Submitted by Edisangela Bastos (edisangela@ufpa.br) on 2013-04-23T18:02:31Z No. of bitstreams: 2 license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) Dissertacao_PrevalenciaHelicobacterPylori.pdf: 934699 bytes, checksum: b0ff88938ac2eac1e23b4faf11e82eb3 (MD5) / Approved for entry into archive by Ana Rosa Silva(arosa@ufpa.br) on 2013-04-24T14:45:38Z (GMT) No. of bitstreams: 2 license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) Dissertacao_PrevalenciaHelicobacterPylori.pdf: 934699 bytes, checksum: b0ff88938ac2eac1e23b4faf11e82eb3 (MD5) / Made available in DSpace on 2013-04-24T14:45:38Z (GMT). No. of bitstreams: 2 license_rdf: 23898 bytes, checksum: e363e809996cf46ada20da1accfcd9c7 (MD5) Dissertacao_PrevalenciaHelicobacterPylori.pdf: 934699 bytes, checksum: b0ff88938ac2eac1e23b4faf11e82eb3 (MD5) Previous issue date: 2013 / Introdução: Infecções por Helicobacterpylori(HP) e vírusEpstein-Barr (VEB) são comuns no mundo todo, embora o HP seja o maior fator em doenças gastroduodenais, seu percentual de associação com VEB é incerto. Tanto o VEB quanto o HP são classificados como carcinógenos classe 1 pela Organização Mundial de Saúde, e uma substancial fração de indivíduos se tornam co-infectados na adultice. Esses dois patógenos podem potencializar sinergicamente para causar gastrite crônica perpetua. O objetivo deste trabalho foi verificar a prevalência de HP e do vírus Epstein-Barr em crianças e adolescentes. Material e Método: Estudo descritivo, do tipo transversal. Foram analisadas amostras de mucosa gástrica de 64 crianças e adolescentes através do Teste da Urease para diagnóstico do HP, da técnica de PCR para detecção da cepa cagA de H. pylori, da técnica de hibridização in situ para detecção do EBV e da análise patológica para determinação de características histopatológicas. Resultados: A prevalência de HP nas crianças e adolescentes em estudo foi de 53,1% enquanto a prevalência de VEB foi 3,1%. Entre os pacientes infectados por HP, a maioria (94,3%) apresentava gastrite a endoscopia digestiva alta, sendo gastrite enantemática a mais comumente encontrada. Na análise histopatológica, também a maioria (97,1%) dos pacientes apresentava algum grau de gastrite, com 80% classificados com gastrite crônica moderada. Cepas cagA positivas foram encontradas em 64,7% dos infectados com HP e entre estes todos tinham gastrite, com predomínio de gastrite crônica moderada (54%), no entanto não se observou correlação com significância estatística entre esses achados. Em adição, também não houve significância estatística para a associação entre infecção por HP e por VEB na população estudada, a baixa prevalência de VEB nesta análise sugere que esse vírus não é um agente etiológico das lesões da mucosa gástrica. No nosso conhecimento, este é o primeiro estudo que relaciona estes dois agentes infecciosos na mucosa gástrica de crianças e adolescentes do norte do Brasil. Conclusão: A maioria dos achados deste estudo se assemelha aos relatos da literatura, contudo evidenciou-se a necessidade de estudos com maior casuística, envolvendo a população pediátrica imunocompetente afim de melhor esclarecer se há ou não correlação entre a infecção por HP e VEB em nossa região. / Introduction: Infections by Helicobacter pylori (HP) and Epstein-Barr virus (EBV) are common worldwide, although HP is the highest factor in gastroduodenal diseases, its percentage of association with EBV is uncertain. Both EBV and HP are classified are class 1 carcinogens by the World Health Organization, and a substantial number of individuals become co-infected in adulthood. These two pathogens may have synergic potential to cause perpetual chronic gastritis. The purpose of this paper was to verify the prevalence of HP and Epstein-Barr virus in children and adolescents. Material and Methods: Transversal descriptive study. The gastric mucosa of 64 children and adolescents was analyzed through the Urease Test to diagnose HP and the PCR technique to detect H. pylori’s cagA strain, the in situ hybridization technique to detect EBV and the pathological analysis to determine the histopathological characteristics. Results: The prevalence of HP and EBV found by this study was 53.1% and 3.1, respectively. Most of the patients infected by HP (94.3%) presented gastritis in the upper gastrointestinal endoscopy, with enanthemathous gastritis being the most commonly found type. In the histopathological analysis, most patients (97.1%) presented some level of gastritis, 80% of which classified as moderate chronic gastritis. Positive cagA strains were found in 64.7% of the patients infected with HP and all of them had gastritis, with predominance of moderate chronic gastritis (54%); however, there was no statistically significant correlation between these findings. There was also no statistically significant association between infection by HP and EBV in the studied population. The low prevalence of EBV in this analysis suggests that this virus is not an etiological agent in gastric mucosa lesions. To our knowledge, this is the first study that relates these two infectious agents in the gastric mucosa of children and adolescents in northern Brazil. Conclusion: Most of the findings in this study are in line with the literature; however, it is necessary to conduct larger studies, involving aimmunocompetent pediatric population in order to determine whether there is a correlation between infection by HP and EBV in our region.

Tese de Mestrado em Nutrição Clínica apresentada à Faculdade de Ciências de Nutrição e Alimentação da Universidade do Porto / Resumo da dissertação: A infecção por Helicobacfer pylori (H. pylorg afecta 50 % da população mundial e está associada a gastrite crónica, a úlcera péptica e ao cancro gástrico. A aquisição da infecção por H. pylori e a sua erradicação espontãnea parece ser comum na infância. Na fase adulta, a infecção é mais persistente. Alguns autores defendem que o consumo de bebidas alcoólicas pode contribuir para a erradicação espontãnea de H. pylori, nos adultos. Esta hipótese é apoiada por vários estudos epidemiológicos e experimentais. No presente trabalho foi testada, in vifro, a actividade anti H. pylori de vinho tinto e branco, de diferentes tipos de cerveja (branca com e sem álcool, preta com álcool e preta com álcool enriquecida com xantohumol e iso-xantohumol), assim como do resveratrol e do xantohumol, compostos fenólicos presentes no vinho e na cerveja, respectivamente. Onze estirpes clínicas e uma estirpe de referência (CCUG 15818) de H. pylori foram inoculadas em agar Columbia suplementado com 10 % de sangue, ao qual foram adicionadas as várias bebidas e os compostos fenólicos, em diferentes concentrações, e incubadas em condições de microaerofilia, a 36+-1ºC durante 48 horas.

<p>Prokaryotes are continually exposed to variations in their environment. Survival in unstable milieu requires a wide range of transcriptional regulators (TRs) that respond to specific environmental and cellular signals by modulating gene expression and provide an appropriate physiological response to external stimuli. These adaptive responses to environmental signals are mostly mediated by TRs from one of two families: the single or the two component signal transduction systems (1CSTS; 2CSTS). In this thesis the structural analysis of two 1CSTS – DntR and NikR − are presented. One study was carried out to try to develop a bacterial biosensor for synthetic dinitrotulenes compounds, the other to characterise the Ni-sensing mechanism that contributes to the acid adaptation of the human pathogen<i> Helicobacter pylori.</i> DntR belongs to the LysR family and the crystal structures obtained have allowed the proposal a model of the interaction of DntR with salicylate inducer as well as giving insights into the signal propagation mechanism in LysR-type transcription factors (<b>paper I</b>). DntR mutant crystal structures combined with the modelling of DntR-2,4-dnt interactions led to the design of a DntR mutant that has a limited response to 2,4-dnt in a whole cell biosensor system (<b>paper 2</b>). Crystal structures of apo-NikR from <i>H. pylori </i>(HpNikR) and of Ni-bound intermediary states of the protein were obtained. The latter have helped in unravelling the Ni incorporation and selectivity mechanisms of NikRs and have shown a strong cooperativity between conformational changes in the Ni binding domain with movements of the DNA binding domain (<b>paper 3</b>). Biochemical studies and comparisons of the HpNikR crystal structures with those of NikR homologues strongly suggest that HpNikR has evolved different surface properties (<b>paper 4</b>) and a new mode of DNA binding. </p>

<p>Availability of genome sequences for numerous bacterial species comprising of different bacterial strains allows elucidation of species and strain specific adaptations that facilitate their survival in widely fluctuating micro-environments and enhance their pathogenic potential. Different bacterial species use different strategies in their pathogenesis and the pathogenic potential of a bacterial species is dependent on its genomic complement of virulence factors. A bacterial virulence factor, within the context of this study, is defined as any endogenous protein product encoded by a gene that aids in the adhesion, invasion, colonization, persistence and pathogenesis of a bacterium within a host. Anecdotal evidence suggests that bacterial virulence genes are undergoing diversifying evolution to counteract the rapid adaptability of its host&rsquo / s immune defences. Genome sequences of pathogenic bacterial species and strains provide unique opportunities to study the action of diversifying selection operating on different classes of bacterial genes.</p>

Prokaryotes are continually exposed to variations in their environment. Survival in unstable milieu requires a wide range of transcriptional regulators (TRs) that respond to specific environmental and cellular signals by modulating gene expression and provide an appropriate physiological response to external stimuli. These adaptive responses to environmental signals are mostly mediated by TRs from one of two families: the single or the two component signal transduction systems (1CSTS; 2CSTS). In this thesis the structural analysis of two 1CSTS – DntR and NikR − are presented. One study was carried out to try to develop a bacterial biosensor for synthetic dinitrotulenes compounds, the other to characterise the Ni-sensing mechanism that contributes to the acid adaptation of the human pathogen Helicobacter pylori. DntR belongs to the LysR family and the crystal structures obtained have allowed the proposal a model of the interaction of DntR with salicylate inducer as well as giving insights into the signal propagation mechanism in LysR-type transcription factors (<b>paper I</b>). DntR mutant crystal structures combined with the modelling of DntR-2,4-dnt interactions led to the design of a DntR mutant that has a limited response to 2,4-dnt in a whole cell biosensor system (<b>paper 2</b>). Crystal structures of apo-NikR from H. pylori (HpNikR) and of Ni-bound intermediary states of the protein were obtained. The latter have helped in unravelling the Ni incorporation and selectivity mechanisms of NikRs and have shown a strong cooperativity between conformational changes in the Ni binding domain with movements of the DNA binding domain (<b>paper 3</b>). Biochemical studies and comparisons of the HpNikR crystal structures with those of NikR homologues strongly suggest that HpNikR has evolved different surface properties (<b>paper 4</b>) and a new mode of DNA binding.

Helicobacter pylori (H. pylori) is a human-specific gastric pathogen which is responsible for a spectrum of diseases ranging from superficial gastritis to gastric and duodenal ulceration, and which is also highly associated with gastric cancer. The pathogenesis of severe gastric disorders caused by H. pylori is multifactorial and involves complex interactions between the microbe and the gastric mucosa. H. pylori expresses several adhesion proteins. These molecules have important roles in the establishment of persistent infection and chronic inflammation, which cause tissue damage. The aim of this thesis was to study the attachment of this bacterium to human gastric epithelium, mediated by blood group antigens in both health and disease. One of the bestcharacterized H. pylori adhesins is the histo-blood group antigen binding adhesin (BabA), which binds specifically to the Lewis b antigen (Leb) in the gastric mucosa. A protective mucus layer lines the stomach. The mucosal glycosylation patterns (GPs) vary between different cell lineages, different locations along the gastrointestinal (GI) tract and different developmental stages. In addition, GPs undergo changes during malignant transformation. MUC5AC is a mucin molecule produced by the surface epithelium. Three distinctly different types of human gastrointestinal tissue were studied by bacterial adherence analysis in situ. MUC5AC is the most important carrier of Leb and the new results demonstrate that it forms major receptors for H. pylori adherence. By analysing an H. pylori babA-deletion mutant, a novel adhesin-receptor binding mode was found. Surprisingly, the mutant bound efficiently to both human gastric mucosa and to gastric mucosa of Leb transgenic mice. The sialylated and fucosylated blood group antigen, sialyl-dimeric-Lewis x (sdiLex), was structurally identified as the new receptor. A positive correlation was found between adherence of H. pylori to sialyl-Lewis x (sLex) and elevated levels of inflammation response in the human gastric mucosa. These results were supported by detailed analysis of sialylated and fucosylated blood group antigen glycosylation patterns and, in addition, in situ bacterial adherence to gastric mucosa of experimentally challenged Rhesus monkey. The cognate sialic acid-binding adhesin (SabA) was purified by the retagging technique, and the corresponding sabA-gene was identified. H. pylori lipopolysaccharide (LPS) contains various Lewis blood group antigens such as Lewis x (Lex) and Lewis y (Ley). Additional bacterial adherence modes, which are independent of the BabA and/or SabA adhesins, could possibly be mediated by Lex interactions. Adherence of a clinical isolate and its corresponding Lex mutant to human gastric mucosa with various gastric pathologies was studied in situ. The results suggest that H. pylori LPS plays a distinct but minor role in promotion of bacterial adhesion. Taken together, the results suggest mechanisms for continuous selection of H. pylori strains, involving capacity to adapt to changes in the local environment such as shifts in cell differentiation and associated glycosylation patterns. Adherence of H. pylori is dependent on both the BabA and the SabA adhesin. Multi-step dependent attachment mechanisms may direct the microbes to distinct ecological niches during persistent infections, driving the chronic inflammation processes further toward the development of peptic ulcer disease and/or malignant transformation. Key words: H. pylori, BabA, adhesin, Lewis b, MUC5AC, sialyl-dimeric-Lewis x, chronic inflammation, SabA, Lewis x, LPS.

ABSTRACT Protein-protein interactions play a central role in most biological processes. One such biological process is the maintenance of a reducing environment inside the cell. To maintain an internal reducing environment, living cells have evolved two enzymatic systems (glutathione and thioredoxin (Trx) systems). The Trx system is composed of the enzyme TrxR and its substrate Trx. The two proteins constitute an important thiol-dependent redox system that catalyzes the reduction of many proteins that are responsible for a variety of cellular functions. The system relies on transient protein-protein interactions between Trx and TrxR for its function. Cross-reactivity of components of the Trx system between species has been shown to be medically relevant. For example, Helicobacter pylori Trx (HP Trx) is thought to mediate catalytic reduction of human immunoglobulins and thus facilitate immune evasion. It has also been proposed that Helicobacter pylori gains access to the impenetrable gastric mucous layer by using secreted HP Trx to reduce the disulfide bonds present in the cysteine-rich mucin regions that are responsible for cross-linking mucin monomers. Therefore, disruption of secreted HP Trx-host protein interaction may result in restoration of the viscoelastic and hydrophobic protective properties of mucus. Previous studies aimed at understanding the nature of cross-reactivity of Trx system components among various species have shown that Trxs have higher affinity for cognate TrxRs (same species), than for TrxRs from different species. However, the basis for this specificity is not known. A growing body of evidence suggests that most protein-protein interactions are mediated by a small number of protein-protein interface residues, referred to as hot spot residues or binding epitopes. Therefore, understanding the biochemical basis of the affinity of proteins for their partners usually begins by identifying the hot spot residues responsible for the protein complex interactions. In this study, the crystal structures of Deinococcus radiodurans thioredoxin reductase (DR TrxR) and Helicobacter pylori TrxR (HP TrxR) were determined at 1.9 Å and 2.4 Å respectively. Analysis of the Trx-binding sites of both structures suggests that the basis of affinity and specificity of Trx for TrxR is primarily due to the shape rather than the charge of the surface. In addition, the complex between Escherichia coli thioredoxin reductase (EC TrxR) and its substrate thioredoxin (EC Trx) was used to identify residues that are responsible for TrxR-Trx interface stability. Using computational alanine scanning mutagenesis and visual inspection of the EC TrxR-Trx interface, 22 EC TrxR side chains were shown to make contact across the TrxR-Trx interface. Although more than 20 EC TrxR side chains make contact across the TrxR-Trx interface, our results suggest that only 4 residues (F81, R130, F141, and F142) account for the majority of the EC TrxR-Trx interface stability. Individual replacement of equivalent DR TrxR residues (M84, K137, F148, F149) with alanine resulted in drastic changes in binding affinity, confirming that the four residues account for most of TrxR-Trx interface stability. These hot spot residues are surrounded by less important residues (hydrophobic and hydrophilic) that are also predicted to contribute to interface stability. F148 and F149 are invariant across bacterial TrxRs, however other residues that contact Trx are less conserved including M84 and K137. When M84 and K137 were changed to match equivalent E. coli TrxR residues (K137R, M84F); D. radiodurans TrxR substrate specificity was altered from its own Trx to that of E. coli Trx. The results suggest that a small subset of the TrxR-Trx interface residues are responsible for the majority of Trx binding affinity and specificity, a property that has been shown to general to protein-protein interfaces.

ABSTRACT Protein-protein interactions play a central role in most biological processes. One such biological process is the maintenance of a reducing environment inside the cell. To maintain an internal reducing environment, living cells have evolved two enzymatic systems (glutathione and thioredoxin (Trx) systems). The Trx system is composed of the enzyme TrxR and its substrate Trx. The two proteins constitute an important thiol-dependent redox system that catalyzes the reduction of many proteins that are responsible for a variety of cellular functions. The system relies on transient protein-protein interactions between Trx and TrxR for its function. Cross-reactivity of components of the Trx system between species has been shown to be medically relevant. For example, Helicobacter pylori Trx (HP Trx) is thought to mediate catalytic reduction of human immunoglobulins and thus facilitate immune evasion. It has also been proposed that Helicobacter pylori gains access to the impenetrable gastric mucous layer by using secreted HP Trx to reduce the disulfide bonds present in the cysteine-rich mucin regions that are responsible for cross-linking mucin monomers. Therefore, disruption of secreted HP Trx-host protein interaction may result in restoration of the viscoelastic and hydrophobic protective properties of mucus. Previous studies aimed at understanding the nature of cross-reactivity of Trx system components among various species have shown that Trxs have higher affinity for cognate TrxRs (same species), than for TrxRs from different species. However, the basis for this specificity is not known. A growing body of evidence suggests that most protein-protein interactions are mediated by a small number of protein-protein interface residues, referred to as hot spot residues or binding epitopes. Therefore, understanding the biochemical basis of the affinity of proteins for their partners usually begins by identifying the hot spot residues responsible for the protein complex interactions. In this study, the crystal structures of Deinococcus radiodurans thioredoxin reductase (DR TrxR) and Helicobacter pylori TrxR (HP TrxR) were determined at 1.9 Å and 2.4 Å respectively. Analysis of the Trx-binding sites of both structures suggests that the basis of affinity and specificity of Trx for TrxR is primarily due to the shape rather than the charge of the surface. In addition, the complex between Escherichia coli thioredoxin reductase (EC TrxR) and its substrate thioredoxin (EC Trx) was used to identify residues that are responsible for TrxR-Trx interface stability. Using computational alanine scanning mutagenesis and visual inspection of the EC TrxR-Trx interface, 22 EC TrxR side chains were shown to make contact across the TrxR-Trx interface. Although more than 20 EC TrxR side chains make contact across the TrxR-Trx interface, our results suggest that only 4 residues (F81, R130, F141, and F142) account for the majority of the EC TrxR-Trx interface stability. Individual replacement of equivalent DR TrxR residues (M84, K137, F148, F149) with alanine resulted in drastic changes in binding affinity, confirming that the four residues account for most of TrxR-Trx interface stability. These hot spot residues are surrounded by less important residues (hydrophobic and hydrophilic) that are also predicted to contribute to interface stability. F148 and F149 are invariant across bacterial TrxRs, however other residues that contact Trx are less conserved including M84 and K137. When M84 and K137 were changed to match equivalent E. coli TrxR residues (K137R, M84F); D. radiodurans TrxR substrate specificity was altered from its own Trx to that of E. coli Trx. The results suggest that a small subset of the TrxR-Trx interface residues are responsible for the majority of Trx binding affinity and specificity, a property that has been shown to general to protein-protein interfaces.

<p>Availability of genome sequences for numerous bacterial species comprising of different bacterial strains allows elucidation of species and strain specific adaptations that facilitate their survival in widely fluctuating micro-environments and enhance their pathogenic potential. Different bacterial species use different strategies in their pathogenesis and the pathogenic potential of a bacterial species is dependent on its genomic complement of virulence factors. A bacterial virulence factor, within the context of this study, is defined as any endogenous protein product encoded by a gene that aids in the adhesion, invasion, colonization, persistence and pathogenesis of a bacterium within a host. Anecdotal evidence suggests that bacterial virulence genes are undergoing diversifying evolution to counteract the rapid adaptability of its host&rsquo / s immune defences. Genome sequences of pathogenic bacterial species and strains provide unique opportunities to study the action of diversifying selection operating on different classes of bacterial genes.</p>

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