Journal
CLINICAL MICROBIOLOGY REVIEWS
Volume 23, Issue 4, Pages 713-739Publisher
AMER SOC MICROBIOLOGY
DOI: 10.1128/CMR.00011-10
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Funding
- National Institutes of Health [DK053620, AT004821, CA116087, CA028842, DK058404, DK58587, DK77955]
- Office of Medical Research, Department of Veterans Affairs
- Vanderbilt Digestive Diseases Research Center [DK058405]
- NATIONAL CANCER INSTITUTE [P01CA028842, P01CA116087] Funding Source: NIH RePORTER
- National Center for Complementary & Integrative Health [R01AT004821] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES [K01DK077955, P30DK058404, R01DK058587, R01DK053620] Funding Source: NIH RePORTER
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Helicobacter pylori is a gastric pathogen that colonizes approximately 50% of the world's population. Infection with H. pylori causes chronic inflammation and significantly increases the risk of developing duodenal and gastric ulcer disease and gastric cancer. Infection with H. pylori is the strongest known risk factor for gastric cancer, which is the second leading cause of cancer-related deaths worldwide. Once H. pylori colonizes the gastric environment, it persists for the lifetime of the host, suggesting that the host immune response is ineffective in clearing this bacterium. In this review, we discuss the host immune response and examine other host factors that increase the pathogenic potential of this bacterium, including host polymorphisms, alterations to the apical-junctional complex, and the effects of environmental factors. In addition to host effects and responses, H. pylori strains are genetically diverse. We discuss the main virulence determinants in H. pylori strains and the correlation between these and the diverse clinical outcomes following H. pylori infection. Since H. pylori inhibits the gastric epithelium of half of the world, it is crucial that we continue to gain understanding of host and microbial factors that increase the risk of developing more severe clinical outcomes.
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