through Type IV secretion system (Suganuma et al 2005); and (4) clinical isolates of H. pylori obtained from gastric cancer patients secreted Tipa protein in larger amounts than did H. pylori from patients with simple gastritis (Suganuma et al 2008), strongly suggesting that Tipa plays an important role in H. pylori-induced inflammation and cancer development in human stomach (Balkwill 2009). All these features are different from those of other virulence factors, such as the cag pathogenicity island (cagPAI), CagA (cytotoxin associated antigen) and VacA (vacuolating cytotoxin A).…”