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Spiral\u2010shaped <jats:italic>H. pylori<\/jats:italic> undergo morphologic conversion to a viable but not culturable coccoid form when they transit from the microaerobic stomach into the anaerobic intestinal tract. However, little is known about the morphological and pathogenic characteristics of <jats:italic>H. pylori<\/jats:italic> under prolonged anaerobic conditions. In this study, scanning electron microscopy was used to document anaerobiosis\u2010induced morphological changes of <jats:italic>H. pylori<\/jats:italic>, from helical to coccoid to a newly defined fragmented form. Western blot analysis indicated that all three forms express certain pathogenic proteins, including the bacterial cytotoxin\u2010associated gene A (CagA), components of the <jats:italic>cag<\/jats:italic>\u2010Type IV secretion system (TFSS), the blood group antigen\u2010binding adhesin BabA, and UreA (an apoenzyme of urease), almost equally. Similar urease activities were also detected in all three forms of <jats:italic>H. pylori<\/jats:italic>. However, in contrast to the helical form, bacterial motility and TFSS activity were found to have been abrogated in the anaerobiosis\u2010induced coccoid and fragmented forms of <jats:italic>H. pylori<\/jats:italic>. Notably, it was demonstrated that some of the anaerobiosis\u2010induced fragmented state cells could be converted to proliferation\u2010competent helical bacteria <jats:italic>in vitro<\/jats:italic>. These results indicate that prolonged exposure to the anaerobic intestine may not eliminate the potential for <jats:italic>H. pylori<\/jats:italic> to revert to the helical pathogenic state.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1348-0421.12582","type":"journal-article","created":{"date-parts":[[2018,2,15]],"date-time":"2018-02-15T12:26:41Z","timestamp":1518697601000},"page":"221-228","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Characterization of morphological conversion of <i>Helicobacter pylori<\/i> under anaerobic conditions"],"prefix":"10.1111","volume":"62","author":[{"given":"Sayaka","family":"Hirukawa","sequence":"first","affiliation":[{"name":"Division of Bacteriology Department of Infectious Diseases Control International Research Center for Infectious Diseases Institute of Medical Science The University of Tokyo Tokyo 108\u20108639 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Bacteriology Department of Infectious Diseases Control International Research Center for Infectious Diseases Institute of Medical Science The University of Tokyo Tokyo 108\u20108639 Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahito","family":"Sanada","sequence":"additional","affiliation":[{"name":"Division of Bacteriology Department of Infectious Diseases Control International Research Center for Infectious Diseases Institute of Medical Science The University of Tokyo Tokyo 108\u20108639 Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Kiyono","sequence":"additional","affiliation":[{"name":"Division of Mucosal Immunology Institute of Medical Science The University of Tokyo Tokyo 108\u20108639 Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitomi","family":"Mimuro","sequence":"additional","affiliation":[{"name":"Division of Bacteriology Department of Infectious Diseases Control International 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