The pathogenesis of Helicobacter pylori infection

Authors S.N. Sgouros, Christine Bergele, A. Avgerinos.


It is well established that the presence of Helicobacter pylori
in the gastric mucosa is associated with chronic active
gastritis and is implicated in more severe gastric diseases,
including chronic atrophic gastritis (a precursor of gastric
carcinomas), peptic ulceration and mucosa-associated lymphoid
tissue lymphomas. On the other hand, it is well recognized
that only a minority of infected individuals develop
severe inflammation leading to peptic ulcer or gastric cancer.
In an effort to evaluate the factors that could determine
the clinical outcome of infection, investigators focused
on virulence factors of the organism, but substantial data
failed to support this model. In the present study we tried
to overview the mechanisms involved in the pathogenesis
of Helicobacter pylori infection in humans, emphasizing
the factors which are likely to be more crucial in disease
progression to peptic ulcer disease, MALT lymphomas and
gastric cancer. It seems likely that other hostderived and
environmental factors are more significant in determining
clinical outcome but additional studies are needed in order
to clarify the underlying mechanisms involved in the clinical
outcome of infection.
Key words: Helicobacter pylori, gastritis, gastric cancer,
MALT lymphoma, peptic ulcer