Authors
1 Department of Medicine (Endoscopy Unit) DHPulwama/Visiting Endoscopist, District Hospital, DHHandwara, Jammu and Kashmir, India
2 Department of Community Medicine, SKIMS, Srinagar, Jammu and Kashmir, India
Abstract
Helicobacter pylori has been associated with colonization of gastro duodenal mucosa of humans from millions of years. The main burden of the disese is in the developing countries, due to overcrowding and poor hygiene. If left untreated it leads to lot of sequlae from minor to sinister diseases over a period of time. The main challenges that remain are prevention of H. pylori-related diseases by effective treatment and screening procedures and development of a vaccine, which can address all these issues including beneficial aspects of H. pylori. The literature pertaining to different aspects of H. pylori were scrutinized from Pubmed. Material on clinical behavior, complications of chronic gastric involvement, and prevention besides role of H. pylori in nongastric diseases and the latest trends of management was collected for research and review. We continue to face many challenges.The prevention of cancer of the stomach, a worst sequlae of H. pylori continues to be a big challenge despite population screening and prevention surveys being underway in many countries. On the other hand continued scientific work has now unfolded involvement of H. pylori in extragastric diseases like cerebrovascular, cardiovascular, idiopathic thrombocytopenia, sideroblastic anemia, mental diseases, and collagen vascular diseases. In contrast, the beneficial effects of H. pylori with respect to allergic diseases and obesity are now clear. Moreover, problem of drug resistance for eradication of H. pylori has arisen for which novel treatments are being tried. Lactobacillus reuteri having anti H. pylori action is emerging as one of the promising treatment.
Keywords
1. | Atgerton JC, laser MJ. Helicobacter pylori infections. In: Fauci, Breunwald, Kasper, Hauser, Longo, Jameson, Loscalzo, editors. Harrisons principles of internal medicine. 17th ed. Vol 1. New York: Mc Graw Hill Inc; 2008. p. 946-9. |
2. | Elfert AA, Montaser TB. Helicobacter and extragastric diseases: Innocent until proved guilty. Arab J Gastroenterol 2008;9:21-7. |
3. | Malferthenier P, Selgard M. Helicobacter infection and current clinical areas of contention. Curr Opin Gastroenterol 2010;26:618-23. |
4. | Khuroo MS, Khuroo NS, Khuroo MS. Diffuse duodenal nodular lymphoid hyperplasia: A large cohort of patients etiologically related to Helicobacter pylori infection. BMC Gastroenterol 2011;11:36. |
5. | Pellicano R, Franceschi F, Sarccco G. Helicobcters and extragastric diseases. Helicobacter 2009;14:58-68. |
6. | Malfernthnir P, Bornschein J, Selgard M. Role of H. pylori infection in gastric ca pathogenesis: A chance for prevention. J Dig Dis 2010;11:2-11. |
7. | Graham DY, Asaka M. Eradication of gastric cancer and more gastric cancer surveillance in Japan; two pens in pod. J Gastroenterol 2010;45:1-8. [PUBMED] |
8. | Choi I. Gastric cancer screening and diagnosis. Korean J Gastroenterol 2009;54:67-76. |
9. | Bornschein J, Rokaas T, Selgrad M, Malfertheiner P. H. pylori and clinical aspects of gastric cancer. Helicobacter 2009;14:41-5. |
10. | De Vries AC, Kuipers EJ, Rauws EA. H. pylori eradication and gastric cancer: When is the horse out of the barn? Am J Gastroenterol 2007;102:1808-25. |
11. | Yeh JM, Kuntz KM, Ezzati M, Goldie SJ. Exploring the cost effectiveness of h pylori screening to prevent gastric cancer in china in anticipation of clinical trial results. Int J Cancer 2009;124:157-66. [PUBMED] |
12. | Fukase K, Kato M, Kikuchi S, Inoue K, Uemura N, Okamoto S, et al. Japan Gast Study Group. Effect of eradication of H. pylori on incidence of metachronous gastric ca after endoscopic resection of early gastric cancer: An open-label randomised controlled trial. Lancet 2008;372:392-7. |
13. | Vaananen H, Vaukonen M, Helske T, Kääriäinen I, Rasmussen M, Tunturi-Hihnala H, et al. Non endoscopic diagnosis of atrophic gastritis with blood test. Correlation between gastric histlology and serum levels of gastrin-17 and pepsinogen 1: A multicentre study. Eur J Gastroenterol Hepatol 2003;15:885-91. |
14. | Watabe H, Mitsushima T, Yamaji Y, Okamoto M, Wada R, Kokubo T, et al. Predicting the development gastric cancer from combining Hpylori antibodies and serum pepsinogen status: A prospective endoscopic cohort study. Gut 2005;5:764-8. |
15. | Miki K, Fujishiro M, Kodashima S, Yahagi N. Long-term results of gastric cancer screening using the serum pepsinogen test method among an asymptomatic middle-aged Japanese population. Dig Endosc 2009;21:78-81. [PUBMED] |
16. | Gasbarrini A, Franceschi F, Ttataglione R, Landolfi R, Pola P, Gasbarrini G. Regression of autoimmune thrombocytopenia after eradication of Helicobacter pylori. Lancet 1998;352:878. |
17. | Ferrara M, Capozzi L, Russo R. Effect of Helicobacter pylori eradication on platelet count in children with chronic idiopathic thrombocytopenia purpura. Hematology 2009;14:282-5. [PUBMED] |
18. | Huang X, Qu X, Yan W. Iron deficiency anemia can be improved after erdication of Helicobacter pylori. Postgrad Med J 2010;86:272-8. |
19. | Yuan W, Li Yumin, Yang Kehu, Ma Bin, Guan Quanlin, Wang D, et al. Iron deficiency anemia in Helicobacter pylori infection: Meta-analysis of randomized controlled trials. Scand J Gastroenterol 2010;45:665-76. [PUBMED] |
20. | Qu XH, Huang XL, Xiong P. Does H pylori infection may play a role in iron deficiency anemia. A metaanalysis. World J Gastroenterol 2010;16:886-96. |
21. | Reibman J, Marmour M, Filner J, Fernandez-Beros ME, Rogers L, Perez-Perez GI, et al. Asthma is inversely associated with H. pylori status in urban population. PLoS One 2008;3:e4060. |
22. | D Elios MM, Codolo G, Amedei A, Mazzi P, Berton G, Zanotti G, et al. H. pylori, asthama and allergy. FEMS Immunol Med Microbiol 2009;56:1-8. |
23. | Blaser MJ, Chen Y, Reibman J. Does Helicobacter pylori protect against asthma and allergy. Gut 2008;57:561-7. [PUBMED] |
24. | Chen Y, Blaser MJ. Inverse association of H. pylori with asthma and allergy. Arch Intern Med 2007;167:821-7. [PUBMED] |
25. | Del Guidance G, Malfertheiner P, Rappuoli R. Development of vaccine against H. pylori. Expert Rev Vaccines 2009;8:1037-49. |
26. | Asaka M, Kato M, Tkahashi S. Guidelines for the management of H. pylori infection in Japan: 2009 revised edition. Helicobacter pylori infection. J Gastroenterol Hepatol 2009;24:1587-600. |
27. | De Vries AC, Kuipres EJ. Review article: H. pylori eradication for the prevention of gastric cancer. Aliment Pharmacol Ther 2007;26:25-35. |
28. | Graham DY, Fischbach L. Helicobacter pylori treatment in the era of increasing antibiotic resistance. Gut 2010;5:1143-53. |
29. | De Francesco V, Zullo A, Lerardi E, Giorgio F, Perna F, Hassan C, et al. Phenotypic and genotypic Helicobacter pylori clarithromycin resistance and therapeutic outcome: Benefits and limits. J Antimicrob Chemother 2010;65:327-32. |
30. | Cambau E, Allerhelligen V, Coloun C, Corbel C, Lascols C, Deforges L, et al. Evaluation of a new test, genotype Helico DR, for molecular detection of antibiotic resistance in H. pylori. J Clin Microbiol 2009;4:3600-7. |
31. | Francavilla R, Lionetti E, Castellaneta SP, Magistà AM, Maurogiovanni G, Bucci N, et al. Inhibition of Helicobacter pylori infection in humans by Lactobacillus reuteri ATCC 55730 and effect on eradication therapy: A pilot study. Helicobacter 2008;13:127-34. |
32. | Imase K, Tanaka A, Tokunaga K, Sugano H, Ishida H, Takahashi S. Lactobacillus reuteri tablets suppress Helicobacter pylori infection-a double-blind randomised placebo-controlled cross-over clinical study. Kansenshogaku Zasshi 2007;81:387-93. [PUBMED] |
33. | Saggioro A, Caroli M, Pasini M, Bortoluzzi F, Girardi L, Pilone G. Helicobacter pylori eradication with Lactobacillus reuteri. A double blind placebo-controlled study. Dig Liver Dis 2005;37:S88. |
34. | Sinkiewicz G, Cronholm S, Ljinggren L, Dahlen G, Bratthall G. Influence of dietary supplementation with Lactobacillus reuteri on the oral flora of healthy subjects. Swed Dent J 2010;34:197-206. |
35. | Lactobacillus Reuteri Good for Health. Swedish study finds. Science Daily, 2010. |
36. | Muller A, Solnick JV. Inflamation and immunity and vaccine development for Helicobacter pylori. Helicobacter 2011;16(Suppl 1):26-32. |
37. | Moss SF, Moise L, Lee DS, Kim W, Zhang S, Lee J, et al. HelicoVax: Epitope-based therapeutic Helicobacter pylori vaccination in a mouse model. Vaccine 2011;29:2085-91. [PUBMED] |
38. | Infection Control Today Magazine. Researchers closer to vaccine against Helicobacter pylori, 2011. |
39. | Bianchard TG, Eisenberg JC, Matsumoto Y. Clearence of H. pylori infection through immunization: The site of Tcell activation contributes to vaccine efficacy. Vaccine 2004;22:888-97. |
40. | Sutton P. Progress in vaccination against H. pylori. Vaccine 2001;19:2286-90. [PUBMED] |
41. | Sijun H, Yong X. Helicobacter pylori vaccine: Mucosal adjuvant and delivery systems. Indian J Med Res 2009;130:115-24. [PUBMED] |
42. | Michetti P, Kreiss C, Kotloff KL, Porta N, Blanco JL, Bachmann D, et al. Oral immunization with urease and E. coli heat labile enterotoxin is safe and immunogenic in H. pylori infected adults. Gastroenterology 1999;116:804-12. |