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Page: Colonization
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With its flagella, the bacterium moves through the stomach lumen and drills into the mucus gel layer of the stomach. It then finds ways to live in various areas of the stomach. The known areas include: inside the mucus gel layer (with a preference for the superficial area), above epithelial cells, and inside vacuoles in epithelial cells. It produces adhesins which bind to membrane-associated lipids and carbohydrates and help its adhesion to epithelial cells. It produces large amounts of urease enzymes which are localized inside and outside of the bacterium. Urease metabolizes urea (which is normally secreted into the stomach) to ammonia and carbon dioxide which neutralizes stomach acid. The survival of H. pylori in the acidic stomach is dependant on urease and eventually dies without it. The ammonia that is produced is toxic to the epithelial cells, and with other products of H. pylori, including protease, catalase, and phospholipases, causes damage to those cells.
Some strains of the bacteria have a particular mechanism for "injecting" the inflammatory inducing agent peptidoglycan from their own cell wall into epithelial stomach cells. (See below for "cagA pathogenicity island" in the section "Genome studies of different strains".) This factor may play a role in allowing certain strains to invade host tissue.
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