Editorial on the Research TopicThe interactions between gastrointestinal microbiota and Helicobacter pylori in diseases Helicobacter pylori (H. pylori) is a medically important pathogen colonizing the stomach, leading to the damage of gastric mucosa from chronic active gastritis, chronic atrophic gastritis, intestinal metaplasia and dysplasia to intestinal-type gastric cancer (GC) in a subset of infected subjects (Correa, 2013). H. pylori was defined as a carcinogen by the World Health Organization in 1994 and the U.S. Department of Health and Human Services in 2021. According to Maastricht VI/Florence consensus report, H. pylori infection is a primary cause for the development of GC, and H. pylori eradication prior to the stage of chronic atrophic gastritis is the most effective for the prevention of GC (Malfertheiner et al., 2022). It has been documented that the occurrence of spontaneous atrophic gastritis and gastrointestinal intraepithelial neoplasia (GIN) was not developed in germ-free (GF) transgenic insulin-gastrin (INS-GAS) mice by 13 months of age. However, H. pylori infection accelerated the development of GIN in GF INS-GAS mice, which was noted by 9 to 11 months post-H. pylori infection (equivalent to 11 to 13 months of mouse age). Comparing with H. pylori-infected INS-GAS mice with the complex gastric microbiota, H. pylori monoassociation caused less severe gastric lesions and delayed onset of GIN (Lofgren et al., 2011). In human patients, a distinct cluster of oral bacteria (Peptostreptococcus etc.) were associated with emergence and persistence of atrophy and intestinal metaplasia in subjects who developed atrophy 1 year after H. pylori eradication (Sung et al., 2020), which indicated that other organisms might be also involved in gastric inflammation and gastric carcinogenesis.