Vaccine development against <i>Helicobacter pylori</i>: from ideal antigens to the current landscape

Viana, Irineu dos Santos; Santos, Maria Luísa Cordeiro; Marques, Hanna Santos; Gonçalves, Vinícius Lima de Souza; Brito, Breno Bittencourt de; Silva, Filipe Antônio França da; Silva, Natália Oliveira e; Pinheiro, Fillipe Dantas; Teixeira, Adriano Fernandes; Costa, Davi Tanajura; Souza, Briza Oliveira; Souza, Cláudio Lima; Oliveira, Márcio Vasconcelos; Melo, Fabrício Freire de

doi:10.1080/14760584.2021.1945450

Cited by 28 publications

(15 citation statements)

References 92 publications

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“…A prophylactic or therapeutic vaccine needs the selection and combination of immunogenic bacterial antigens with effective adjuvants and its administration via an available route [ 109 ]. The main antigens related to vaccines are CagA, VacA, BabA, HpaA, NapA, OipA, GGT, HspA, Omp, and FliD [ 110 ], and their combinations of multivalent epitopes with adjuvants, usually composed of CD4 + and CD8 + epitopes [ 111 ] (e.g., CTB-UE, CWAE vaccine [ 112 ], CFdAE vaccine [ 113 ], FVPE vaccine [ 114 ], HUepi-LTB vaccine [ 115 ], LHUC-LTB [ 116 ], and CTB-HUUC vaccine [ 117 ]). Some vaccines have been developed, such as oral delivery of either whole cell or subunit vaccines in combination with cholera toxin and Escherichia coli enterotoxin as mucosal adjuvant to increase the immunogenicity, oral delivery of live vector vaccines expressing H. pylori antigens to stimulate durable immunity (e.g., avirulent strains of Salmonella and attenuated Listeria monocytogenes ), and intramuscular delivery of H. pylori subunits vaccines with aluminum hydroxide adjuvant [ 118 – 120 ].…”

Section: Potential Alternative Treatment Strategiesmentioning

confidence: 99%

“…H. pylori vaccines could reduce bacterial load and sometimes provide sterilizing immunity, whereas ineffective or only partially effective results were achieved in larger animals and patients [ 121 ]. Most vaccines are at a very early stage (phase I or even preclinical) lack of continuity and with inconsistent results [ 110 ]. However, a randomized phase 3 study with children indicated oral vaccines with recombinant urease B was efficacious and safe [ 122 ].…”

Section: Potential Alternative Treatment Strategiesmentioning

confidence: 99%

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Detection and Treatment of Helicobacter pylori: Problems and Advances

Yang

Guan

2022

Gastroenterology Research and Practice

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Helicobacter pylori (H. pylori) infection is chronic and etiologically linked to gastric cancer (GC) derived from gastric epithelium. The potential mechanism is complex, covering chronic inflammation, epithelial senescence, NF-κB activation, the cytotoxin-associated gene A protein translocation, and related abnormal signaling pathways. In clinical practice, the test-and-treat strategy, endoscopy-based strategy, and (family-based) screen-and-treat strategy are recommended to detect H. pylori and prevent GC. It has been demonstrated that the decreasing annual incidence of GC is largely attributable to the management of H. pylori. This study reviews the current clinical practice of H. pylori on the detection and eradication, alternative treatment strategies, and related problems and advances, and hopes to contribute to the better clinical management of H. pylori.

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Section: Potential Alternative Treatment Strategiesmentioning

confidence: 99%

Section: Potential Alternative Treatment Strategiesmentioning

confidence: 99%

Detection and Treatment of Helicobacter pylori: Problems and Advances

Yang

Guan

2022

Gastroenterology Research and Practice

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“…Both PPIs and bismuth act synergistically with antibiotics against Hp [ 9 , 10 ]. The antibiotics used in the Hp eradication regimen include clarithromycin, metronidazole, ampicillin, fluoroquinolone, and tetracycline [ 11 ]. Nowadays, recommendations for first-line Hp treatment depend on local rates of resistance to the above-mentioned antibiotics and may correspond to PPI-based triple therapy (PPI plus two antibiotics), bismuth-based quadruple therapy (bismuth, PPI, and two antibiotics), non-bismuth concomitant quadruple therapy (PPI plus three antibiotics) or other combinations [ 12 ].…”

Section: Treatment Of Helicobacter Pylori Infectio...mentioning

confidence: 99%

Recombinant Helicobacter pylori Vaccine Delivery Vehicle: A Promising Tool to Treat Infections and Combat Antimicrobial Resistance

et al. 2022

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Antimicrobial resistance (AMR) has become a global public health threat. Experts agree that unless proper actions are taken, the number of deaths due to AMR will increase. Many strategies are being pursued to tackle AMR, one of the most important being the development of efficient vaccines. Similar to other bacterial pathogens, AMR in Helicobacter pylori (Hp) is rising worldwide. Hp infects half of the human population and its prevalence ranges from <10% in developed countries to up to 90% in low-income countries. Currently, there is no vaccine available for Hp. This review provides a brief summary of the use of antibiotic-based treatment for Hp infection and its related AMR problems together with a brief description of the status of vaccine development for Hp. It is mainly dedicated to genetic tools and strategies that can be used to develop an oral recombinant Hp vaccine delivery platform that is (i) completely attenuated, (ii) can survive, synthesize in situ and deliver antigens, DNA vaccines, and adjuvants to antigen-presenting cells at the gastric mucosa, and (iii) possibly activate desired compartments of the gut-associated mucosal immune system. Recombinant Hp vaccine delivery vehicles can be used for therapeutic or prophylactic vaccination for Hp and other microbial pathogens.

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“…Encouraging recent data suggest the potential of new, nontraditional therapeutic approaches such as plant-derived polyphenols, including those found in the extract of the Qing Guo fruit [5,6]. Vaccines targeting some of the virulence factors described above have theoretical promise but are still at very early stages of development [7]. Despite the interest these strategies have garnered for future research, antibiotic-based regimens remain the most critical treatment for H. pylori at this time.…”

Section: Introductionmentioning

confidence: 99%

Clinical Factors Implicated in Antibiotic Resistance in Helicobacter pylori Patients

et al. 2022

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Helicobacter pylori is a common gastric pathogen associated with multiple clinical syndromes, including cancer. Eradication rates of H. pylori remain suboptimal despite the progress made in the past few decades in improving treatment strategies. The low eradication rates are mainly driven by antibiotic resistance of H. pylori. Non-invasive molecular testing to identify patients with antibiotic-resistant H. pylori represents a promising therapeutic avenue, however this technology currently remains limited by availability, costs, and lack of robust validation. Moreover, there is insufficient evidence to demonstrate that resistance-testing-based treatment approaches are superior to appropriately designed empiric strategies. Consensus guidelines recommend use of proven locally effective regimens; however, eradication data are inconsistently generated in several regions of the world. In this review, we describe several clinical factors associated with increased rates of antibiotic resistant H. pylori, including history of previous antibiotic exposure, increasing age, female gender, ethnicity/race, extent of alcohol use, and non-ulcer dyspepsia. Assessment of these factors may aid the clinician in choosing the most appropriate empiric treatment strategy for each patient. Future study should aim to identify locally effective therapies and further explore the clinical factors associated with antibiotic resistance.

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Vaccine development against Helicobacter pylori: from ideal antigens to the current landscape

Cited by 28 publications

References 92 publications

Detection and Treatment of Helicobacter pylori: Problems and Advances

Detection and Treatment of Helicobacter pylori: Problems and Advances

Recombinant Helicobacter pylori Vaccine Delivery Vehicle: A Promising Tool to Treat Infections and Combat Antimicrobial Resistance

Clinical Factors Implicated in Antibiotic Resistance in Helicobacter pylori Patients

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