Skip to main content
Science Progress logoLink to Science Progress
. 2019 Feb 27;85(1):13–31. doi: 10.3184/003685002783238898

Helicobacter: A Paradigm Shift in Peptic Ulcer Disease and More?

Christelle Basset 1, John Holton 2, Dino Vaira 3
PMCID: PMC10367521  PMID: 11969117

Abstract

There are many diseases where the cause is unknown and this makes a specific treatment difficult. In many cases all that can be achieved is amelioration of the illness. Peptic ulcer disease was one such condition no more that 20 years ago. The management was drastic – either an operation or life-long medication in order to reduce the acid secreted by the stomach. However, the cause of this condition was discovered in 1983. Although initially sceptical, the medical fraternity now almost universally endorse Helicobacter pylori as the cause of the majority of stomach ulcers. Peptic ulcers can now be cured by antibiotics. This is a major shift in medical practice. Continued investigations on Helicobacter pylori are bringing to light other possible associations with disease as well as delineating plausible biological mechanisms for disease pathogenesis.

Full Text

The Full Text of this article is available as a PDF (308.4 KB).

References

  • 1.Warren J.R., & Marshall B. (1983) Unidentified curved bacilli on gastric epithelium in active chronic gastritis. Lancet, 1: 1273–1275 [PubMed] [Google Scholar]
  • 2.IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. (1994) Schistosomes, liver flukes and Helicobacter pylori. IARC-Monogr-Eval-Carcinog-Risks-Hum. 61, 1–241 [PMC free article] [PubMed] [Google Scholar]
  • 3.de Boer W.A., & Tytgat G.N.J. (2000) Treatment of Helicobacter pylori infection BMJ, 320, 31–34 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 4.Talley N.J., & Xia H.H. (1998) Helicobacter pylori infection and non-ulcer dyspepsia. Br. Med. Bull., 5463–9. [DOI] [PubMed] [Google Scholar]
  • 5.Cahill R.J., Foltz C.J., Fox J.G., Dangler C.A., Powrie F., & Schauer D.B. Inflammatory bowel disease: an immune mediated condition triggered by bacterial infection with Helicobacter hepaticus. Infection Immunity 65, 3126–3131 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 6.Fox J.G., Dewhirst F.E., Shen Z., Feng Y., Taylor N.S., Paster B.J., Ericson R.L., Lau C.N., Correa P., Araya J.C., & Roa I. (1998) Hepatic Helicobacter species identified in bile and gallbladder tissue from Chileans with chronic cholecystitis. Gastroenterology, 114, 755–763 [DOI] [PubMed] [Google Scholar]
  • 7.Ridker P.M., Danesh J., Youngman L., Collins R., Stampfer M.J., Peto R., & Hennekens C.H. (2001) A prospective study of Helicobacter pylori sero-positivity and the risk for future myocardial infarction among socioeconomically similar U.S. men. Ann. Intern. Med. 135, 184–188. [DOI] [PubMed] [Google Scholar]
  • 8.Tomb J.F., White O., Kerlavage A.R., Clayton R.A., Sutton G.G., Fleischmann R.D., Ketchum K.A., Klenk H.P., Gill S., Dougherty B.A., Nelson K., Quackenbush J., Zhou L., Kirkness E.F., Peterson S., Loftus B., Richardson D., Dodson R., Khalak H.G., Glodek A., McKenney K., Fitzegerald L.M., Lee N., Adams M.D., Hickey E.K., Berg D.E., Gocayne J.D., Utterback T.R., Peterson J.D., Kelley J.M., Cotton M.D., Weidman J.M., Fujii C., Bowman C., Watthey L., Wallin E., Hayes W.S., Borodovsky M., Karp P.D., Smith H.O., Fraser C.M., & Venter C. (1997) The complete genome sequence of the gastric pathogen Helicobacter pylori. Nature, 388: 539–547. [DOI] [PubMed] [Google Scholar]
  • 9.Salaun L., Audibert C., Le Lay G., Burucoa C., Fauchere J.L., Picard B. (1998) Panmictic structure of Helicobacter pylori demonstrated by the comparative study of six genetic markers. FEMS Microbiol Lett. 161, 31–39. [DOI] [PubMed] [Google Scholar]
  • 10.Covacci A., Falkow S., Berg DE., & Rappuoli R. (1997) Did the inheritance of a pathogenicity island modify the virulence of Helicobacter pylori? Trends Microbiology, 5, 205–209 [DOI] [PubMed] [Google Scholar]
  • 11.Atherton J.C., Cover T.L., Twells R.J., Morales M.R., Hawkey C.J., & Blaser M.J. (1999) Simple and accurate PCR-based system for typing vacuolating cytotoxin alleles of Helicobacter pylori J. Clin. Micro., 37, 2979–2982 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 12.Xiang Z., Censini S., Bayeli P.F., Telford J.L., Figura N., Rappuoli R., & Covacci A. (1995) Analysis of expression of CagA and VacA virulence factors in 43 strains of Helicobacter pylori reveals that clinical isolates can be divided into two major types and that CagA is not necessary for expression of the vacuolating cytotoxin. Infect. Immun., 63(1), 94–98. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 13.Dore MP., Bilotta M., Vaira D., Manca A., Massarelli G., Leandro G., Atzei A., Pisanu G., Graham DY., & Realdi G. (1999) High prevalence of Helicobacter pylori infection in shepherds. Dig Dis Sci., 44, 1161–1164. [DOI] [PubMed] [Google Scholar]
  • 14.Hulten K., Han S.W., Enroth H., Klein P.D., Opekun A.R., Gilman R.H., Evans D.G., Engstrand L., Graham D.Y., & El-Zaatari F.A.K. (1996) Helicobacter in the drinking water in Peru. Gastroenterology, 110, 1031–1035 [DOI] [PubMed] [Google Scholar]
  • 15.Vaira D., & Holton J. (1998) Vector potential of houseflies (Musca domestica) for Helicobacter pylori. Helicobacter, 3, 65–66 [PubMed] [Google Scholar]
  • 16.Webb P.M., Knight T., Greaves S., Wilson A., Newell D.G., Elder J., & Forman D. (1994) Relation between infection with Helicobacter pylori and living conditions in childhood: evidence for person to person transmission in early life, BMJ, 308, 750–753 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 17.Lambert J.R., Lin S.K., Sievert W., Nicholson L., Schembri M., & Guest C. (1995) High prevalence of Helicobacter pylori antibodies in an institutionalized population: evidence for person-to-person transmission, Am. J. Gastroenterol., 90, 2167–2171 [PubMed] [Google Scholar]
  • 18.Weeks D.L., & Sachs G. (2001) Sites of pH regulation of the urea channel of Helicobacter pylori., Mol Microbiol., 40, 1249–1259. [DOI] [PubMed] [Google Scholar]
  • 19.Prinz C., Schoniger M., Rad R., Becker I., Keiditsch E., Wagenpfeil S., Classen M., Rosch T., Schepp W., & Gerhard M. (2001) Key importance of the Helicobacter pylori adherence factor blood group antigen binding adhesin during chronic gastric inflammation. Cancer Res., 61, 1903–1909. [PubMed] [Google Scholar]
  • 20.Cover T.L. (1996) The vacuolating cytotoxin of Helicobacter pylori [DOI] [PubMed]
  • 21.Calam J. (1999) Helicobacter pylori modulation of gastric acid. Yale J. Biol. Med., 72, 195–202. [PMC free article] [PubMed] [Google Scholar]
  • 22.Parente F., Negrini R., Imbesi V., Maconi G., Sainaghi M., Vago L., & Porro G.B. (2001) Presence of gastric autoantibodies impairs gastric secretory function in patients with Helicobacter pylori-positive duodenal ulcer. Scand. J. Gastroenterol., 36, 474–47 [DOI] [PubMed] [Google Scholar]
  • 23.Segal E.D., Lange C., Covacci A., Tompkins L.S., Falkow S. (1997) Induction of host signal transduction pathways by Helicobacter pylori. PNAS, 94, 7595–7599 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 24.Tomita T., Jackson A.M., Hida N., Hayat M., Dixon M.F., Shimoyama T., Axon Atr, Robinson PA., & Crabtree JE. (2001) Expression of Interleukin-18, a Th1 cytokine in human gastric mucosa is increased in Helicobacter pylori infection. J. Infect. Dis., 183, 620–627 [DOI] [PubMed] [Google Scholar]
  • 25.Noach L.A., Bosma N.B., Jansen J., Hoek F.J., van Deventer S.J., & Tytgat G.N. (1994) Mucosal tumor necrosis factor alpha, interleukin-1 beta and interleukin 8 production in patients with Helicobacter pylori infection. Scand. J. Gastroenterol., 29, 425–429 [DOI] [PubMed] [Google Scholar]
  • 26.Mori N., Ueda A., Geleziunas R., Wada A., Hirayama T., Yoshimura T., Yamamoto N. (2001) Induction of monocyte chemoattractant protein –1 by Helicobacter pylori involves NFκB. Infection Immunity, 69, 1280–1286 [DOI] [PMC free article] [PubMed] [Google Scholar] [Retracted]
  • 27.Mori N., Wada A., Hirayama T., Parks T.P., Stratowa C., Yamamoto N. (2000) Activation of intracellular adhesion molecule-1 expression by Helicobacter pylori is regulated by NFκB in gastric epithelial cancer cells. Infection Immunity, 68, 1806–1814 [DOI] [PMC free article] [PubMed] [Google Scholar] [Retracted]
  • 28.Blaser M.J., Perez-Perez G.I., Kleanthous H., Cover T.L., Peek R.M., Chyou P.H., Stemmermann G.N., & Normura A. (1995) Infection with Helicobacter pylori strains possessing cagA is associated with increased risk of developing adenocarcinoma of the stomach. Cancer Res., 55, 2111–2115 [PubMed] [Google Scholar]
  • 29.Peek R.M., Wirth H.P., Moss S.F., Yang M., Abdalla A.M., Tham K.T., Zhang T., Tang L.H., Modlin I.M., & Blaser M.J. (2000) Helicobacter pylori alters gastric epithelila cell cycle events and gastrin secretion in Mongolian Gerbils Gastroenterology, 118, 48–59 [DOI] [PubMed] [Google Scholar]
  • 30.Shibayama K., Doi Y., Shibata N., Yagi T., Nada T., Linuma Y., & Arakawa Y. (2001) Apoptotic signalling pathway activated by Helicobacter pylori infection and increase of apoptosis-inducing activity under semi-starved conditions. Infection Immunity, 69, 3181–3189 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 31.Shirin H., Sordillo E.M., Kolevska T.K., Hibshoosh H., Kawabata Y., Oh S.H., Kuebler J.F., Delohery T., Weghorst C.M., Weinstein I.B., & Moss S.F. (2000) Chronic Helicobacter pylori infection induces an apoptosis-resistant phenotype associated with decreased expression of p27kip1. Infection Immunity, 68, 5321–5328 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 32.El-Omar E.M., Carrington M., Chow W.H., McColl K.E., Bream J.H., Young H.A., Herrera J., Lissowska J., Yuan C.C., Rothman N., Lanyon G., Martin M., Fraumeni J.F., & Rabkin C.S. (2000) Interleukin-1 polymorphisms associated with increased risk of gastric cancer. Nature, 404, 398–402. [DOI] [PubMed] [Google Scholar]
  • 33.Vaira D., Holton J., Menegatti M., Ricci C., Gatta L., Geminiani A., & Miglioli M. (2000) Review article:invasive and non-invasive tests for Helicobacter pylori infection. Aliment. Pharmacol. Ther. Suppl 3, 13–22. [DOI] [PubMed] [Google Scholar]

Articles from Science Progress are provided here courtesy of SAGE Publications

RESOURCES