Image from review article Keilberg & Ottemann (2016). Environ Microbiol 18, 791.
The Ottemann lab studies the stomach-infecting bacterium, Helicobacter pylori (H. pylori). H. pylori infects about 50% of the global population, a whopping 3.9 billion people. It is most prevalent in the developing world, but even in the United States, it colonizes 35% of the population. In these individuals, H. pylori triggers chronic inflammation and it spurs disease—ulcers and cancer—in ~15% of them. Ulcers are non-healing wounds in the stomach lining that cause significant morbidity and some mortality. H. pylori is responsible for 90% of ulcers, causing this disease in ~20 million people annually. Gastric cancer is in the top five leading cause of cancer deaths, killing over 750,000 people annually, with H. pylori responsible for ~90% of gastric cancer cases. While the recent incidence of H. pylori infection has declined in the high-income countries but still remains in 10-20% of the population. H. pylori infections can be eliminated by antibiotics, which in turn cure ulcers and prevent gastric cancer. Indeed, gastric cancer is considered one of the most preventable cancers because we know the cause. H. pylori infections, unfortunately, can be difficult to eradicate: Standard therapy fails in about 25% of cases. Improving H. pylori cures is a top health priority and our lab is focused on this goal by identifying new targets for therapeutics.
One attribute that H. pylori uses to colonize the stomach is flagellar motility and chemotaxis. Chemotaxis is the process by which bacteria sense environmental cues and move in response. The Ottemann lab has a particular expertise in understanding how chemotaxis and motility foster bacterial disease, and the variation that are found in H. pylori that give it unique abilities. We are currently exploring three main themes: (1) What chemotaxis signals are sensed by H. pylori and what benefits do these confer? (2) How are flagella regulated and used by H. pylori? (3) What growth forms does H. pylori adopt during acute and chronic infection?
H. pylori and it's chemotaxis signals that it moves toward (green) and away (red). Adapted from Keilberg and Ottemann, 2016,
Chemotaxis is system in which bacteria use specific receptor proteins to sense signals and then swim in response, toward beneficial compounds and away from harmful ones. H. pylori possesses four chemoreceptors called TlpA, TlpB, TlpC and TlpD. Each of the chemoreceptors senses distinct input signals, and transfers the information via a signal transduction system that in turn regulates swimming. Our lab has defined that chemotaxis promotes initial colonization and attainment of high bacterial numbers, spread to new parts of the stomach, and triggering a host response that leads to inflammation (Keilberg et al. 2016). Multiple input signals are sensed by H. pylori to orient itself inside the stomach, including pH, urea, reactive oxygen species, arginine, fumarate, cysteine, and autoinducer 2, but a particularly important one is lactate that was discovered as part of a collaboration with the lab of Anne Roujeinikova (Machuca et al. 2017). L-lactate is used as a major nutrient by H. pylori (Keilberg et al. 2021) and also to activate a response that allows H. pylori to resist complement (Hu and Ottemann, 2023). Indeed, a role for complement in lower H. pylori infection was not entirely known before the lacate discovery.
Our lab has made substantial contributions to our understanding of how flagella are used and operate in two areas. The first was a finding that H. pylori does not turn off flagella synthesis when making a biofilm and instead incorporates the flagellar filament as a key part of the biofilm matrix (Hathroubi et al. 2018). The second has been in the area of differences in the flagellar proteins building on seminal work from the Jensen and Liu labs that found flagellar motors are highly variable between different bacterial species. H. pylori has the largest known motor, able to incorporate 18 MotAB stator units (E. coli has only 12), and additionally incorporate many other proteins that have only recently been identified. Our lab played key roles in identifying these H. pylori flagellar proteins. For example, we characerized the first flagellar C-ring with four types of proteins instead of the usual three, finding that all four are needed for motility (Lowenthal et al. 2009). We then worked on the location and function of FliL, a widely conserved flagellar protein (Liu et al. 2023; Tachiyama et al. 2022). In Sagoo et al. 2024 and Liu et al. 2024, we described the components that make up a structure called the flagellar cage. This structure had been seen on electron tomography, but its identity and function were entirely unknown. Our lab identified the cage proteins as remote homologs of the type 4 pili proteins PilMNO. These proteins create the lower cage that encircles the MotAB stator. Surprisingly, loss of these proteins resulted in H. pylori that migrate better on soft agar, instead of operating as predicted to enhance motility. We determined that these proteins inhibited soft agar migration because they drive H. pylori to form aggregates, through an as-yet-unknown mechanism.
Description to come!