The inflammatory and immune response to Helicobacter pylori infection.
Lifelong Helicobacter pylori infection and its associated gastric inflammation underlie peptic ulceration and gastric carcinogenesis. The immune and inflammatory responses to H. pylori are doubly responsible: gastric inflammation is the main mediator of pathology, and the immune and inflammatory response is ineffective, allowing lifelong bacterial persistence. However, despite inducing gastric inflammation, most infections do not cause disease, and bacterial, host and environmental factors determine individual disease risk. Although H. pylori avoids many innate immune receptors, specific virulence factors (including those encoded on the cag pathogenicity island) stimulate innate immunity to increase gastric inflammation and increase disease risk. An acquired T helper 1 response upregulates local immune effectors. The extent to which environmental factors (including parasite infection), host factors and H. pylori itself influence T-helper differentiation and regulatory T-cell responses remains controversial. Finally, effective vaccines have still not been developed: a better understanding of the immune response to H. pylori may help.
Robinson
Karen
K
Wolfson Digestive Diseases Centre, University of Nottingham, C Floor, South Block, Queen's Medical Centre Campus, Nottingham University Hospital NHS Trust, Nottingham NG7 2UH, UK. karen.robinson@nottingham.ac.uk
Argent
Richard H
RH
Atherton
John C
JC
D000208:Acute Disease; D000942:Antigens, Bacterial / Q000276:immunology / Q000502:physiology; D001426:Bacterial Proteins / Q000276:immunology / Q000502:physiology; D001428:Bacterial Vaccines; D002454:Cell Differentiation; D002908:Chronic Disease; D005753:Gastric Mucosa / Q000473:pathology; D016481:Helicobacter Infections / Q000276:immunology* / Q000473:pathology / Q000503:physiopathology / Q000517:prevention & control; D016480:Helicobacter pylori; D006801:Humans; D007113:Immunity, Innate; D007249:Inflammation / Q000821:virology; D007962:Leukocytes / Q000502:physiology; D010766:Phosphorylation; D013601:T-Lymphocytes / Q000276:immunology; D006377:T-Lymphocytes, Helper-Inducer / Q000166:cytology / Q000502:physiology; D050378:T-Lymphocytes, Regulatory / Q000502:physiology
D000942:Antigens, Bacterial; D001426:Bacterial Proteins; D001428:Bacterial Vaccines; C080866:cagA protein, Helicobacter pylori