Metronidazole (MTZ) is often used in combination therapies to treat infections caused by the gastric pathogen Helicobacter pylori.Resistance to MTZ results from loss-of-function mutations in genes encoding RdxA and FrxA nitroreductases. MTZ-resistant strains, when cultured at sub-MICs of MTZ (5 to 20 g/ml), show dose-dependent defects in bacterial growth; depressed activities of many Krebs cycle enzymes, including pyruvate:ferredoxin oxidoreductase (PFOR); and low transcript levels of porGDAB (primer extension), phenotypes consistent with an involvement of a transcriptional regulator. Using a combination of protein purification steps, electrophoretic mobility shift assays (EMSAs), and mass spectrometry analyses of proteins bound to porG promoter sequences, we identified HP1043, an essential homeostatic global regulator (HsrA [for homeostatic stress regulator]). Competition EMSAs and supershift analyses with HsrA-enriched protein fractions confirmed specific binding to porGDAB and hsrA promoter sequences. Exposure to MTZ resulted in >10-fold decreases in levels of HsrA and in levels of the HsrA-regulated gene products PFOR and TlpB. Exposure to paraquat (PQ), hydrogen peroxide, or organic peroxides showed near equivalence with MTZ, revealing a common oxidative stress response pathway. Finally, direct superoxide dismutase (SOD) assays showed an inverse relationship between HsrA levels and SOD activity, suggesting that HsrA may serve as a repressor of sodB. As a homeostatic sentinel, HsrA appears to be ideally positioned to enable rapid shutdown of genes associated with metabolism and growth while activating (directly or indirectly) oxidative defense genes in response to low levels of toxic metabolites (MTZ or oxygen) before they reach DNA-damaging levels.
Helicobacter pylori is a microaerobic bacterium that causes lifelong infections of the gastric mucosa of over 3 billion persons worldwide, and while most of these infections result in mild superficial gastritis, some infections progress to more serious diseases such as peptic and duodenal ulcers, mucosa-associated lymphoid tissue lymphoma, and gastric cancer (1-3). The remarkable ability of H. pylori to both colonize and persist in the gastric milieu is attributed to several systems that monitor local pH, including a novel pH-gated urea transporter (UreI) that modulates a powerful urease system (4, 5), a pH-sensing chemoreceptor (TlpB) that directs both colonization and avoidance of washout with mucus turnover (6), and a pH-sensing two-component regulatory system (ArsRS) that modulates expression of acid survival genes in sync with the daily cycling of stomach acid (7-10). In contrast to acid stress, little is known regarding the response to oxidative stress, yet H. pylori promotes gastric inflammation and the recruitment of neutrophils and macrophages, all of which produce reactive oxygen and nitrogen species (11, 12). While H. pylori responds to oxidative stress insults by increasing the expression levels of many genes, including catalase, alkyl hydroperoxide r...