Modern aspects of Helicobacter pylori infection

Abstract

A systematic review of current data on the structure and functions of Helicobacter pylori (Hp), pathogenesis, diagnosis and treatment of Hp-infection is presented. The relevance of the topic of helicobacteriosis is due to the proven connection of this infection with chronic, widespread diseases of the digestive organs among the population. The review used materials from the databases including PubМed, Medline, EMBASE, Scopus, Google Scholar, RSCI. A systematic review based on studies with a high degree of evidence has shown significant progress in the diagnosis and treatment of Hp-infection in recent years in adults and children. Coordination of the scientific search for the regularities of the formation of Hp-associated forms of pathology, continuous improvement of diagnostic technologies and the search for new therapies, periodic well-organized international revisions of standard methods of Hp diagnosis and treatment contribute to the creation of effective methods of Hp eradication, preservation of the optimal composition of the microbiota of the gastrointestinal tract and prevention of antibiotic resistance. Of particular importance for the prevention of complications of Hp-infection are original diagnostic algorithms using specialized endoscopic and molecular technologies before and after Hp eradication with long-term follow-up and the determination of the leading factors correlating with a high risk of stomach cancer. The review indicates the emergence of potentially effective and promising areas for the diagnosis and treatment of Hp-infection, including genetic modification of the Hp genome to ensure its existence as a human symbiont and a significant reduction in its pathogenic properties. At the same time, sequencing of a new generation reveals mutations in Hp genes associated with its pathogenicity and antibiotic resistance, which contributes to the creation of new classes of drugs to increase the effectiveness of Hp eradication with a decrease in the proportion of antibiotics and an increase in pathogenetically significant inhibitors of its pathogenic factors for the prevention of side effects, a significant reduction in the empirical use of several antibiotics and increased compliance to treatment.