The future of Helicobacter pylori research: the agenda for microbiologists

Abstract

Remarkably, it is only about 16 years since the first culture of Helicobacter pylori 1 The research effort into this organism, presumably catalysed by the intense commercial interest in gastric diseases and their medications, has been eclipsed only by AIDS research. Thus, the Medline database since 1984, the first year of publication on H. pylori, contains 8500 articles with either Campylobacter pyloridis, Campylobacter pylori, CLO or Helicobacter in the title. In the chapters in the preceding pages the increasing sophistication of Helicobacter research is well illustrated. With increasingly effective therapies and evidence of a decline in H. pylori infection rates in the developed world, it could be well asked whether the bubble has burst, and are there major priorities for the future? The personal viewpoint described below is clearly in the affirmative. There are many challenges ahead that will ensure microbiologists are happily and rewardingly occupied for the years to come.

Keywords

Pylorus Infection Transitional Zone Acid Output Pylorus Strain Local Acid 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Marshall BJ, Royce H, Annear DI et al. Original isolation of Campylobacter pyloridis from human gastric mucosa. Microbiol Lett. 1984;25:83–8.Google Scholar
  2. 2.
    Debetsossenkopp YJ, Sparrius M, Kusters JG, Kolkman JJ. Vandenbrouckegrauls CMJE. Mechanism of clarithromycin resistance in clinical isolates of Helicobacter pylori. FEMS Microbiol Lett. 1996;142:37–42.CrossRefGoogle Scholar
  3. 3.
    Jorgensen M, Daskalopoulos G, Warburton V, Mitchell HM, Hazell SL. Multiple strain colonization and metronida7ole resistance in Helicobacter pylori-infected patients ¡ª identification from sequential and multiple biopsy specimens. J Infect Dis. 1996;174:631–5.PubMedCrossRefGoogle Scholar
  4. 4.
    Megraud F. Resistance of Helicobacter pylori to antibiotics. Aliment Pharmacol Ther. 1997;11(Suppl. 1):43–53.PubMedCrossRefGoogle Scholar
  5. 5.
    Czinn SJ. What is the role for vaccination in Helicobacter pylon? Gastroenterology. 1997;113(6 Suppl. S):S149–53.PubMedCrossRefGoogle Scholar
  6. 6.
    Dunn BE Cohen H, Blaser MJ. Helicobacter pylori. Clin Microbiol Rev. 1997;10:720–41.PubMedGoogle Scholar
  7. 7.
    Parsonnet J. Helicobacter pylori in the stomach - a paradox unmasked. N Engl J Med. 1996;335:278–80.PubMedCrossRefGoogle Scholar
  8. 8.
    Lee A, Dixon MF, Danon SJ et al. Local acid production and Helicobacter pylori: a unifying hypothesis of gastroduodenal disease. Eur J Gastroenterol Hepatol. 1995;7:461–5.PubMedGoogle Scholar
  9. 9.
    Lee A, Van Zanten SV. The aging stomach or the stomachs of the ages ¡ª commentary. Gut. 1997;41:575–6.PubMedCrossRefGoogle Scholar
  10. 10.
    Meyer Rosberg K, Scott DR, Rex D, Melchers K, Sachs G. The effect of environmental pH on the proton motive force of Helicobacter pylori. Gastroenterology. 1996;111:886–900.PubMedCrossRefGoogle Scholar
  11. 11.
    Clyne M, Labigne A, Drumm B Helicobacter pylori requires an acidic environment to survive in the presence of urea. Infect Immun. 1995;63:1669–73.PubMedGoogle Scholar
  12. 12.
    Lee A, Mellgard B, Larsson H. Effect of gastric acid on Helicobacter pylori ecology. In: Hunt RH, Tytgat GNJ, editors. Helicobacter pylori: Basic mechanisms to clinical cure. Dordrecht: Kluwer; 1996:50–63.Google Scholar
  13. 13.
    Kinoshita Y, Kawanami C, Kishi K, Nakata H, Seino Y, Chiba T. Helicobacter pylori independent chronological change in gastric acid secretion in the Japanese. Gut. 1997;41:452–8.PubMedCrossRefGoogle Scholar
  14. 14.
    Van Zanten S, O’Rourke J, Larsson H, Mellgard B, Lee A. Urease and local acid: critical factors in the behaviour of Helicobacter species in the gastric mucosa. Gut. 1997;41(Suppl. 1):A118.Google Scholar
  15. 15.
    Leung V, O’Rourke J, Velan G, Robertson B, A. L. Helicobacter versus helicobacter: Insights into the microbial ecology of gastric colonisation. Gut. 1997;41(Suppl. 1):Al20.Google Scholar
  16. 16.
    Lee A, Phillips MW, O’Rourke JL et al. Helicobacter pylori sp. nov., a microaerophilic helical bacterium with a novel ultrastructure isolated from the intestinal mucosa of rodents. Int J Syst Bacteriol. 1992;42:27–36.PubMedCrossRefGoogle Scholar
  17. 17.
    Ferrero RL, Hazell SL, Lee A. The urease enzymes of Campylobacter pylori and a related bacterium. J Med Microbiol. 1988;27:33–40.PubMedCrossRefGoogle Scholar
  18. 18.
    Van Zanten S, Lee A. The gastric transitional zones: the neglected link in Helicobacter pathology. Gut. 1997;41(Suppl 1):A23.Google Scholar
  19. 19.
    Stadelmann O, Miederer SE. Die Magensekretion: Physiologie, Pathophysiologie, Bestimmungsmehoden and Klinische Bedeutung. Schweiz Apoth Zeitschrift. 1970;108:431–56.Google Scholar
  20. 20.
    Oi M, Oshida K, Sugimura S. The location of gastric ulcer. Gastroenterology. 1959;36:45–56.PubMedGoogle Scholar
  21. 21.
    Kimura K, Takemoto T. An endoscopic recognition of the atrophic border and its significance in chronic gastritis. Endoscopy. 1969;3:87–97.CrossRefGoogle Scholar
  22. 22.
    Anon. Public good, private gain (editorial). New Sci. 1995;147:3.Google Scholar
  23. 23.
    Tomb JF, White O, Kerlavage AR et al. The complete genome sequence of the gastric pathogen Helicobacter pylori. Nature. 1997;388:539–47.PubMedCrossRefGoogle Scholar
  24. 24.
    Lee A. The Helicobacter pylori genome. Opportunities for new insights into pathogenesis and new therapeutics. The New Microbiology? N Engl J Med. 1998 (In press).Google Scholar
  25. 25.
    Covacci A, Falkow F, Berg DE, Rappuoli R. Did the inheritance of a pathogenocity island modify the virulence of Helicobacter pylori? Trends Microbiol. 1997;5:205–8.PubMedCrossRefGoogle Scholar
  26. 26.
    Segal ED, Lange C, Covacci A, Tompkins LS, Falkow S. Induction of host signal transduction pathways by Helicobacter pylori. Proc Natl Acad Sci USA. 1997;94:7595–9.PubMedCrossRefGoogle Scholar
  27. 27.
    Hazell SL, Lee A, Brady L, Hennessy W. Campylobacter pyloridis and gastritis: association with intercellular spaces and adaptation to an environment of mucus as important factors in colonization of the gastric epithelium. J Infect Dis. 1986;153:658–63.PubMedCrossRefGoogle Scholar
  28. 28.
    Moran AP, Appelmelk BJ, Aspinall GO. Molecular mimicry of host structures by liposaccharides of Campylobacter and Helicobacter spp. - implications in pathogenesis. J Endotoxin Res. 1996;3:521–31.Google Scholar
  29. 29.
    Perez Perez GI, Shepherd VL, Morrow JD, Blaser MJ. Activation of human THP-1 cells and rat bone marrow-derived macrophages by Helicobacter pylori lipopolysaccharide. Infect Immun. 1995;63:1183–7.Google Scholar
  30. 30.
    Appelmelk BJ, Simoonssmit I, Negrini R et al. Potential role of molecular mimicry between Helicobacter pylori lipopolysaccharide and host Lewis blood group antigens in autoimmunity. Infect Immun. 1996;64:2031–40.PubMedGoogle Scholar
  31. 31.
    Alderuccio F, Gleeson PA, Berzins SP, Martin M, Vandriel IR, Toh BH. Expression of the gastric H/K-ATPase alpha-subunit in the thymus may explain the dominant role of the beta-subunit in the pathogenesis of autoimmune gastritis. Autoimmunity. 1997;25:167–75.PubMedCrossRefGoogle Scholar
  32. 32.
    Appelmelk BJ, Strayer S, Claeys D et al. Helicobacter pylori associated autoantibodies recognize Lewis antigens, and peptide epitopes of gastric 11+,1C-ATPase and intrinsic factor. Gut. 1997;41(Suppl. 1):A17.Google Scholar
  33. 33.
    Sakagami T, Dixon M, O’Rourke J et al. Atrophic gastric changes in both Helicobacter fells and Helicobacter pylori infected mice are host dependent and separate from antral gastritis. Gut. 1996;39:639–48.PubMedCrossRefGoogle Scholar
  34. 34.
    Kapadia CR. Host factors in Helicobacter infection. Gastroenterology. 1997;113:361–2.PubMedCrossRefGoogle Scholar
  35. 35.
    Ge ZM, Chan NWC, Palcic MM, Taylor DE. Cloning and heterologous expression of an alpha-1,3-fucosyltransferase gene from the gastric pathogen Helicobacter pylori. J Biol Chem. 1997;272:21357–63.PubMedCrossRefGoogle Scholar
  36. 36.
    Martin SL, Edbrooke MR, Hodgman TC, Vandeneijnden DH, Bird MI. Lewis x biosynthesis in Helicobacter pylori - molecular cloning of an alpha(1,3)-fucosyltransferase gene. J Biol Chem. 1997;272:21349–56.PubMedCrossRefGoogle Scholar
  37. 37.
    Ernst PB, Reyes VE, Gourley WH, Haberle H, Bamford KB. Is the Thl/Th2 lymphocyte balance upset by Helicobacter pylori infection? In: Hunt RH, Tytgat GNJ, editors. Helicobacter pylori: Basic mechanisms to clinical cure. Dordrecht: Kluwer; 1996:150–7.Google Scholar
  38. 38.
    Velupillai P, Harn DA. Oligosaccharide-specific induction of interleukin 10 production by B220+ cells from schistosome-infected mice: A mechanism for regulation of CD4+ T-cell subsets. Proc Natl Acad Sci USA. 1994;91:18–22.PubMedCrossRefGoogle Scholar
  39. 39.
    Peura DA. The report of the Digestive Health Initiative International Update Conference on Helicobacter pylori. Gastroenterology. 1997;113(6 Suppl. S):S4–S8.CrossRefGoogle Scholar
  40. 40.
    Arvind AS, Cook RS, Tabaqchali S, Farthing MJ. Campylobacter pylori and protein losing enteropathy in children. Lancet. 1988;1:865–6.Google Scholar
  41. 41.
    Fall CHD, Goggin PM, Hawtin P, Fine D, Duggleby S. Growth in infancy, infant feeding, childhood living conditions, and Helicobacter pylori infection at age 70. Arch Dis Child. 1997;77:310–14.PubMedCrossRefGoogle Scholar
  42. 42.
    Goodman KJ, Correa P, Aux H, Delany JP, Collazos T. Nutritional factors and Helicobacter pylori infection in Colombian children. J Ped Gastroenterol Nutr. 1997;25:507–15.CrossRefGoogle Scholar
  43. 43.
    Kehrt R, Becker M, Brosicke H, Kruger N, Helge H. Prevalence of Helicobacter pylori infection in Nicaraguan children with persistent diarrhea, diagnosed by the C-13-urea breath test. J Ped Gastroenterol Nutr. 1997;25:84–8.CrossRefGoogle Scholar
  44. 44.
    Perri F, Pastore M, Leandro G et al. Helicobacter pylori infection and growth delay in older children. Arch Dis Child. 1997;77:46–9.PubMedCrossRefGoogle Scholar
  45. 45.
    Patel P, Mendall MA, Khulusi S, Northfield TC, Strachan DP. Helicobacter pylori infection in childhood: risk factors and effect on growth. Br Med J. 1994;309:1119–23.CrossRefGoogle Scholar
  46. 46.
    Solnick JV, O’Rourke J, Lee A, Paster BJ, Dewhirst FE, Tompkins LS. An uncultured gastric spiral organism is a newly identified helicobacter in humans. J Infect Dis. 1993;168:379–85.PubMedCrossRefGoogle Scholar
  47. 47.
    Hanninen ML, Happonen I, Saari S, Jalava K. Culture and characteristics of Helicobacter bizzozeronii, a new canine gastric helicobacter sp. Int J Syst Bacteriol. 1996;46:160–6.PubMedCrossRefGoogle Scholar
  48. 48.
    Vandamme P, Goossens H. Taxonomy of Campylobacter,Arcobacter, and Helicobacter - a review. Zbl Bakt-Int J Med Microbiol. 1992;276:447–72.Google Scholar
  49. 49.
    Murray CJL, Lopez AD. Alternative projections of mortality and disability by cause 1990–2020 - global burden of disease study. Lancet. 1997;349:1498–504.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 1998

Authors and Affiliations

  • A. Lee

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