Lactobacillus acidophilus ameliorates H. pylori-induced gastric inflammation by inactivating the Smad7 and NFκB pathways
© Yang et al; licensee BioMed Central Ltd. 2012
Received: 12 August 2011
Accepted: 19 March 2012
Published: 19 March 2012
H. pylori infection may trigger Smad7 and NFκB expression in the stomach, whereas probiotics promote gastrointestinal health and improve intestinal inflammation caused by pathogens. This study examines if probiotics can improve H. pylori-induced gastric inflammation by inactivating the Smad7 and NFκB pathways.
Challenge with H. pylori increased IL-8 and TNF-α expressions but not TGF-β1 in MKN45 cells. The RNA levels of Smad7 in AGS cells increased after H. pylori infection in a dose-dependent manner. A higher dose (MOI 100) of L. acidophilus pre-treatment attenuated the H. pylori-induced IL-8 expressions, but not TGF-β1. Such anti-inflammatory effect was mediated via increased cytoplasmic IκBα and depletion of nuclear NFκB. L. acidophilus also inhibited H. pylori-induced Smad7 transcription by inactivating the Jak1 and Stat1 pathways, which might activate the TGF-β1/Smad pathway. L. acidophilus pre-treatment ameliorated IFN-γ-induced Smad7 translation level and subsequently reduced nuclear NF-κB production, as detected by western blotting.
H. pylori infection induces Smad7, NFκB, IL-8, and TNF-α production in vitro. Higher doses of L. acidophilus pre-treatment reduce H. pylori-induced inflammation through the inactivation of the Smad7 and NFκB pathways.
Helicobacter pylori infection is considered a major factor inducing chronic gastritis, peptic ulcer, and even gastric cancer in humans [1–3]. In mice and human studies, the gastric mucosa of H. pylori-infected subjects show up-regulated NF-κB pathway and Th1 type cytokine responses [4–9], which may disturb the integrity of the gut epithelial barrier . Accordingly, the inactivation of the NF-κB pathway and its downstream immune cascades may be helpful in preventing serious H. pylori-induced complications.
Probiotics are known to inhibit enteric pathogens likes Salmonella, Shigella, and Citrobacter rodentium in both in vitro and animal models [11–13]. Their potential clinical benefits in preventing or resolving gastrointestinal diseases have been emphasized [14, 15]. There are several mechanisms through which they provide gut protection, including decreasing the luminal pH value by producing lactic acid [16, 17] or by competing with gut pathogens for host surface receptors .
Nonetheless, Coconnier et al. have shown that probiotics may inhibit H. pylori growth independent of pH and lactic acid levels  while Tien et al. report that Lactobacillus casei may down-regulate Shigella flexneri-induced pro-inflammatory cytokines, chemokines, and adherence molecules by inhibiting the NF-κB pathway . Another critical mechanism involving probiotics relates to changes in host immune responses to infection via reduced TNF-α and IL-8 but increased IL-10 [20, 21]. Regarding the brief contact between the flora of probiotics and the gastric epithelium, an intake of probiotics by H. pylori-infected patients has anti-inflammation benefits resulting from a change in host immune responses.
Transforming growth factor (TGF)-β1 negatively regulates Th1 cell such that TGF-β1/deficient mice spontaneously develop gastritis [22, 23]. It is well accepted that the TGF-β1 signaling pathway is positively regulated by receptor-associated Smad 2/3, but negatively by Smad7 [24, 25]. H. pylori infection is reportedly associated with increased expression of gastric Smad7, but controversial results in TGF-β1 levels [26, 27]. These suggest that the TGF-β1/Smad signaling pathway plays an important role in gut inflammation. However, the exact mechanism of probiotics reducing H. pylori-induced gastric inflammation remains unclear. Thus, this study aimed to examine whether probiotics could regulate the Smad- and NFκB-mediated signaling pathways to reduce the down-stream inflammatory cytokine production after H. pylori infection.
Cell lines and culture condition
This study was approved by the Ethical Committee of National Cheng Kung University Hospital (ER-98-208). Two human gastric epithelial cancer cell lines (MKN45 and AGS) were obtained from the Health Science Research Resources Bank in Japan and maintained in RPMI 1,640 medium (GIBCO BRL, Grand Island, NY) and F-12 medium (GIBCO BRL, Grand Island, NY) containing 10% FBS at 37°C in a humidified atmosphere (95%) with 5% CO2. The cells were sub-cultured every second day. Prior to the bacterial infection study, the cells were incubated in antibiotic-free RPMI 1,640 medium containing 10% FBS overnight at 37°C in 5% CO2.
Bacteria and culture condition
Bacterial strain (HP238) isolated from a clinical patient was used. The HP238 expressed CagA, VacA, and BabA proteins in previous studies [28, 29]. The bacteria were maintained on a Brucella agar plate containing 10% horse serum and incubated under micro-aerophilic conditions (10% CO2, 5% O2 and 85% N2) for 24-48 hours. The bacteria were then transferred to PBS before infecting the cells. Growth density was measured spectrophotometrically at 600 nm. The infectious dose of bacteria was 1 × 108 bacteria/ml at an OD of 1.
The MKN45 cells were infected with a multiplicity of infection (MOI) 1-100 for various time periods. A probiotic strain, one contained in AB-yogurt, Lactobacillus acidophilus (LA5®, originated from the Chr. Hansen, Denmark, provided by the President Corp., Tainan, Taiwan) was used. The bacteria were maintained on a Brucella agar, incubated in anaerobic conditions, and then harvested and suspended in phosphate-buffered saline (PBS) before infection. The viable density of L. acidophilus was 1 × 108 bacteria/ml at an OD of 1.
MKN45 cells viability after exposure to H. pylori and L. acidophilus
The cytotoxicity of MKN45 cell exposure to H. pylori and L. acidophilus was determined by percentage of lactate dehydrogenase (LDH) leakage (Cytotoxicity Assay, Promega Co., Madison, WI, USA) and by assessing viable cell counts using non-stained trypan blue. The culture supernatant and remaining MKN45 cells were collected after incubation with variable doses (MOI 1-1000) of L. acidophilus and H. pylori (MOI 100) for 8 and 4 hours, respectively. Cell cultures without bacterial infection served as controls. The procedures were performed according to the instruction manuals and post-infection cells with non-stained trypan blue staining were directly counted.
Enzyme-linked immuno-sorbent assay (ELISA) for cytokines
To determine the optimal dose and incubation time of various bacteria, bacteria (H. pylori and L. acidophilus) were cultured with MKN45 cells (MOI 1-100) in an antibiotic-free RPMI 1,640 medium (5 ml) containing 10% FBS at 35°C in micro-aerophilic conditions for up to 8 hours. In the experimental study, L. acidophilus were added to MKN45 cells and incubated for 8 hours under the same conditions. After PBS washing and removal of the bacilli, an equal volume of H. pylori was added and the cells were incubated for another 4 hours. The final culture supernatant was centrifuged at 12,000 rpm for 5 min to remove bacteria and cell debris. Concentrations of TNF-α, IL-8 (R & D System, Minneapolis, MN), and TGF-β1 (eBioscience, San Diego, CA) were measured by ELISA according to the manufacturer's instructions. The absorbance of each micro-plate was read on a spectro-photometer using 450 nm as the primary wave length and 570 nm as the reference wave length. All tests were done in triplicate.
Preparation of cytoplasmic and nuclear extracts
The MKN45 and AGS cells were pre-treated with L. acidophilus for 8 hours followed by various doses of H. pylori for 1 hour; then cytoplasmic and nuclear extracts were isolated by a Nuclear Extract Kit (Active Motif, Japan). Briefly, cells were washed with ice-cold saline containing phosphatase inhibitors and pelleted. The cell pellets were then re-suspended in a hypotonic buffer and incubated for 15 min on ice. They were lysed by the addition of detergent and vortexed vigorously for 10 s. After the nuclei were pelleted and re-suspended in complete lysis buffer, the tube was vigorously shaken at 4°C for 30 min on a shaking platform. The nuclear extracts were then centrifuged and the supernatants were aliquoted and stored at -80°C.
RT-PCR for cytoplasmic Smad7
Total RNA was isolated from MKN45 cells using a commercial kit (ImProm-ll™ Reverse Transcription System, Promega, USA) after H. pylori and L. acidophilus incubation. The RNA was quantified by determining absorbance at 260 nm. One μg RNA was converted to cDNA, which was stored at -72°C until use. The human Smad7 primer sequences were forward 5'-CATCACCTTAGCCGACTCTG-3' and reverse 5'GTCTTCTCCTCCCAGTATGC-3', generating a 224 bp fragment . For Jak1 and Stat1, the primer sequences were forward 5'-GCAGCCAGCATGATGAGA-3' and 5'-GTGGACGAGGTTTTGTAAGGA-3' and reverse 5'-CTCGGAAGAAAGGCCTCTG-3' and 5'-CAGACACAGAAATCAACTC-3', generating fragments of 607 bp and 518 bp, respectively [31, 32]. The PCR condition was as follows; 95°C for 5 min, followed by 25 cycle of 95°C for 1 min, 56°C for 1 min, and 72°C for 1 min, and finally 72°C for 7 min. The primer sequences for human β-actin was forward 5'-GTCTTCCCCTCCATCGTG-3' and reverse 5'-GTCATCTTCTCGCGGTTG-3', generating a 272 bp fragment. The amplification conditions were as follows: 95°C for 5 min, then a 20 cycle of 95°C for 1 min, 50°C for 1 min, 72°C for 1 min, and 72°C for 7 min.
Western blotting for NF-κB, IκB-α and Smad7
Interferon gamma (IFN-γ) (PeproTech Inc., NJ, USA) 50 μl (100 ng/ml) was added to each dish in the experimental studies. The cytoplasmic and nuclear extracts were washed with ice-cold PBS and lysed in a 0.5 ml/well lysis buffer (150 mmol/l NaCl, 20 mmol/l Tris, pH 7.5, 0.1% Triton X-100, 1 mmol/l phenylmethylsulfonyl fluoride [PMSF] and 10 μg/ml aprotonin) as modified from the reports of Kim et al. and Moon et al. [33, 34]. Protein concentrations in the lysates were determined using the Pierce BCA Protein Assay Kit (Thermo scientific, USA). Protein/lane 10 μg was then size-fractionated into a denaturing, non-reducing 10% polyacrylamide minigel and electrophoretically transferred to polyvinylidene fluoride (PVDF) (0.45-μm pore size) (Millpore Corparation, USA).
Specific proteins were detected using rabbit antihuman NF-κB p65, rabbit anti-human IκB-α (1:1000, Cell Signaling, Boston, MA, USA), and mouse anti-human Smad7 (1:500, R&D System, USA, MN) as primary antibodies, and peroxidase-conjugated anti-rabbit IgG, anti-mouse IgG (1:10000) as a secondary antibody. Specifically bound peroxidase was detected by Chemiluminescent HRP Substrate (ECL system, Millpore Corparation, USA) and then exposed to x-ray (GE Healthcare, UK) for 10-30 s.
The Student's t test and paired t test were used, as appropriate, for parametric differences. One-way analysis of variance (ANOVA) with Bonferroni's correction was applied for the multiple testing of data. The Mann-Whitney U test was used for the difference between non-parametric data while Pearson's χ2 test was used for non-parametric proportion difference. All tests were two-tailed and a P < 0.05 was considered statistically significant.
Cell viability after incubation with H. pylori and L. acidophilus
Cell cytotoxicity and viable cell counts of MKN45 after co-incubation with H. pylori and L. acidophilus determined by the percentage of LDH leakage (in triplicate) and non-stained trypan blue (single)
Bacteria and MOI
Cytotoxicitya (% LDH)
Viable cell count (× 106)
Cell only for 4 and 8 hours
H. pylori for 4 hours
Lactobacillus for 8 hours
H. pylori stimulated IL-8 and TNF-α but not TGF-β1 production in vitro
In contrast, L. acidophilus did not induce IL-8, TNF-α, and TGF-β1 expressions of MKN45 at least within the 8-hour co-incubation period.
Pre-treatment of L. acidophilus attenuated H. pylori-induced IL-8
L. acidophilus reduced H. pylori-induced NF-κB by increasing IκBα
L. acidophilus inhibited H. pylori-and IFN-γ-induced Smad7 expression
Human immunity plays an important role in the development of more serious clinical diseases after H. pylori infection because of increased pro-inflammatory cytokine expressions on the patients' gastric mucosa [6, 8]. H. pylori infection can activate NF-κB in gastric epithelium cells and subsequently up-regulate IL-8 gene transcription . Consistent with previous human studies [6–9], the present study reveals that H. pylori infection can induce TNF-α and IL-8 pro-inflammatory cytokine expressions in vitro. In agreement with the animal study reported by McCarthy et al. , the present study illustrates that yogurt-containing probiotics, L. acidophilus does not stimulate pro-inflammatory cytokines after an 8-hour incubation with MKN45 cells. This suggests that probiotics can exert anti-inflammatory effects in vitro. Accordingly, it will be interesting to test how the inflammatory cascades can be counteracted by probiotics.
The antimicrobial activity of Lactobacillus against enteric pathogens is, in part, due to the accumulation of lactic acid [17, 21]. The ability of lactic acid production varies in the Lactobacillus spp. and L. acidophilus is a low lactic acid-production strain . Experimentally, L. acidophilus decreases the viability of H. pylori in vitro independent of pH and lactic acid levels . The pH value of each suspension in this study is around 6.8-7.0 (data not shown). Other mechanisms like immuno-modulation should therefore contribute largely to the anti-inflammatory effects of L. acidophilus.
The current study demonstrates that L. acidophilus pre-treatment can decrease the H. pyloriinduced nuclear NF-κB expression in the 1st hour and IL-8 in the 4th hour, after co-culture with H. pylori and MKN45 cells. Furthermore, the TNF-α level is also decreased although its value is quite low (data not shown). This study further confirms that such suppression occurs in a dose-dependent manner and is mediated through the stabilization of IκBα. The finding is compatible with the results of Tien et al. showing that anti-inflammatory effects can only be achieved at an adequate bacteria count in probiotics . Data from the present study indicate that L. acidophilus can counteract H. pylori-induced gastric inflammation specifically by mediation through the IκBα/NF-κB pathway in a dose-dependent manner.
Smad7 can also be induced in normal gastric specimens by IFN-γ through a STAT1 dependent pathway . In fact, the gastric epithelium does not secret IFN-γ. Therefore, H. pylori (up-regulation) and L. acidophilus (down-regulation) both significantly regulates Smad7 in epithelium cells through the mediation of the STAT1-dependent Smad7 pathway. Inhibiting Smad7 can restore the TGF-β1/Smad3 signaling and result in the suppression of inflammatory cytokine production in patients with inflammatory bowel diseases [37, 38]. The data here reveals that probiotics contained in yogurt can inhibit Smad7 to diminish H. pylorirelated gastric inflammation. Such probiotics can be quite promising for the improvement of H. pylori infection control.
Yogurt-containing L. acidophilus can improve H. pylori-induced gastric inflammation through the inactivation of the Smad7 and NF-κB mediated pathways. Intake of L. acidophilus-containing yogurt may improve gastric inflammation in H. pylori-infected patients.
This study was supported by grants from National Cheng Kung University Hospital, Tainan, Taiwan (NCKUH-9701013 and NCKUH-9904011), the National Science Council, Taiwan (NSC97-2314-B-006-032), and the Department of Health, Taiwan (DOH99-TD-C-111-003). The authors declare that there is no financial relationship with any company involved in this study and that there is no conflict of interest.
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