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Bacillary is the most common form of H. pylori observed during human infection. However, it is known that the morphology change of H. pylori from bacillary to coccoid can be occurred with a response to the environmental stresses such as the nutrient depletion, accumulation of toxic metabolites, pH alteration, and exposure to antimicrobial agents. The coccoid form of H. pylori, which is viable but non-culturable in vitro, seems to be the major cause of antibiotic resistancy and high reinfectability of H. pylori. In this regard, we studied the environmental factors that can induce the morphological change in vitro of H. pylori, and the change of fatty acid composition of plasma membrane. The morphological change from bacillary to coccoid could be observed with the depletion of nutrients, pH variation and reactive oxygen species added in the culture media. This morphologic conversion was paralleled by a dramatic decrease in unsaturated fatty acids and an increase in saturated fattv acids of plasma membrane. The change in composition of membrane fatty acid seems to be a kind of protection mechanism of H. pylori against these environmental stresses.

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