Expansion of cagA Copy Number in Helicobacter pylori During Co-Infection in a Mouse Model

Kavinda Tissera1, Ashansa Ramanayake2, Myeong-A Kim2

  • 1Department of Medical Laboratory Science, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka.

Helicobacter
|December 29, 2025
PubMed
Abstract

Insights

Co-infection with Salmonella increases Helicobacter pylori cagA copy number, enhancing its virulence. High-cagA isolates offer valuable models for studying H. pylori pathogenesis in vivo.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Bacterial Pathogenesis

Background:

  • Helicobacter pylori utilizes the virulence factor CagA to mediate inflammation.
  • H. pylori PMSS1 dynamically modulates cagA copy number in response to host immune pressure.
  • Co-infection with Salmonella enterica serotype Typhimurium heightens inflammation and impacts H. pylori colonization.

Purpose of the Study:

  • To investigate if H. pylori PMSS1 regulates its cagA copy number during systemic co-infection in a mouse model.
  • To determine the impact of co-infection-induced inflammatory environments on H. pylori virulence mechanisms.

Main Methods:

  • Quantitative real-time PCR was used to analyze cagA gene copy number in H. pylori isolates from control and co-infected mice.
  • High-cagA copy isolates were characterized for virulence phenotypes.
  • Whole-genome sequencing was performed to identify co-infection-associated mutations.

Main Results:

  • H. pylori isolates from co-infected mice showed significantly higher cagA copy numbers compared to control mice (3.22 vs. 2.64).
  • Three isolates with high cagA copy numbers (6.1-11.0) demonstrated maintained elevated cagA phosphorylation and cell elongation.
  • Whole-genome sequencing identified co-infection-associated mutations in genes including fur and membrane transport proteins.

Conclusions:

  • Co-infection with Salmonella promotes an increase in H. pylori cagA copy number, enhancing virulence potential.
  • This study underscores the complex interplay between H. pylori and co-infecting pathogens.
  • High-cagA copy isolates serve as valuable models for in vivo H. pylori pathogenesis studies.