title: Beyond the stomach: an updated view of Helicobacter pylori pathogenesis, diagnosis, and treatment.
abstract: Helicobacter pylori (H. pylori) is an extremely common, yet underappreciated, pathogen that is able to alter host physiology and subvert the host immune response, allowing it to persist for the life of the host. H. pylori is the primary cause of peptic ulcers and gastric cancer. In the United States, the annual cost associated with peptic ulcer disease is estimated to be $6 billion and gastric cancer kills over 700000 people per year globally. The prevalence of H. pylori infection remains high (> 50%) in much of the world, although the infection rates are dropping in some developed nations. The drop in H. pylori prevalence could be a double-edged sword, reducing the incidence of gastric diseases while increasing the risk of allergies and esophageal diseases. The list of diseases potentially caused by H. pylori continues to grow; however, mechanistic explanations of how H. pylori could contribute to extragastric diseases lag far behind clinical studies. A number of host factors and H. pylori virulence factors act in concert to determine which individuals are at the highest risk of disease. These include bacterial cytotoxins and polymorphisms in host genes responsible for directing the immune response. This review discusses the latest advances in H. pylori pathogenesis, diagnosis, and treatment. Up-to-date information on correlations between H. pylori and extragastric diseases is also provided.
authors.affiliation: Traci L Testerman, Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, United States.
authors.forename: Traci L
authors.initials: TL
authors.lastname: Testerman
authors.affiliation: Traci L Testerman, Department of Microbiology and Immunology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, United States.
authors.forename: James
authors.initials: J
authors.lastname: Morris
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D024882:Drug Resistance, Viral; D020022:Genetic Predisposition to Disease; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology / Q000235:genetics / Q000382:microbiology; D016480:Helicobacter pylori / Q000187:drug effects* / Q000235:genetics / Q000472:pathogenicity; D054884:Host-Pathogen Interactions; D006801:Humans; D015994:Incidence; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D013272:Stomach Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D016896:Treatment Outcome; D014774:Virulence
chemical_list: D000900:Anti-Bacterial Agents
keywords: Autoimmune; CagA; Cancer; Diagnosis; Enterohepatic; Extragastric; Inflammation; Pathogenesis; Treatment; Virulence factor