PMID: 9432351Jul 1, 1997Paper

Identifiable Helicobacter pylori strains or factors important in the development of duodenal ulcer disease

Helicobacter
N Figura

Abstract

Helicobacter pylori is a primary pathogen as its presence in the stomach almost always is associated with a strong mucosal and systemic immune response. Putative virulence factors of H. pylori are numerous. In this article, we evaluate whether currently available evidence supports the existence of factors important in the development of duodenal ulcer disease. The evaluation is conducted by a review of the literature on H. pylori toxins and virulence factors. Most putative H. pylori virulence factors are present in all isolates examined, though some are present only in, or are expressed more intensively by, determined strains. Urease is the main virulence determinant of H. pylori. It generates ammonia from the gastric urea, which in turn injures the gastric mucosa either directly by forming ammonium hydroxide or indirectly by stimulating polymorphonuclear leukocytes and inhibiting cell proliferation. Other enzymes (e.g., mucinase, phospholipases, alcohol dehydrogenase, neuraminidase) could promote tissue erosion and ulceration by destroying the integrity of mucus, by inducing lipid peroxidation, and the like. H. pylori strains that express the vacuolating toxin vacA and the associated protein cagA are called type I and are cons...Continue Reading

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