2. The Association of vacA Genotypes and CytotoxinThe most distinct effect of VacA is vacuolation of cells. After VacA internalization, internalmembranous vesicles accumulate. Anion‐selective channels are created in the membrane of thesevesicles which facilitate the transport of chloride ions. VacA induces the accumulation of membranepermeable weak bases and finally results in osmotic swelling and vacuolation [22,23]. Even thoughthe physiological role of vacuolation is still unclear, vacuolation occurring during H. pylori infection
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