Fig. 3

Local (a) and systemic (b) effects induced by Helicobacter pylori (H. pylori) outer membrane vesicles (OMVs). H. pylori OMVs induce gastric barrier dysfunction due to direct cytotoxicity, apoptosis or tight junctions disruption. Moreover, gastric barrier dysfunction axis may be deepen indirectly by the local inflammation due to accumulation of cytokine, reactive oxygen species (ROS), metaloproteinases (MMP) and other proteolytic enzymes. H. pylori OMVs also induce systemic effects, which may originate from capture of OMVs antigens by M cells, their presentation to immune cells in Payer’s patches and translocation into the circulation, where together with OMV’s-induced cytokines, indirectly induce systemic effects