Helicobacter pylori: Evolution, Pathogenicity, and Implications for Gastric Health

Helicobacter pylori is a globally prevalent human pathogen, chronically infecting nearly half of the world’s population and serving as a major driver of gastritis, peptic ulcer disease, and gastric cancer. Its long-term co-evolution with humans has produced a remarkable diversity of strains, each with distinct virulence repertoires and clinical outcomes. Within the scope of infectious agents and disease, H. pylori represents a powerful model for understanding how microbial adaptation, host interactions, and environmental pressures converge to shape disease risk at both the individual and population level. Foundational discoveries—such as the identification of the cag pathogenicity island and its role in gastric inflammation and carcinogenesis—have transformed our view of this bacterium from a simple colonizer to a dynamic agent of chronic disease, with profound implications for global health.

This article collection focuses on the evolution of H. pylori as an infectious agent, with special emphasis on pathogenicity mechanisms and their links to gastric disease. It aims to integrate genetic, genomic, molecular, and clinical perspectives to reveal how co-evolution with the human host has driven strain diversity, virulence, and tissue tropism. By bringing together studies on bacterial factors, host responses, microbiota interactions, transmission dynamics, and emerging resistance, the collection seeks to define current challenges in diagnosis, management, and prevention of H. pylori infection. In doing so, it will provide an updated framework to guide future research on microbial pathogenicity, host–pathogen interactions, and innovative strategies to prevent H. pylori–associated diseases.

While the following themes on H. pylori infections will guide the collection’s primary focus, submissions are not limited to these topics and complementary, high-quality studies are encouraged.

• Original research on the population genomics and phylogeography of H. pylori, linking strain evolution to host ancestry and disease risk

• Studies dissecting the structure, function, and evolution of the cag pathogenicity island and other key virulence determinants (e.g., VacA, BabA, OipA)

• Mechanistic work on H. pylori–host cell interactions, including signaling pathways involved in gastric inflammation, epithelial damage, and carcinogenesis

• Investigations of host genetic and immunological factors that modulate susceptibility, persistence, and outcomes of H. pylori infection

• Research on H. pylori’s interaction with the gastric and upper gastrointestinal microbiota, and its impact on microbial ecology and pathogenesis

• Experimental on biofilm formation, colonization strategies, and niche adaptation within the gastric environment

• Articles addressing antimicrobial resistance in H. pylori, including surveillance data, resistance mechanisms, and implications for treatment guidelines

• Development and evaluation of novel diagnostic tools, biomarkers, and non-invasive approaches for detecting infection and predicting disease progression

• Explorations of vaccine candidates, immunomodulatory strategies, and other preventive approaches targeting H. pylori infection

• Examination of emerging therapeutic that expands beyond antibiotic usage that can include interventions in the form of nanoparticles, probiotic, and peptide approaches

• Reviews or meta-analyses synthesizing current knowledge on H. pylori evolution, pathogenicity, and its role as a model organism for chronic infectious disease

Article types and fees

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Classification
• Clinical Trial
• Community Case Study
• Data Report
• Editorial
• FAIR² Data
• FAIR² DATA Direct Submission
• ... View all formats

Articles that are accepted for publication by our external editors following rigorous peer review incur a publishing fee charged to Authors, institutions, or funders.

Article types

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Classification
• Clinical Trial
• Community Case Study
• Data Report
• Editorial
• FAIR² Data
• FAIR² DATA Direct Submission
• General Commentary
• Hypothesis and Theory
• Methods
• Mini Review
• Opinion
• Original Research
• Perspective
• Policy and Practice Reviews
• Policy Brief
• Review
• Study Protocol
• Systematic Review
• Technology and Code

Keywords: Antimicrobial Resistance, Cag Pathogenicity Island, Chronic Infection, Gastric Cancer, Gastric Inflammation, Helicobacter pylori, Host–Pathogen Interactions, Microbiota, Nanoparticle, Peptic Ulcer Disease, Peptides, Phylogeography, Probiotics Vaccine Deve

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.