Abstract

Helicobacter pylori, a member of Epsilonproteobacteria, is a Gram-negative microaerophilic bacterium that colonizes gastric mucosa of about 50% of the human population. Although most infections caused by H. pylori are asymptomatic, the microorganism is strongly associated with serious diseases of the upper gastrointestinal tract such as chronic gastritis, peptic ulcer, duodenal ulcer, and gastric cancer, and it is classified as a group I carcinogen. The prevalence of H. pylori infections varies worldwide. The H. pylori genotype, host gene polymorphisms, and environmental factors determine the type of induced disease. Currently, the most common therapy to treat H. pylori is the first line clarithromycin–based triple therapy or a quadruple therapy replacing clarithromycin with new antibiotics. Despite the enormous recent effort to introduce new therapeutic regimens to combat this pathogen, treatment for H. pylori still fails in more than 20% of patients, mainly due to the increased prevalence of antibiotic resistant strains. In this review we present recent progress aimed at designing new anti-H. pylori strategies to combat this pathogen. Some novel therapeutic regimens will potentially be used as an extra constituent of antibiotic therapy, and others may replace current antibiotic treatments.

Key points

• Attempts to improve eradication rate of H. pylori infection.

• Searching for new drug targets in anti-Helicobacter therapies.

中文翻译：

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后抗生素时代的幽门螺杆菌治疗—寻找新药靶点

摘要

幽门螺杆菌（Helicobacter pylori）是Epsilon变形杆菌的一种成员，是一种革兰氏阴性微需氧细菌，它定植在大约50％的人的胃粘膜上。尽管大多数由幽门螺杆菌引起的感染是无症状的，但该微生物与上消化道的严重疾病（如慢性胃炎，消化性溃疡，十二指肠溃疡和胃癌）密切相关，被归类为第一类致癌物。幽门螺杆菌感染的流行程度在全球范围内各不相同。的幽门螺杆菌基因型，宿主基因多态性，和环境因素确定诱导的疾病的类型。目前，最常见的治疗幽门螺杆菌的疗法是基于克拉霉素的一线三联疗法或四联疗法，用新抗生素替代克拉霉素。尽管最近付出了巨大的努力来引入新的治疗方案来对抗这种病原体，但是幽门螺杆菌的治疗仍然在20％以上的患者中失败，这主要是由于抗生素耐药菌株的患病率增加。在这篇综述中，我们介绍了旨在设计新的抗幽门螺杆菌策略来对抗这种病原体的最新进展。一些新颖的治疗方案将有可能被用作抗生素治疗的额外组成部分，而另一些则可能替代当前的抗生素治疗。

关键点

•尝试提高幽门螺杆菌感染的根除率。

•在抗幽门螺杆菌疗法中寻找新的药物靶标。