there were no differences in TLR4 or TLR5 mRNA levels among the different clinical presentations/histological findings (P > 0.05). In the in vitro assay, the mRNA levels of TLR4 or TLR5 in AGS cells were not influenced by the vacAs1 status or the clinical condition associated with the strains (P > 0.05 for both TLR4 and TLR5).
CONCLUSION:The results of this study show that the mRNA levels of TLR4 and TLR5 in gastric cells, both in vivo and in vitro , are independent of H pylori colonization and suggest that vacA may not be a significant player in the first step of innate immune recognition mediated by TLR4 or TLR5.
INTRODUCTIONH pylori is a Gram-negative, flagellated bacterium that colonizes the gastric mucosa of approximately twothirds of the world's population and is the primary cause of peptic ulcers and gastric adenocarcinoma. The complex interactions between different H pylori strains, the host immune system or environmental factors (or combinations thereof) are responsible for the significant variability in disease presentation associated with H pylori infection [1] . Vacuolating cytotoxin (VacA) and the CagA protein are the two major virulence markers usually associated with H pylori pathogenicity. VacA induces the formation of intracellular vacuoles in epithelial cell lines. Aside from its direct cell-damaging effect in vitro, VacA also plays a major role in inducing cytoskeletal changes, apoptosis and suppression of epithelial cell prolifera-
METHODS:For the in vivo assays, gastric biopsies were obtained from 40 patients and H pylori status was determined. For the in vitro assays, human gastric adenocarcinoma mucosal cells (AGS) were cultured in the presence or absence of twelve selected H pylori strains. H pylori strains isolated from culture-positive patients and selected strains were genotyped for cagA and vacA . The cDNA was obtained from mRNA extracted from biopsies and from infected AGS cells. TLR4 and TLR5 mRNA levels were examined by real-time PCR.
RESULTS:The presence of H pylori did not affect the mRNA levels of TLR4 or TLR5 in gastric biopsies. The mRNA levels of both receptors were not influenced by the vacA status (P > 0.05 for both receptors) and