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. 2000 May;46(5):601–607. doi: 10.1136/gut.46.5.601

H pylori colocalises with MUC5AC in the human stomach

G R Van den Brink 1, K Tytgat 1, R W M Van der Hulst 1, C M Van der Loos 1, A Einerhand 1, H Buller 1, J Dekker 1
PMCID: PMC1727935  PMID: 10764701

Abstract

BACKGROUND—The bacterium Helicobacter pylori is able to adhere to and to colonise the human gastric epithelium, yet the primary gene product responsible as a receptor for its adherence has not been identified.
AIMS—To investigate the expression of the gastric mucins MUC5AC and MUC6 in the gastric epithelium in relation to H pylori colonisation in order to examine their possible roles in the binding of H pylori.
PATIENTS—Seventy two consecutive patients suspected of having H pylori infection.
METHODS—MUC5AC, MUC6, and H pylori were detected in single sections of antral biopsy specimens using immunohistochemical triple staining.
RESULTS—MUC5AC was expressed in the superficial epithelium and the upper part of the gastric pits. MUC6 expression was detected in the lower part of the gastric pits. The expression of both mucins in the epithelium was complementary. In each patient, there was a sharply delineated transition between MUC5AC and MUC6 producing cell populations. In all H pylori positive patients there was a striking colocalisation of H pylori and MUC5AC; more than 99% of the bacteria were associated with either extracellular MUC5AC or the apical domain of MUC5AC producing cells.
CONCLUSIONS—H pylori is very closely associated with extracellular MUC5AC and epithelial cells that produce MUC5AC. This indicates that MUC5AC, but not MUC6, plays a role in the adhesion of H pylori to the gastric mucosa.


Keywords: Helicobacter pylori; gastric mucin; MUC5AC; MUC6; stomach

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Figure 1  .

Figure 1  

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Immunohistochemical staining of sections of human stomach. All sections were immunohistochemically triple stained using antibodies against MUC5AC, MUC6, and H pylori. Detection of MUC5AC yielded a turquoise blue colour. MUC6 was detected using a DAB staining, staining MUC6 brown. Detection of H pylori yielded a reddish purple staining. All sections were counterstained with haematoxylin. (A) Section from an individual without H pylori infection. Note the complementary expression of MUC5AC and MUC6 within the epithelium. There is some yellow/orange staining in the mucosa. This is caused by erythrocytes that appear yellow/orange in this particular quadruple staining. (B) Higher magnification of A showing the transition zone of MUC5AC and MUC6 expression. (C) Distribution of MUC5AC and MUC6 along the pit-gland axis in a H pylori negative patient. (D) A H pylori positive patient at the same magnification as C (the bacteria cannot be discerned at this magnification in this patient). Notice in C and D that the glands have approximately the same length, but that the number of MUC6 expressing cells has increased, whereas the number of MUC5AC expressing cells has diminished. (E) and (F) Sections of H pylori positive patients, showing heavy infection of the mucus layer and epithelium. The star indicates a gland that is shown at higher magnification in panel I. (G-I) Higher magnifications of sections from H pylori positive patients. Notice in E-I that the H pylori bacteria colocalise with MUC5AC and with MUC5AC producing cells, but not with MUC6. (J) Section of a H pylori negative patient (after successful eradication of the bacterium), showing a focal area of intestinal metaplasia (im). Notice that the areas of intestinal metaplasia contain characteristic "intestinal type" goblet cells, but stained neither for MUC5AC nor MUC6. Arrows in E-G and I indicate purple stained, clustered H pylori bacteria. In all patients the detection of H pylori in the sections was in accordance with the culturing of the bacterium and routine histology using H&E staining. Original magnification × 62.5 (A); × 125 (B); × 62.5 (C); × 62.5 (D); × 31 (E); × 31 (F); × 250 (G); × 250 (H); × 50 (I); × 125 (J).

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