Regulation of Helicobacter pylori Virulence Within the Context of Iron Deficiency

J Infect Dis. 2015 Jun 1;211(11):1790-4. doi: 10.1093/infdis/jiu805. Epub 2014 Dec 11.


Helicobacter pylori strains that harbor the oncoprotein CagA increase gastric cancer risk, and this risk is augmented under iron-deficient conditions. We demonstrate here that iron depletion induces coccoid morphology in strains lacking cagA. To evaluate the stability of augmented H. pylori virulence phenotypes stimulated by low-iron conditions, H. pylori isolated from iron-depleted conditions in vivo were serially passaged in vitro. Long-term passage decreased the ability of hypervirulent strains to translocate CagA or induce interleukin 8, indicating that hypervirulent phenotypes stimulated by low-level iron conditions are reversible. Therefore, rectifying iron deficiency may attenuate disease among H. pylori-infected persons with no response to antibiotics.

Keywords: CagA; Helicobacter pylori; gastric cancer; iron deficiency.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Animals
  • Antigens, Bacterial / genetics
  • Antigens, Bacterial / metabolism
  • Bacterial Proteins / genetics
  • Bacterial Proteins / metabolism
  • Gene Knockout Techniques
  • Gerbillinae
  • Helicobacter Infections* / microbiology
  • Helicobacter Infections* / physiopathology
  • Helicobacter pylori / cytology
  • Helicobacter pylori / genetics
  • Helicobacter pylori / metabolism
  • Helicobacter pylori / pathogenicity*
  • Interleukin-8 / genetics
  • Interleukin-8 / metabolism
  • Iron / deficiency*
  • Stomach / microbiology
  • Virulence / genetics


  • Antigens, Bacterial
  • Bacterial Proteins
  • Interleukin-8
  • cagA protein, Helicobacter pylori
  • Iron