Helicobacter pylori plays a key role in gastric adenocarcinoma induced by spasmolytic polypeptide-expressing metaplasia

Figure 1 Alteration of glandular cells during spasmolytic polypeptide-expressing metaplasia malignant progression due to Heliobacter pylori infection. Under the influences of chronic inflammation, CD44 variant 9, and whey acidic protein 4-disulfide core domain protein 2 produced by spasmolytic polypeptide-expressing metaplasia (SPEM) malignant cells, M1 and M2 polarization is induced in local macrophages, after which M1 polarized macrophages will secrete interferon-γ, which is one of the important inflammatory factors that aggravate local inflammation. M2 polarization causes macrophages to secrete large amounts of interleukin-33, which aggravates the transdifferentiation of mature master cells and promotes the malignant progression of SPEM. Citation: Created with BioRender.com. (Supplementary material). SPEM: Spasmolytic polypeptide-expressing metaplasia; IL: Interleukin; WFDC: Whey acidic protein 4-disulfide core domain protein 2; CD44v9: CD44 variant isoform 9.