Document Detail


Helicobacter pylori infection and the pathogenesis of duodenal ulceration.
MedLine Citation:
PMID:  9928373     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Helicobacter pylori is a gram-negative spiral bacterium confined to the habitat of gastric-type epithelium. H. pylori causes duodenal ulceration by a cumulative effect of antral predominant gastritis with increased acid secretion, consequent gastric metaplasia in the duodenum (a site of further colonization by H. pylori), duodenitis, reduced duodenal bicarbonate secretion, and mucosal damage. Bacterial factors influence outcome. Major determinants are the production of a vacuolating toxin and the presence of CagA, an immunodominant product of a nonconserved gene cagA, a marker for the cag pathogenicity island that encodes virulence genes involved in induction of epithelial chemokine responses. In ulcer patients the mucosal immune response is polarized to a T-helper-1 (Th1) cell-mediated response, which may contribute to mucosal damage. Eradication of H. pylori restores acid output to normal. Loss of both acid and bacteria halts gastroduodenitis and allows ulcer healing. Gastric metaplasia does not regress in the short term.
Authors:
M M Walker; J E Crabtree
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Annals of the New York Academy of Sciences     Volume:  859     ISSN:  0077-8923     ISO Abbreviation:  Ann. N. Y. Acad. Sci.     Publication Date:  1998 Nov 
Date Detail:
Created Date:  1999-02-24     Completed Date:  1999-02-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7506858     Medline TA:  Ann N Y Acad Sci     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  96-111     Citation Subset:  IM; X    
Affiliation:
Department of Histopathology, Imperial College School of Medicine at St Mary's, London, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Animals
Antigens, Bacterial*
Bacterial Proteins / genetics
Duodenal Ulcer / microbiology,  pathology,  physiopathology*
Duodenum / pathology
Gastric Acid / secretion
Gastric Mucosa / pathology
Gastritis / etiology,  microbiology,  physiopathology
Helicobacter Infections / complications,  pathology,  physiopathology*
Helicobacter pylori* / genetics,  pathogenicity
Humans
Intestinal Mucosa / microbiology,  pathology
Metaplasia
Th1 Cells / immunology
Chemical
Reg. No./Substance:
0/Antigens, Bacterial; 0/Bacterial Proteins; 0/cagA protein, Helicobacter pylori

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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