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World J Immunol. Nov 27, 2015; 5(3): 142-151
Published online Nov 27, 2015. doi: 10.5411/wji.v5.i3.142
Helicobacter pylori vs immune system or antibiotics
David Stubljar, Miha Skvarc
David Stubljar, Miha Skvarc, Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
Author contributions: Stubljar D designed and wrote the manuscript; Skvarc M was involved in revising the manuscript critically and gave final approval of the manuscript to be published.
Conflict-of-interest statement: Authors declare no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: David Stubljar, BSc, Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Zaloska 4, 1000 Ljubljana, Slovenia. d.stubljar@gmail.com
Telephone: +386-15-437494 Fax: +386-15-437485
Received: April 28, 2015
Peer-review started: April 29, 2015
First decision: June 3, 2015
Revised: June 18, 2015
Accepted: July 24, 2015
Article in press: July 27, 2015
Published online: November 27, 2015
Processing time: 213 Days and 14.2 Hours
Abstract

Helicobacter pylori (H. pylori) infection has often no clinical signs and is one of the most common bacterial infections. All infected subjects have histology of active chronic gastritis. In some cases patients develop peptic ulcer and minority of them develop gastric cancer. Gastric cancer is multifactorial disease, thus various progressions of H. pylori infection and disease are dependent on the host genetic factors, the characteristics of the individual’s immune response, environmental factors, and different bacterial virulence factors of the individual bacterial strains. Eradication of the bacteria plays a crucial role in the treatment of these cases however antibiotic therapy does not always help. Bacteria often develop resistance to antibiotics so we recommend that not only screening for H. pylori also the strain determination should have some diagnostic value, especially in the patients who already developed gastritis. Furthermore, for such patients assessment of disease progression (atrophic or metaplastic gastritis) could be followed by polymorphism determination. Until now we cannot predict the disease based only on single polymorphism. Bacteria successfully neutralize the responses of the immune systems using different enzymes or even components of the host immune response. However, the influence of immune system and its components could represent new ways of treatments and could help to eradicate the infection.

Keywords: Helicobacter pylori; Resistance to antibiotics; Immune response; Genetic factors; Bacterial eradication

Core tip: Combination of Helicobacter pylori (H. pylori) and host-associated risk factors do not always allow evaluation of gastric carcinoma. We have learnt that the assessment of patients with H. pylori infection and its strain is very important and concluded that eradication of bacteria has essential meaning. We recommend that not only screening for H. pylori also the strain determination should have some diagnostic value, especially in the patients who already developed gastritis. Furthermore, for such patients assessment of disease progression could be followed by polymorphism determination. Conclusions indicate that host cytokine genotypes, host immune response, as well as H. pylori strains could be important for greater risk for developing gastric cancer.