The Controversy over Anti-Helicobacter pylori Therapy

Abstract

Helicobacter pylori is a Gram-negative spiral-shaped bacterium, member of epsilon-Proteobacteria specifically colonizing the gastric epithelium of humans. It causes one of the most common infections worldwide, affecting about half of the world's population. However, it should be noted that the prevalence of H. pylori, particularly in the Western world, has significantly decreased coinciding with an increase of some autoimmune and allergic diseases, such as asthma. Various epidemiological studies have also documented a negative association between H. pylori colonization and the presence of GERD (gastroesophageal reflux disease) and risk of esophageal cancer. Additionally, an upward trend of obesity recently observed in inhabitants of developed countries raised a question about the relationship between H. pylori infection and the human body mass index. The first part of this review describes common, recommended anti-H. pylori treatments. The second part, presents the results of recent experiments aimed at evaluating the association between H. pylori infections and gastro-esophageal diseases, the level of stomach hormones, the human body mass index and allergic diseases. Although some studies suggest an inverse association of H. pylori infection with some health problems of the modern world such as asthma, obesity or GERD, H. pylori should be considered as a harmful human pathogen responsible for serious and sometimes lethal diseases. Thus, many scientists advocate the eradication of H. pylori.

Changes in plasma ghrelin and leptin levels in patients with peptic ulcer and gastritis following eradication of Helicobacter pylori infection

“…They concluded that H. pylori eradication did not have any significant effect on circulating ghrelin levels. On the other hand, Bocian et al showed that H. pylori eradication was associated with increased circulating leptin levels and decreased ghrelin levels, thereby resulting in an increased BMI in many studies [ 7 ]. Consistent with Bocian et al [ 7 ], the present results showed that plasma ghrelin levels decreased after H. pylori eradication in both peptic ulcer and gastritis patients, and plasma leptin levels increased in peptic ulcer patients.…”

“…On the other hand, Bocian et al showed that H. pylori eradication was associated with increased circulating leptin levels and decreased ghrelin levels, thereby resulting in an increased BMI in many studies [ 7 ]. Consistent with Bocian et al [ 7 ], the present results showed that plasma ghrelin levels decreased after H. pylori eradication in both peptic ulcer and gastritis patients, and plasma leptin levels increased in peptic ulcer patients. A possible mechanism for decreased levels of plasma ghrelin after H. pylori eradication is as follows: before eradication, plasma ghrelin is released transiently into blood due to gastric mucosal oxidative stress and injury induced by H. pylori infection, and after eradication, the release of plasma ghrelin decreases in accordance with improvement of gastric mucosal injury.…”

“…Eradication of H. pylori reduces the relapse rate of peptic ulcer [ 4 ] and the incidence of gastric cancer [ 5 ]. However, much attention has recently been paid to the inverse relationship of H. pylori infection and obesity [ 6 , 7 ].…”

Diversity of the Epsilonproteobacteria Dsb (disulfide bond) systems

“…Based on results of clinical studies, the World Health Organization (WHO) has designated H. pylori infections as class I carcinogens (WHO, 1994 ). However, it should be pointed out that an H. pylori infection has two faces (Bocian and Jagusztyn-Krynicka, 2012 ). This bacterium has accompanied humans for at least 60,000 years (Linz et al, 2007 ).…”

Nano-Based Drug Delivery or Targeting to Eradicate Bacteria for Infection Mitigation: A Review of Recent Advances

“…This pathogen is associated with cystic fibrosis and chronic obstructive pulmonary disease (COPD) (Hadinoto and Cheow, 2014). Helicobacter pylori is a Gram-negative pathogen affecting >50% of the global population (Bocian and Jagusztyn-Krynicka, 2012). H. pylori releases urease to hydrolyze urea to ammonia and bicarbonate for neutralizing acidity of stomach pH from 1-3 to 4.5-7, which is a favorable environment for H. pylori colonization (Ansari and Yamaoka, 2017).…”