from: Helicobacter pylori (Edited by: Lyudmila Boyanova). Caister Academic Press, U.K. (2011)
Discovery of Helicobacter pylori by Marshall and Warren in 1982 was the start of a real revolution in the gastroenterology with a strong impact on medicine as a whole. In the 1870s, despite some reports on spiral bacteria in gastric tissues, stress and diet were thought to be the only causes of peptic ulcers. In 1979, Warren evaluated Campylobacter-like organisms (CLOs) in inflamed gastric tissues and in 1982, his co-worker, Marshall, isolated the bacteria. However, the discovery was initially met with much disagreement. For this reason, in 1985, Marshall performed self-inoculation by CLOs and proved their ability to cause gastritis. Originally called Campylobacter pyloridis and then corrected to Campylobacter pylori, the bacteria were renamed again due to taxonomic data as Helicobacter pylori in a new genus, Helicobacter. In 2005, Warren and Marshall were jointly awarded the Nobel Prize in Physiology or Medicine. Since the year of H. pylori discovery, various invasive and non-invasive diagnostic tests, susceptibility testing methods and treatment regimens for the infection have been developed and then improved. Participation of H. pylori in the pathogenesis of gastric cancer and MALT lymphoma has been proven. Moreover, H. pylori has been associated with several extragastric diseases. The enormous genetic diversity of the bacteria and their numerous virulence factors have been revealed and genomes of many strains have been sequenced. Presently, chronic gastritis and peptic ulcers are treated as bacterial infections by antibiotics combined with acid inhibitors. Improvement in eradication has been obtained by triple, quadruple, rescue, sequential or other regimens. The gift that Marshall and Warren's discovery has given to human medicine has been the consequent detection of the link between chronic bacterial infections and malignancy and, fascinatingly, the option to heal a tumour (as MALT lymphoma) by treating the associated microorganisms. However, at present, the treatment of H. pylori infection is not easy and still no vaccines are available for prophylaxis. Although the global rate of H. pylori infection is gradually decreasing, the antibiotic resistance of the bacteria is growing sharply in many countries. Regrettably, despite the fact that infection is often asymptomatic, H. pylori still infects half of the global human population and every fifth infected subject can develop severe disease. Therefore, it is important to stress that in the field of pathogenesis, epidemiology, diagnosis, prophylaxis and treatment of the infection, there are still approaches to be optimised and many questions to be answered read more ...