Host Determinants of Helicobacter pylori Infection and Its Clinical Outcome

Abstract

Greater than one-half of the world's population harbors Helicobacter pylori. The majority of infected individuals, however, remain asymptomatic, with only 10% to 20% developing diseases, including peptic ulcer disease, gastric cancer, and gastric mucosa-associated lymphoid tissue lymphoma. This article reviews host factors that may predispose an individual to both the acquisition of H. pylori infection and subsequent clinical outcome. Individuals with specific blood group antigens and human leukocyte antigen genotypes may be more susceptible to H. pylori infection. Additional factors, such as the age of acquisition, the host immune response, the site of infection, acid secretion, and interactions with nonhost factors (including bacterial virulence factors and environmental influences) may play a role in determining clinical outcome. Further investigation is required to clarify the mechanisms by which these interactions occur and, more critically, to determine their relative importance. This knowledge will enable the identification of individuals at risk of developing clinical disease with H. pylori infection.

Variations inHelicobacter pyloriLipopolysaccharide To Evade the Innate Immune Component Surfactant Protein D

“…H. pylori colonizes more than one-half of the world's population. However, only 15% of infected individuals are clinically symptomatic (38). While it is clear that the organism induces a strong innate and adaptive immune response leading to active inflammation in the gastric mucosa, the ability of H. pylori to establish persistent infection so efficiently has not been adequately explained.…”

Risks and Benefits ofHelicobacter pyloriEradication: Current Status

“…However, eradication prevented progression of gastric atrophy, which may be a cancer precursor (26,27).…”

Prevalence of resistant Helicobacter pylori isolates in Bulgarian children

“…More than one-half of the world's population is infected by Helicobacter pylori [1]. The acquisition of H. pylori infection occurs mainly in childhood and can trigger the development of peptic ulcers and gastric malignancy throughout life.…”

“…Acquisition of H. pylori early in life can result in prolonged infection, continual inflammatory host response and increased risk of gastric malignancy if other co-factors are present. Delay in acquisition of H. pylori in Western countries may lead to a higher prevalence of duodenal ulcer disease and to a relative reduction of gastric carcinoma [1]. Successful eradication of the infection results in ulcer healing and prevents ulcer recurrences and complications [2].…”