Helicobacter pylori infection and gastrointestinal tract cancer biology: considering a double-edged sword reflection

J. Kountouras, M. Doulberis, A. Papaefthymiou, S. Polyzos, M. Touloumtzi, Vardaka Elisabeth, N. Kapetanakis, C. Liatsos, E. Gavalas, P. Katsinelos

Cellular and Molecular Life Sciences, 2019

In their comprehensive review Mentis et al. [1] discussed some molecular biological mechanisms involved in Helicobacter pylori infection (Hp-I)-related gastric cancer (GC) biology such as the role of stem cells and the link between Hp-I and gastrointestinal microbiota (GI-M). Moreover, they posed some «unsolved conundrums» such as the following: Hp-I induces gastric and duodenal inflammation, but is only linked to GC. This claim, however, is incomplete, because Hp-I is also linked with duodenal adenomas/carcinomas [2]. Moreover, Hp-I induces lower GI tract inflammation, thereby promoting oncogenesis [3, 4]. In this regard, we wish to add some additional data involving Hp-I in upper and lower GI tract oncogenesis. Concerning the role of stem cells in Hp-I-related GC, we earlier reviewed [5] mechanisms of Hp and stem cell interaction in GC such as: activation of the Wnt/β-catenin signaling pathway; CagA impact on the fibroblast growth factor-signal pathways implicated in the development of GC; enhancing transforming growth factor-β/bone morphogenetic proteins signal pathway involved in GC cells invasion; sonic hedgehog signaling dysregulation; and recruitment of mesenchymal stem cells and/or bone marrow-derived stem cells (BMDSCs), also mentioned in one original study (2004) by the authors [1], in the course of chronic inflammatory condition, that gains stepwise transformation to GC cells [5]. Likewise, such aforementioned mechanisms have been confirmed by more recent data [6], further indicated that Hp-I activates epithelial–mesenchymal transition pathway and induces the development of GC stem cells (CSCs), such as CD44(+) [7]. Regarding the latter aspect, using CSC and/or BMDSCs marker CD44, the CD44(+) gastric CSCs appear to display the stem cell self-renewal properties. Moreover, Hp is responsible for CD44(+) increased expression, indicating a potential Hp induction of CD44(+) gastric CSCs implicated in gastric tumorigenesis [3]. Furthermore, our studies showed presence of cyclin D1 involved in GC cell proliferation, as well as CD34 expressed on hematopoietic stem cells and neovessels in human Hp-related GC specimens [8]. Beyond GC, our studies also showed CD44(+) augmented expression in human Hp-connected colorectal adenoma (CRA) and colorectal cancer (CRC) tissues [3]. Therefore, Hp-I could have an impact on colon oncogenesis by stimulating CSCs or recruiting BMDSCs, similar to upper GI Hp-I-connected chronic inflammationmetaplasia-dysplasia sequence and BMDSCs recruitment that contribute to oncogenesis [3]. Thus further large-scale relative studies are warranted. BMDSCs might also contribute to the pathogenesis of Barrett’s esophagus (BE) [9], a complication of gastroesophageal reflux disease (GERD), which predisposes to BErelated esophageal adenocarcinoma (EAC) development. In this concern, it has been proposed that chronic Hp-I induces atrophic gastritis accompanied by decreased acid secretion and acid reflux, thereby reducing the risk of GERD and its related BE and EAC. However, this conventional consideration might represent a double-edged sword one view. Cellular and Molecular Life Sciences

Cited by 2 publications.

Field of study: Medicine

10.1007/s00018-019-03106-4