Division of Gastroenterology, Department of Medicine, Vanderbilt University School of Medicine, and Veterans Affairs Tennessee Valley Healthcare System, Nashville, Tennessee 37232-2279, USA.
Physiol Rev. 2010 Jul;90(3):831-58. doi: 10.1152/physrev.00039.2009.
Helicobacter pylori colonizes the majority of persons worldwide, and the ensuing gastric inflammatory response is the strongest singular risk factor for peptic ulceration and gastric cancer. However, only a fraction of colonized individuals ever develop clinically significant outcomes. Disease risk is combinatorial and can be modified by bacterial factors, host responses, and/or specific interactions between host and microbe. Several H. pylori constituents that are required for colonization or virulence have been identified, and their ability to manipulate the host innate immune response will be the focus of this review. Identification of bacterial and host mediators that augment disease risk has profound ramifications for both biomedical researchers and clinicians as such findings will not only provide mechanistic insights into inflammatory carcinogenesis but may also serve to identify high-risk populations of H. pylori-infected individuals who can then be targeted for therapeutic intervention.
幽门螺杆菌在全球范围内定植于大多数人群中,由此引发的胃部炎症反应是消化性溃疡和胃癌的最强单一危险因素。然而,仅有少数定植个体最终发展为具有临床意义的结局。疾病风险是组合性的,可由细菌因素、宿主反应和/或宿主与微生物之间的特定相互作用所修饰。已鉴定出几种定植或毒力所需的幽门螺杆菌成分,其操纵宿主固有免疫反应的能力将是本综述的重点。鉴定出增强疾病风险的细菌和宿主介质,对生物医学研究人员和临床医生都具有深远的意义,因为这些发现不仅将为炎症性致癌提供机制见解,而且还可能有助于识别出具有高风险的幽门螺杆菌感染个体人群,然后对其进行治疗干预。