Suicide journey of H. pylori through gastric carcinogenesis: the role of non-H. pylori microbiome and potential consequences for clinical practice

  • Paulo Pimentel de AssumpçãoEmail author
  • Taíssa Maíra Thomaz Araújo
  • Paula Baraúna de Assumpção
  • Williams Fernandes Barra
  • André Salim Khayat
  • Carolina Baraúna Assumpção
  • Geraldo Ishak
  • Diana Noronha Nunes
  • Emmanuel Dias-Neto
  • Luiz Gonzaga Vaz Coelho


Despite being one of the most studied cancer-related infections, the relationship between Helicobacter pylori infection and gastric adenocarcinoma (GC) remains, in some points, obscure. Based on a critical analysis of the available literature regarding stomach microbiota, we aimed to shed light to a possible new interpretation of the current understanding about the Helicobacter pylori-related GC carcinogenesis. We analyzed data from the literature on Helicobacter pylori and other potential carcinogenic pathogens, in both benignant conditions and gastric adenocarcinoma. Helicobacter pylori is the dominant microorganism in benignant conditions as non-complicated gastritis. In atrophic gastritis, metaplasia and, mainly, in gastric adenocarcinoma, a strong reduction in Helicobacter pylori abundance, and increased occurrence of other microorganisms is strongly demonstrated by metagenomic experiments. While causing peptic disease and keeping the stomach’s high acidity, Helicobacter pylori infection avoids gastric infection by carcinogenic intestinal microbiota. Nevertheless, Helicobacter pylori persistence may also provoke an atrophic gastritis, a condition that causes its own decline, due to a microenvironment modification, including reduced acidity, resulting in Helicobacter pylori substitution by a cancer-prone microbiota. This new interpretation might result in a dramatic modification on clinical management of Helicobacter pylori-related gastric disease.


Helicobacter pylori Gastric cancer Microbiota Dysbiosis Carcinogenesis 



We acknowledge Universidade Federal do Pará (PROPESP and Fadesp) for technical support and Conselho Nacional de Desenvolvimento Científico e Teconlógico (CNPq) and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) for fellowship support.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Paulo Pimentel de Assumpção
    • 1
    Email author
  • Taíssa Maíra Thomaz Araújo
    • 1
  • Paula Baraúna de Assumpção
    • 2
  • Williams Fernandes Barra
    • 1
  • André Salim Khayat
    • 1
  • Carolina Baraúna Assumpção
    • 3
    • 4
  • Geraldo Ishak
    • 1
    • 5
  • Diana Noronha Nunes
    • 6
  • Emmanuel Dias-Neto
    • 6
  • Luiz Gonzaga Vaz Coelho
    • 7
  1. 1.Núcleo de Pesquisas em OncologiaUniversidade Federal do ParáBelémBrazil
  2. 2.Programa de Pós-Graduação em Génetica e Biologia MolecularUniversidade Federal do ParáBelémBrazil
  3. 3.Departamento de Cirurgia OncológicaHospital Alemão Oswaldo CruzSão PauloBrazil
  4. 4.Departamento de Cirurgia Oncológica, Alameda dos LíriosHospital Geral de GuarulhosGuarulhosBrazil
  5. 5.Hospital Universitário João de Barros BarretoUniversidade Federal do ParáBelémBrazil
  6. 6.Laboratório de Genômica MédicaAC Camargo Cancer CenterSão PauloBrazil
  7. 7.Instituto Alfa de Gastroenterologia do Hospital das ClínicasUniversidade Federal de Minas GeraisBelo HorizonteBrazil

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