Helicobacter pylori CagA promotes epithelial mesenchymal transition in gastric carcinogenesis via triggering oncogenic YAP pathway

J Exp Clin Cancer Res. 2018 Nov 22;37(1):280. doi: 10.1186/s13046-018-0962-5.


Background: Helicobacter pylori (H. pylori) delivers oncoprotein CagA into gastric epithelial cells via the T4SS and drives activation of multiple oncogenic signalling pathways. YAP, a core effector of the Hippo tumour suppressor pathway, is frequently overexpressed in human cancers, suggesting its potential tumor-promoting role. Although CagA is a casual factor in H. pylori induced gastric carcinogenesis, the link between CagA and YAP pathway has not been identified. In this work, we investigated the regulation of oncogenic YAP pathway by H. pylori CagA.

Methods: Expression of YAP and E-cadherin protein in human gastric biopsies were assessed by immunohistochemistry. H. pylori PMSS1 cagA- isogenic mutant strains were generated. Gastric epithelial cells were co-cultured with H. pylori wild-type cagA+ strains or isogenic mutants and were also treated by recombinant CagA expression. Immunofluorescence was performed for YAP localization. Immunoblot and quantitative PCR were performed for examining levels of YAP, downstream effectors and markers of epithelial-mesenchymal transition. Verteporfin and siRNA silencing were used to inhibit YAP activity.

Results: YAP is significantly upregulated in human gastric carcinogenesis. We generated PMSS1 CagA isogenic mutant strains with chloramphenicol resistance successfully. Our analysis indicated that H. pylori infection induced YAP and downstream effectors in gastric epithelial cells. Importantly, knockout of CagA in 7.13 and PMSS1 strains reduced the expression of YAP by H. pylori infection. Moreover, Inhibition of YAP suppressed H. pylori infection-induced Epithelial-mesenchymal transition (EMT).

Conclusion: Our results indicated that H. pylori CagA as a pathogenic protein promotes oncogenic YAP pathway, which contributes to EMT and gastric tumorigenesis. This study provided a novel mechanistic insight into why cagA+ H. pylori infection is associated with a higher risk for the development of gastric cancer.

Keywords: Epithelial-mesenchymal transition; Gastric carcinogenesis; H. pylori CagA; YAP.

MeSH terms

  • Antigens, Bacterial / genetics
  • Antigens, Bacterial / metabolism*
  • Antigens, CD / biosynthesis
  • Antigens, CD / metabolism
  • Bacterial Proteins / genetics
  • Bacterial Proteins / metabolism*
  • Cadherins / biosynthesis
  • Cadherins / metabolism
  • Cell Cycle Proteins
  • Cell Line, Tumor
  • Epithelial-Mesenchymal Transition
  • Helicobacter Infections / metabolism*
  • Helicobacter Infections / microbiology
  • Helicobacter Infections / pathology
  • Helicobacter pylori / genetics
  • Helicobacter pylori / metabolism
  • Humans
  • Neoplasm Metastasis
  • Nuclear Proteins / biosynthesis
  • Nuclear Proteins / metabolism*
  • Signal Transduction
  • Stomach Neoplasms / metabolism
  • Stomach Neoplasms / microbiology*
  • Stomach Neoplasms / pathology
  • Transcription Factors / biosynthesis
  • Transcription Factors / metabolism*
  • Transfection
  • Up-Regulation


  • Antigens, Bacterial
  • Antigens, CD
  • Bacterial Proteins
  • CDH1 protein, human
  • Cadherins
  • Cell Cycle Proteins
  • Nuclear Proteins
  • Transcription Factors
  • YY1AP1 protein, human
  • cagA protein, Helicobacter pylori