Diseases from Helicobacter pylori (Hp) are causing major global health challenges. Hp is involved in different diseases such as chronic active gastritis, peptic ulcer disease, gastric carcinoma, mucosa-associated lymphoid tissue (MALT) lymphoma as well as other endothelial dysfunctions leading to vascular diseases and infection is virtually lifelong in the absence of treatment. Treatment includes the use of antibiotics and proton pump inhibitors, but increasing antibiotic resistance calls for more research on novel, more effective and natural antibacterial compounds. The resistance to antibiotics is a big issue for infection therapy and the mutations underlying this problem such as the mutations in genes gyrA (levofloxacin), 23SrRNA (clarithromycin), 16SrRNA (tetracycline), rdxA (metronidazole), pbp1A (amoxicillin) and rpoB (rifabutin) should be carefully taken into account. Hetero-resistance may cause an increasing prevalence of resistant strains and eradication failure and gut-microbiome and probiotics can have a pathogenetic and prognostic effect on Hp infection.
Helicobacter pylori pathogenesis and disease outcomes are mediated by a complex interplay between bacterial virulence markers, host, and environmental factors. Important virulence factors are flagella, bacterial adhesins, cag pathogenicity island, and vacuolating cytotoxin. This cytotoxin A, being mainly involved in the carcinogenesis process and apoptosis represents the major virulence factor secreted by H. pylori. Diagnostics tests rely more on molecular assays, which provide fast, accurate and sensitive detection. Antimicrobial resistance is a growing problem leading to eradication therapy failure. Hp acquires resistance by mutation, which has enabled the development of numerous tests to detect mutations leading to resistance. The genotypic tests used directly on the clinical specimens could predict the antibiotic resistance by addressing changes in previous ineffective treatments or by evaluating the primary resistance to antibiotics (i.e. clarithromycin). The current approved H. pylori eradication regimen combines bismuth, a proton pump inhibitor (PPI) and two antibiotics (Bismuth Quadruple Therapy). Vonoprazan, a novel potassium-competitive acid blocker (P-cab), shows promising results as a PPI replacement for a stronger suppression of the stomach acid secretion. The clarithromycin-resistance levels (<15% or > 15%) and the local susceptibility in the different geographical areas turn out to be crucial for establishing a correct therapy.
The aim of this issue is to attract reviews, original articles and case reports aimed at considering the potential following topics (but not only limited to these):
• Influence of the virulence markers in different pathologies
• Vac-A protein involvement in the gastric cancer: pathogenetic cascade with options for its prevention
• Options and strategy for non-invasive testing
• Role of gut microbiome and probiotics
• Evaluation of the crucial importance of the local antibiotic resistance in a determinate country for the therapy formulation
• Analysis of mutations correlated with the resistance to clarithromycin, tetracycline, levofloxacin, metronidazole, amoxicillin and rifabutin as a guide for the eradication therapy
• Influence of hetero-resistance in eradication failure and resistance underestimation.
• Detection of non-traditional therapies as the antimicrobial peptides (AMPs), guanidine derivate, N-acetylcysteine and vonoprazan
• Investigation of first line, second line and rescue therapies
• Updated treatment strategies following the current international guidelines in the management of H.pylori infection
Diseases from Helicobacter pylori (Hp) are causing major global health challenges. Hp is involved in different diseases such as chronic active gastritis, peptic ulcer disease, gastric carcinoma, mucosa-associated lymphoid tissue (MALT) lymphoma as well as other endothelial dysfunctions leading to vascular diseases and infection is virtually lifelong in the absence of treatment. Treatment includes the use of antibiotics and proton pump inhibitors, but increasing antibiotic resistance calls for more research on novel, more effective and natural antibacterial compounds. The resistance to antibiotics is a big issue for infection therapy and the mutations underlying this problem such as the mutations in genes gyrA (levofloxacin), 23SrRNA (clarithromycin), 16SrRNA (tetracycline), rdxA (metronidazole), pbp1A (amoxicillin) and rpoB (rifabutin) should be carefully taken into account. Hetero-resistance may cause an increasing prevalence of resistant strains and eradication failure and gut-microbiome and probiotics can have a pathogenetic and prognostic effect on Hp infection.
Helicobacter pylori pathogenesis and disease outcomes are mediated by a complex interplay between bacterial virulence markers, host, and environmental factors. Important virulence factors are flagella, bacterial adhesins, cag pathogenicity island, and vacuolating cytotoxin. This cytotoxin A, being mainly involved in the carcinogenesis process and apoptosis represents the major virulence factor secreted by H. pylori. Diagnostics tests rely more on molecular assays, which provide fast, accurate and sensitive detection. Antimicrobial resistance is a growing problem leading to eradication therapy failure. Hp acquires resistance by mutation, which has enabled the development of numerous tests to detect mutations leading to resistance. The genotypic tests used directly on the clinical specimens could predict the antibiotic resistance by addressing changes in previous ineffective treatments or by evaluating the primary resistance to antibiotics (i.e. clarithromycin). The current approved H. pylori eradication regimen combines bismuth, a proton pump inhibitor (PPI) and two antibiotics (Bismuth Quadruple Therapy). Vonoprazan, a novel potassium-competitive acid blocker (P-cab), shows promising results as a PPI replacement for a stronger suppression of the stomach acid secretion. The clarithromycin-resistance levels (<15% or > 15%) and the local susceptibility in the different geographical areas turn out to be crucial for establishing a correct therapy.
The aim of this issue is to attract reviews, original articles and case reports aimed at considering the potential following topics (but not only limited to these):
• Influence of the virulence markers in different pathologies
• Vac-A protein involvement in the gastric cancer: pathogenetic cascade with options for its prevention
• Options and strategy for non-invasive testing
• Role of gut microbiome and probiotics
• Evaluation of the crucial importance of the local antibiotic resistance in a determinate country for the therapy formulation
• Analysis of mutations correlated with the resistance to clarithromycin, tetracycline, levofloxacin, metronidazole, amoxicillin and rifabutin as a guide for the eradication therapy
• Influence of hetero-resistance in eradication failure and resistance underestimation.
• Detection of non-traditional therapies as the antimicrobial peptides (AMPs), guanidine derivate, N-acetylcysteine and vonoprazan
• Investigation of first line, second line and rescue therapies
• Updated treatment strategies following the current international guidelines in the management of H.pylori infection