Timothy L. Cover

CHAPTER 11 – H. pylori Pathogenesis

This chapter reviews current understanding of how pylori persistently colonize the human gastric mucosa and discuss factors that determine whether infections progress to clinically evident disease or remain asymptomatic. Helicobacter pylori are extraordinary among bacteria in their ability to colonize the human gastric mucosa, an inherently inhospitable acidic environment, despite the development of host immune and inflammatory responses. To the available knowledge, no other bacteria, with the possible exception of the closely related H. heilmanii , can establish long-term residence in the human gastric mucosa. More than half of the worlds human population is persisently colonized with H. pylori , usually without disease. However, in about 10% of cases, colonization, probably in combination with other critical risk factors, leads to serious illnesses, ranging from peptic ulcers to two different forms of gastric cancer. H . pylori occupy an interesting position in the history of medicine and biomedical research..