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Updated: May 16, 2026

Gastric Mucosa Quantitative Polymerase Chain Reaction Analysis for Detecting Helicobacter pylori and Antibiotic Resistance
Published on: March 7, 2025
Helicobacter pylori peptidoglycan modifications confer lysozyme resistance and contribute to survival in the host
Ge Wang1, Leja F Lo, Lennart S Forsberg
1Department of Microbiology, University of Georgia, Athens, GA, USA.
Unlabelled:
The prominent host muramidase lysozyme cleaves bacterial peptidoglycan (PG), and the enzyme is abundant in mucosal secretions. The lytic enzyme susceptibility of Gram-negative bacteria and mechanisms they use to thwart lytic enzyme activity are poorly studied. We previously characterized a Helicobacter pylori PG modification enzyme, an N-deacetylase (PgdA) involved in lysozyme resistance. In this study, another PG modification enzyme, a putative PG O-acetyltransferase (PatA), was identified. Mass spectral analysis of the purified PG demonstrated that a patA strain contained a greatly reduced amount of acetylated muropeptides, indicating a role for PatA in H. pylori PG O-acetylation. The PG modification mutant strains (pgdA, patA, or pgdA patA) were more susceptible to lysozyme killing than the parent, but this assay required high lysozyme levels (up to 50 mg/ml). However, addition of host lactoferrin conferred lysozyme sensitivity to H. pylori, at physiologically relevant concentrations of both host components (3 mg/ml lactoferrin plus 0.3 mg/ml lysozyme). The pgdA patA double mutant strain was far more susceptible to lysozyme/lactoferrin killing than the parent. Peptidoglycan purified from a pgdA patA mutant was five times more sensitive to lysozyme than PG from the parent strain, while PG from both single mutants displayed intermediate sensitivity. Both sensitivity assays for whole cells and for purified PGs indicated that the modifications mediated by PgdA and PatA have a synergistic effect, conferring lysozyme tolerance. In a mouse infection model, significant colonization deficiency was observed for the double mutant at 3 weeks postinoculation. The results show that PG modifications affect the survival of a Gram-negative pathogen.
Importance:
Pathogenic bacteria evade host antibacterial enzymes by a variety of mechanisms, which include resisting lytic enzymes abundant in the host. Enzymatic modifications to peptidoglycan (PG, the site of action of lysozyme) are a known mechanism used by Gram-positive bacteria to protect against host lysozyme attack. However, Gram-negative bacteria contain a thin layer of PG and a recalcitrant outer membrane permeability barrier to resist lysis, so molecular modifications to cell wall structure in order to combat lysis remain largely unstudied. Here we show that two Helicobacter pylori PG modification enzymes (PgdA and PatA) confer a clear protective advantage to a Gram-negative bacterium. They protect the bacterium from lytic enzyme degradation, albeit via different PG modification activities. Many pathogens are Gram negative, so some would be expected to have a similar cell wall-modifying strategy. Understanding such strategies may be useful for combating pathogen growth.
Insights
Helicobacter pylori uses peptidoglycan (PG) modifications, mediated by PgdA and PatA enzymes, to resist host lysozyme. These PG modifications are crucial for bacterial survival and colonization.
Area of Science:
- Microbiology
- Bacterial Pathogenesis
- Host-Pathogen Interactions
Background:
- Gram-negative bacteria possess mechanisms to evade host antibacterial enzymes like lysozyme.
- Peptidoglycan (PG) modifications are known to confer lysozyme resistance in Gram-positive bacteria.
- Molecular mechanisms of PG modification for lysis resistance in Gram-negative bacteria are understudied.
Purpose of the Study:
- To investigate the role of Helicobacter pylori PG modification enzymes in lysozyme resistance.
- To identify and characterize PG modification enzymes contributing to Gram-negative bacterial survival against host defenses.
Main Methods:
- Characterization of a novel PG O-acetyltransferase (PatA) in H. pylori.
- Mass spectral analysis of purified PG from wild-type and mutant strains (pgdA, patA, pgdA patA).
- Lysozyme and lactoferrin susceptibility assays on whole cells and purified PG.
- Assessment of bacterial colonization in a mouse infection model.
Main Results:
- PatA was identified as a key enzyme for H. pylori PG O-acetylation.
- Mutant strains lacking PgdA and/or PatA showed increased susceptibility to lysozyme and lactoferrin.
- The pgdA patA double mutant exhibited significantly reduced colonization in a mouse model.
- PgdA and PatA-mediated PG modifications synergistically enhance lysozyme tolerance.
Conclusions:
- PG modifications mediated by PgdA and PatA are essential for H. pylori survival against host lytic enzymes.
- These findings highlight a conserved strategy in Gram-negative pathogens for evading host immunity.
- Understanding these mechanisms can inform strategies to combat bacterial infections.
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