The life and death of helicobacter pylori

• Published in: Gut Vol. 43; no. suppl 1; pp. S56 - S60
• Main Authors: Scott, D, Weeks, D, Melchers, K, Sachs, G
• Format: Journal Article Conference Proceeding
• Language: English
• Published: London BMJ Publishing Group Ltd and British Society of Gastroenterology 01.07.1998; BMJ; BMJ Publishing Group LTD
• Subjects: Action of physical and chemical agents on bacteria; Adenosine Triphosphate - biosynthesis; Anti-Bacterial Agents; Bacteriology; Biological and medical sciences; Drug Therapy, Combination - therapeutic use; Fundamental and applied biological sciences. Psychology; Gastritis - microbiology; Helicobacter Infections - drug therapy; Helicobacter pylori - drug effects; Helicobacter pylori - metabolism; Helicobacter pylori - physiology; Histamine H2 Antagonists - therapeutic use; Humans; Hydrogen-Ion Concentration; Microbiology; Proton Pump Inhibitors; Ranitidine - therapeutic use; Stomach - microbiology; Urease - metabolism; Human; Stomach; Spirillales; Growth; Adaptive response; Spirillaceae; Cell division; Action principle; Review; Bacteriology; Gastritis; Infection; Chemotherapy; Helicobacter pylori; Antisecretory agent; Bacteriosis; pH; Digestive diseases; Bacteria; Antibacterial agent; Gastric disease
• ISSN: 0017-5749; 1468-3288; 1458-3288
• DOI: 10.1136/gut.43.2008.S56

The ability of Helicobacter pylori to survive in the varying acidity of the stomach is considered to be linked to its ability to maintain a tolerable pH in its periplasmic space by acid dependent activation of internal urease activity. Whereas survival of H pylori can occur between a periplasmic pH of 4.0 to 8.0, growth can only occur between a periplasmic pH of 6.0 to 8.0. When urease activity is only able to elevate periplasmic pH to between 4.0 and 6.0, the organisms will survive but not divide. In the absence of division, antibiotics such as clarithromycin and amoxycillin are ineffective. Proton pump inhibitors, by elevating gastric pH, would increase the population of dividing organisms and hence synergise with these antibiotics.