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Chapter category: Vaccines

Helicobacter pylori Vaccines

This chapter appears in the following book:

New Bacterial Vaccines

Edited by: Ronald W. Ellis and Bernard R. Brodeur
ISBN: 0-306-47832-3
» Get more information about this book at landesbioscience.com «

Chapter authors:
Gabriela Garcia and Jacques Pappo

Helicobacter pylori is a motile, Gram negative spiral organism with gastric trophism. Approximately half of the world’s population is infected with H. pylori, and the infection persists for life unless treated with antimicrobials and a proton-pump inhibitor. Commonly acquired during childhood, the infection stimulates the immune system to commit a relatively high frequency of immune effector cells throughout the course of the infection, but the natural immune response against this organism does not effect clearance nor does it confer protective immunity against reinfection after antimicrobial therapy.1 Cases of spontaneous clearance in animal and human populations remain largely unexplained, but mathematical and animal models have strongly suggested an important role for the host response in regulating the severity of H. pylori disease.2,3 Colonization of the gastric mucosa results in gastritis, mucosal atrophy and metaplasia.4 These damaging infection outcomes are linked to the genesis of Th1 cells and persistent proinflammatory signaling. Gastroduodenal ulcer disease develops in ~10% of infected subjects, and a small subset (~1%) can progress to develop adenocarcinoma and mucosal B cell lymphoma.5,6 Based on evidence from animal infection models, as well as from human clinical trials, the concept of immunization against H. pylori has evolved from the strict notion of vaccine-mediated “sterilizing immunity” to the ability to greatly attenuate the severity of the infection and to protect from the chronic inflammatory sequelae secondary to infection.

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