Helicobacter pylori chronic infection and mucosal inflammation switches the human gastric glycosylation pathways

Helicobacter pylori exploits host glycoconjugates to colonize the gastric niche. Infection can persist for decades promoting chronic inflammation, and in a subset of individuals lesions can silently progress to cancer. This study shows that H. pylori chronic infection and gastric tissue inflammation result in a remodeling of the gastric glycophenotype with increased expression of sialyl-Lewis a/x antigens due to transcriptional up-regulation of the B3GNT5, B3GALT5, and FUT3 genes. We observed that H. pylori infected individuals present a marked gastric local pro-inflammatory signature with significantly higher TNF-a levels and demonstrated that TNF-induced activation of the NF-kappaB pathway results in B3GNT5 transcriptional up-regulation. Furthermore, we show that this gastric glycosylation shift, characterized by increased sialylation patterns, favors SabA-mediated H. pylori attachment to human inflamed gastric mucosa. This study provides novel clinically relevant insights into the regulatory mechanisms underlying H. pylori modulation of host glycosylation machinery, and phenotypic alterations crucial for life-long infection. Moreover, the biosynthetic pathways here identified as responsible for gastric mucosa increased sialylation, in response to H. pylori infection, can be exploited as drug targets for hindering bacteria adhesion and counteract the infection chronicity. IPATIMUP integrates the i3S Research Unit, which is partially supported by FCT, the Portuguese Foundation for Science and Technology (PEst C/SAU/LA0003/2013). This work is funded by FEDER funds through the Operational Programme for Competitiveness Factors-COMPETE (NORTE 07 0124 FEDER 000024; FCOMP-01-0124-FEDER028188; FCOMP-01-0124-FEDER 041276) and National Funds through the FCT-Foundation for Science and Technology (EXPL/CTM-BIO/0762/2013, PTDC/BBB-EBI/0786/2012) and acknowledges support by the EuropeanUnion (Seventh Framework Programme GastricGlycoExplorer project, grant number 316929). Grants were received from FCT, POPH (Programa Operacional Potencial Humano) and FSE (Fundo Social Europeu) (SFRH/BPD/75871/2011 to AM;SFRH/SINTD/60034/2009 to RMP; SFRH/BPD/84084/2012 to RMF; SFRH/BPD/89764/2012 to PO). AM acknowledges EMBO for a Short-Term Fellowship (EMBO ASTF 330-212). Transcript analysis was funded by NIH (grant P41GM103490) to KWM.