English: Figure 1. Summary of the strategy of MAH related to mucosal epithelial cell adhesion and invasion. (A) Biofilm formation and eDNA export, which greatly contributes to colonization, persistence and drug resistance, are important survival strategies for MAH. MAH lipoprotein (LprB) and GPL-related genes are involved in biofilm formation, and biofilms are involved in adhesion to mucosal epithelium and non-biological surfaces including PVC pipes, shower heads, and hot tubs. (B) MAH binds to host proteins such as vimentin, and attaches to epithelial cells, and planktonic bacteria are rapidly recruited to form microaggregates. Furthermore, the MAH microaggregates interact with the host protein filamin A through MIP-1 and further manipulate the host cytoskeleton to efficiently invade the host epithelium. (C) MAH can effectively invade mucosal epithelial cells by cytoskeletal rearrangement of host cells by activating the Cdc42 signaling pathway by fadD2, cipA, and other downstream transcriptional regulators. CipA, a domain similar to the PXXP motif of the human piccolo protein; eDNA, extracellular DNA; Fad2, fatty acyl coenzyme A synthase; GPL, glycopeptidolipid; LrpB, leucine-responsive regulatory protein B; MBP-1, microaggregate binding protein 1; MIP-1, microaggregate invasion Protein-1.