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Helicobacter pylori Immune Response in Children Versus Adults
1Department of Pediatrics, Department of Microbiology and Immunology, University of Texas Medical Branch, 301 University Blvd. Galveston, TX 77555-0372 USA.
Insights
Helicobacter pylori infections in children typically elicit a tolerogenic immune response, unlike the inflammatory response in adults. This difference explains why children experience less severe gastric issues from H. pylori.
Area of Science:
- Microbiology
- Immunology
- Gastroenterology
Background:
- * Helicobacter pylori (H. pylori) is a widespread human pathogen infecting nearly half the global population.
- * Infections are often acquired in childhood and can persist lifelong without treatment, particularly in developing nations.
Purpose of the Study:
- * To compare H. pylori infection characteristics in children versus adults.
- * To elucidate H. pylori virulence mechanisms driving pathogenesis and immune evasion.
Main Methods:
- * Comparative review of H. pylori infection in pediatric and adult populations.
- * Analysis of immune responses, including cellular and cytokine profiles.
- * Examination of H. pylori virulence factors and their role in disease.
Main Results:
- * Children typically develop a tolerogenic immune response with regulatory T cells and immunosuppressive cytokines (IL-10, TGF-β).
- * Adults exhibit a predominantly inflammatory response with Th1/Th17 cells and pro-inflammatory cytokines (TNF-α, IFN-γ, IL-1, IL-6, IL-8, IL-17).
- * Children generally experience less gastric inflammation and fewer peptic ulcer complications compared to adults.
Conclusions:
- * Age-dependent immune responses significantly influence the clinical outcomes of H. pylori infections.
- * H. pylori employs immune evasion strategies to maintain chronic infections, potentially leading to severe adult diseases like PUD, gastric cancer, and MALT lymphoma.
- * Understanding these differences is crucial for targeted prevention and treatment strategies.
Abstract:
H. pylori is perhaps the most prevalent human pathogen worldwide and infects almost half of the world's population. Despite the decreasing prevalence of infection overall, it is significant in developing countries. Most infections are acquired in childhood and persist for a lifetime unless treated. Children are often asymptomatic and often develop a tolerogenic immune response that includes T regulatory cells and their products, immunosuppressive cytokines, such as interleukin (IL)-10, and transforming growth factor-β (TGF-β). This contrasts to the gastric immune response seen in H. pylori-infected adults, where the response is mainly inflammatory, with predominant Th1 and Th17 cells, as well as, inflammatory cytokines, such as TNF-α, IFN-γ, IL-1, IL-6, IL-8, and IL-17. Therefore, compared to adults, infected children generally have limited gastric inflammation and peptic ulcer disease. H. pylori surreptitiously subverts immune defenses to persist in the human gastric mucosa for decades. The chronic infection might result in clinically significant diseases in adults, such as peptic ulcer disease, gastric adenocarcinoma, and mucosa-associated lymphoid tissue lymphoma. This review compares the infection in children and adults and highlights the H. pylori virulence mechanisms responsible for the pathogenesis and immune evasion.
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