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Culture of spiral\n                    <jats:italic>H. pylori<\/jats:italic>\n                    in brucella broth (BBR) containing 250 \u00b5M cholesterol produced mucoid colonies with coccoid bacteria (m-coccoids). Since\n                    <jats:italic>H. pylori<\/jats:italic>\n                    do not metabolize cholesterol as a carbon source, we examined the possible role of cholesterol or its water-soluble impurity cholesterol sulfate as signaling molecules. Cultures of spiral\n                    <jats:italic>H. pylori<\/jats:italic>\n                    in BBR containing 50\u2013250 \u00b5M cholesterol were examined for bacterial growth and morphology. After 72\u00a0h microaerobic incubation, a 50-\u00b5L volume of each culture was surface-inoculated on brucella blood agar (BBA). After 72\u00a0h, cultures of\n                    <jats:italic>H. pylori<\/jats:italic>\n                    in 150 and 250 \u00b5M cholesterol produced m-coccoids on BBA. Compared with spiral\n                    <jats:italic>H. pylori<\/jats:italic>\n                    , m-coccoids exhibited enhanced motility, flagellation, biofilm formation, expression of signaling genes,\n                    <jats:italic>hom B<\/jats:italic>\n                    ,\n                    <jats:italic>lep A<\/jats:italic>\n                    and\n                    <jats:italic>lux S<\/jats:italic>\n                    and resistance to 65\u00a0\u00b0C, pH 2\u20134, 10% NaCl, oxygen, antibiotics and atorvastatin (ATV). Looking for the time point when spiral\n                    <jats:italic>H. pylori<\/jats:italic>\n                    turned into m-coccoids, ATV was added every 6\u00a0h to cultures of spiral\n                    <jats:italic>H. pylori<\/jats:italic>\n                    in BBR containing 250 \u00b5M cholesterol up to 72\u00a0h. A 50-\u00b5L volume from each tube was inoculated on BBA for bacterial morphology and colony characteristics. Cultures of spiral\n                    <jats:italic>H. pylori<\/jats:italic>\n                    with ATV added before 54\u00a0h produced pinpoint colonies however those with ATV added after 54\u201372\u00a0h produced m-coccoids. Cholesterol sulfate may have activated signaling systems in\n                    <jats:italic>H. pylori<\/jats:italic>\n                    that resulted in spiral transformation into m-coccoids with resistance to stresses. Cholesterol sulfate availability in stomach may be among the reasons for selective colonization of\n                    <jats:italic>H. pylori<\/jats:italic>\n                    .\n                  <\/jats:p>","DOI":"10.1007\/s10123-026-00784-6","type":"journal-article","created":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T02:14:44Z","timestamp":1771640084000},"page":"315-330","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cholesterol sulfate signaling facilitates persistent colonization of mucoid-coccoid H. pylori in gastric environment"],"prefix":"10.1007","volume":"29","author":[{"given":"Elham","family":"Godini","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farideh","family":"Siavoshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,21]]},"reference":[{"issue":"5","key":"784_CR1","doi-asserted-by":"publisher","first-page":"1232","DOI":"10.1128\/JCM.36.5.1232-1235.1998","volume":"36","author":"N Albertson","year":"1998","unstructured":"Albertson N, Wenngren I, Sjostrom J-E (1998) Growth and survival of Helicobacter pylori in defined medium and susceptibility to Brij 78. 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