Bommelaer G, Stef A
Service d'Hépatogastroentérologie, Hôtel-Dieu, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France.
Gastroenterol Clin Biol. 2009 Aug-Sep;33(8-9):626-34. doi: 10.1016/j.gcb.2009.07.004. Epub 2009 Aug 13.
Before the discovery of Helicobacter pylori, ulcer disease was considered as the result of a conflict between gastric acid and pepsin, on one side, and protection afforded by gastric mucosal barrier, on the other side. The discovery of H. pylori by Marshall and Warren in 1982 overthrew this conception and revealed ulcer disease mainly as an infectious disease. H. pylori eradication with an appropriate triple therapy is now considered as the gold standard treatment of gastroduodenal ulcer. The pathogenic role of H. pylori lies far beyond ulcer disease since H. pylori is looked as involved in nonulcer dyspepsia, nonsteroidal anti-inflammatory drug ulcers, gastric cancer, MALT lymphoma and, eventually, oesophageal adenocarcinoma, and nondigestive diseases as cardiovascular diseases. The pandemic nature of the H. pylori infection, particularly within developing countries, combined with emerging resistances to antibiotics make the development of a vaccine a public health necessity. The relationships between the human host and the bacterium remains mostly unknown, some of which could be beneficial.
在幽门螺杆菌被发现之前，溃疡病被认为是胃酸和胃蛋白酶一方面与胃黏膜屏障提供的保护另一方面之间冲突的结果。1982年马歇尔和沃伦发现幽门螺杆菌推翻了这一概念，并揭示溃疡病主要是一种传染病。目前，采用适当的三联疗法根除幽门螺杆菌被视为胃十二指肠溃疡的金标准治疗方法。幽门螺杆菌的致病作用远远超出溃疡病，因为幽门螺杆菌被认为与非溃疡性消化不良、非甾体抗炎药溃疡、胃癌、黏膜相关淋巴组织淋巴瘤以及最终的食管腺癌有关，还与心血管疾病等非消化系统疾病有关。幽门螺杆菌感染的流行特性，尤其是在发展中国家，再加上对抗生素新出现的耐药性，使得开发一种疫苗成为公共卫生的必要需求。人类宿主与这种细菌之间的关系大多仍不为人知，其中一些关系可能是有益的。
