Division of Gastroenterology, Vanderbilt University School of Medicine, 2215 Garland Ave., 1030C MRB IV, Nashville, TN 37232-2279, USA.
Clin Microbiol Rev. 2010 Oct;23(4):713-39. doi: 10.1128/CMR.00011-10.
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.
幽门螺杆菌是一种胃部病原体，大约有 50%的世界人口受到其感染。感染幽门螺杆菌会导致慢性炎症，并显著增加十二指肠和胃溃疡病以及胃癌的发病风险。感染幽门螺杆菌是已知的导致胃癌的最强危险因素，而胃癌是全球癌症相关死亡的第二大主要原因。一旦幽门螺杆菌在胃部环境中定植，它将在宿主的整个生命周期中持续存在，这表明宿主的免疫反应无法有效清除这种细菌。在这篇综述中，我们讨论了宿主的免疫反应，并研究了其他增加这种细菌致病潜力的宿主因素，包括宿主多态性、顶-连接复合体的改变以及环境因素的影响。除了宿主的作用和反应外，幽门螺杆菌菌株具有遗传多样性。我们讨论了幽门螺杆菌菌株中的主要毒力决定因素，以及这些因素与感染幽门螺杆菌后不同的临床结果之间的相关性。由于幽门螺杆菌抑制了世界上一半人口的胃上皮细胞，因此我们必须继续深入了解增加发生更严重临床结果风险的宿主和微生物因素。
