Research Topic

Helicobacter pylori and the hygiene hypothesis: the controversies

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Helicobacter pylori (H. pylori), an ancient bacterium that infects half of the world population is associated with diseases of major global health concerns including gastric cancer and peptic ulcer disease.

The discovery of H. pylori by Marshall and Warren has led to major ...

Helicobacter pylori (H. pylori), an ancient bacterium that infects half of the world population is associated with diseases of major global health concerns including gastric cancer and peptic ulcer disease.

The discovery of H. pylori by Marshall and Warren has led to major understanding of these disorders, which prior to 1984 were assumed to be associated with acid and stress. Due to public health burden associated with these diseases, leading experts believe that H. pylori should be eradicated, similar to small pox and polio. As Professor David Graham from Houston, Texas pointed out, “the only good H. pylori is a dead H. pylori” and indeed there is a gradual disappearance of this bacterium in the developed countries. Epidemiological studies indicate that certain populations starting with a low prevalence of H. pylori also have a low prevalence of gastric cancer and peptic ulcer disease, further supporting its eradication.

Other experts, however, caution against elimination of H. pylori with a view that it may cause a rise of other morbidities including gastroesophageal reflux disease, esophageal adenocarcinoma and childhood asthma. The pathophysiology of gastroesophageal reflux disease is related to alterations in the barrier function and acid secretion. In this regard, H. pylori only affects acid secretion and it may be either increased or decreased acid secretion. On the other hand, asthma and other allergic diseases are linked with initial exposure of the immune system to environmental antigens, or the “hygiene hypothesis”. Evidence is pretty much divided on whether H. pylori plays any significant role as a protective agent in asthma.

The current research topic hopes to provide a platform for researchers in this area to submit their studies to support or to refute the role of H. pylori in the hygiene hypothesis.


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