Toxins (esp. CagA and VacA)

CagA was the first protein antigen identified as a marker for the more evil type of H.pylori. cagA is one of about 30 genes in Cag pathogenicity island (cagPAI). These genes form a secretion system which injects CagA protein into cells where it causes disorganised cellular structure due to "growth factor like" effects.
VacA is a toxin which causes vacuolation of epithelial cells (bubbles within) when H.pylori attaches. VacA is a activated in acid to form a membrane pore which causes cells to become leaky, especially to urea. It also suppresses some of the immune response allowing H.pylori to persist.

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