Muc5ac null mice are predisposed to spontaneous gastric antro-pyloric hyperplasia and adenomas coupled with attenuated H. pylori induced corpus mucous metaplasia

Gastric cancer (GC) is the third leading cause of cancer-related deaths worldwide and is strongly associated with chronic Helicobacter pylori (Hp) infection. The ability of Hp to closely adhere to the gastric surface protective mucous layer containing mucins (MUC in humans and Muc in animals), primarily Muc5ac, is integral in the step wise pathogenesis from gastritis to cancer. To probe the role of Muc5ac in Hp -induced gastric pathology, Muc5ac(−/−) and Muc5ac(+/+) (WT) mice were experimentally infected with Hp Sydney strain (SS1). At 16 weeks and 32 weeks post infection (wpi), groups of mice were euthanized and evaluated for the following: gastric histopathological parameters, immunohistochemical expression of mucins (Muc5ac, Muc1, Muc2), Trefoil factor family proteins (Tff1 and Tff2), Griffonia (Bandeiraea) simplicifolia lectin II (GSL II) (mucous metaplasia marker) and Clusterin (Spasmolytic Polypeptide Expressing Metaplasia (SPEM) marker), Hp colonization density by qPCR and gastric cytokine mRNA levels. Our results demonstrate that Muc5ac(−/−) mice developed spontaneous antro-pyloric proliferation, adenomas and in one case with neuroendocrine differentiation; these findings were independent of Hp infection along with strong expression levels of Tff1, Tff2 and Muc1. Hp-infected Muc5ac(−/−) mice had significantly lowered gastric corpus mucous metaplasia at 16wpi and 32 wpi (P=0.0057 and P=0.0016, respectively), with a slight reduction in overall gastric corpus pathology. GSII positive mucous neck cells were decreased in Hp-infected Muc5ac(−/−) mice compared to WT mice and clusterin positivity was noted within metaplastic glands in both genotypes following Hp infection. Additionally, Hp colonization densities were significantly higher in Muc5ac(−/−) mice compared to WT at 16 wpi in both sexes (P=0.05) along with a significant reduction in gastric Tnfα (16 wpi- males and females, P=0.017 and P=0.036, respectively and 32 wpi- males only, P=0.025) and Il-17a (16 wpi- males) (P=0.025). Taken together, our findings suggest a protective role for MUC5AC/Muc5ac in maintaining gastric antral equilibrium and inhibiting Hp colonization and associated inflammatory pathology.