Adhesion, infection, and therapeutic treatment of Helicobacter pylori: a review on current aspects and future promise

Abstract

Background Helicobacter pylori is a Gram-negative bacterium infecting over half of the human population worldwide. In addition to causing chronic gastritis, the bacterial infection often progresses to gastrointestinal pathologies at various degrees, including gastric carcinoma. World Health Organization announced in 1994 that H. pylori is Group 1 carcinogen. Although antibiotics-based treatment is mostly effective, the alarming rise in drug resistance have resulted in a serious concern for the health. Main body This review covers the aspects of bacterial infection, epidemiology and therapy of H. pylori. An additional emphasis is placed on the bacterial adhesion and anti-adhesion because the attachment of H. pylori to gastric epithelial cells is crucial for the pathogenesis. We review several anti-adhesion agents that have been shown to interfere with the bacterial adhesion. These agents can either function as receptor and adhesin analogs or foster preventive probiotics. Furthermore, cholesteryl 6′-O-acyl-α-d-glucopyranoside (CAG), exclusively produced in H. pylori by the unique biosynthetic pathway, has been shown critical for the bacterial virulence. Studies are reviewed to show how CAG influences bacterial adhesion by affecting membrane features, including lipid rafts clustering. Conclusion Owing to the emerging threat of multiple drug resistance, current therapy is not always effective to H. pylori infection, demonstrating the necessity to develop other alternatives. The approaches of anti-adhesion appear to be attractive since they blockade the initial step of bacterial pathogenesis. This in-depth review of anti-adhesive agents and corresponding mechanisms showcases their potential for future development of therapeutic intervention.