Helicobacter pylori and gastroduodenal disorders: new approaches for prevention, diagnosis and treatment

Prevention and treatment of H. pylori infection through immunization would be an important achievement considering the high cost of drug therapy, the appearance of antibiotic resistant strains, and the failure of drug therapy to prevent reinfection. Success hinges on determining the extent to which immunologic memory can be evoked in the stomach, and the ability to identify antigens and delivery systems which stimulate protective immunity rather than disease-promoting responses. Recent experiments by several groups have demonstrated that mice immunized orally or intragastrically (along with mucosal adjuvant) with whole H. pylori lysate, purified or recombinant urease, or purified VacA were significantly protected against challenge with virulent Helicobacter. Several vaccine candidates will enter clinical trials in humans in the near future.