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Targeting mitochondria is a powerful strategy for pathogens to subvert cell physiology and establish infection.  Helicobacter pylori  is a bacterial pathogen associated with gastric cancer development that is known to target mitochondria directly and exclusively through its pro-apoptotic and vacuolating cytotoxin VacA. By  in vitro  infection of gastric epithelial cells with wild-type and VacA-deficient  H .  pylori  strains, treatment of cells with purified VacA proteins and infection of a mouse model, we show that  H .  pylori  deregulates mitochondria by two novel mechanisms, both rather associated with host cell survival. First, early upon infection VacA induces transient increase of mitochondrial translocases and a dramatic accumulation of the mitochondrial DNA replication and maintenance factors POLG and TFAM. These events occur when VacA is not detected intracellularly, therefore do not require the direct interaction of the cytotoxin with the organelle, and are independent of the toxin vacuolating activity.  In vivo , these alterations coincide with the evolution of gastric lesions towards severity. Second,  H .  pylori  also induces VacA-independent alteration of mitochondrial replication and import components, suggesting the involvement of additional  H .  pylori  activities in mitochondria-mediated effects. These data unveil two novel mitochondrial effectors in  H .  pylori -host interaction with links on gastric pathogenesis.

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Helicobacter pylori targets mitochondrial import and components of mitochondrial DNA replication machinery through an alternative VacA-dependent and a VacA-independent mechanisms