Helicobacter pylori

• Published in: Current topics in microbiology and immunology Vol. 445; p. 127
• Main Author: Graham, David Y
• Format: Journal Article
• Language: English
• Published: Germany 2024
• Subjects: Animals; Bacterial Vaccines - immunology; Gastric Mucosa - microbiology; Gastric Mucosa - pathology; Helicobacter Infections - drug therapy; Helicobacter Infections - microbiology; Helicobacter pylori - drug effects; Helicobacter pylori - genetics; Humans; Stomach Neoplasms - microbiology; Protocols; Helicobacter pylori; Oral vaccination; Techniques; Parenteral vaccination; Vaccine development; Human challenge; Guidelines
• ISSN: 0070-217X
• DOI: 10.1007/82_2021_235

Helicobacter pylori (H. pylori) is an important human pathogen etiologically associated with peptic ulcers and gastric cancer. The infection is present in approximately one-half of the world's population. Population-based H. pylori eradiation has confirmed that cure or prevention of the infection produces a marked reduction in gastric cancer and peptic ulcer disease. Antimicrobial therapy has become increasingly ineffective, and complexity and costs of antimicrobial therapy for infected individuals residing in and, immigrating from, the developing world combined with the cost of treatment for cancer make vaccine development a cost-effective alternative. Challenge studies allowed making a "go-no go" decision regarding vaccine effectiveness. We provide detailed protocols regarding challenge strain selection and administration as well as guidance regarding the clinical and laboratory tests used to confirm and monitor experimental infection. Experience shows that reliance of noninvasive methods led to the erroneous conclusion that some subjects were not infected. The current data suggests that histologic assessment of gastric mucosal biopsies may be one of the most sensitive and specific means of assessment of the presence of experimental infection as well as of successful H. pylori eradication. We recommend detailed recommendations for acquiring, processing, embedding, sectioning, and examining the gastric biopsies.