Suicide journey of H. pylori through gastric carcinogenesis: the role of non- H. pylori microbiome and potential consequences for clinical practice

AbstractDespite being one of the most studied cancer-related infections, the relationship betweenHelicobacter pylori infection and gastric adenocarcinoma (GC) remains, in some points, obscure. Based on a critical analysis of the available literature regarding stomach microbiota, we aimed to shed light to a possible new interpretation of the current understanding about theHelicobacter pylori-related GC carcinogenesis. We analyzed data from the literature onHelicobacter pylori and other potential carcinogenic pathogens, in both benignant conditions and gastric adenocarcinoma.Helicobacter pylori is the dominant microorganism in benignant conditions as non-complicated gastritis. In atrophic gastritis, metaplasia and, mainly, in gastric adenocarcinoma, a strong reduction inHelicobacter pylori abundance, and increased occurrence of other microorganisms is strongly demonstrated by metagenomic experiments. While causing peptic disease and keeping the stomach ’s high acidity,Helicobacter pylori infection avoids gastric infection by carcinogenic intestinal microbiota. Nevertheless,Helicobacter pylori persistence may also provoke an atrophic gastritis, a condition that causes its own decline, due to a microenvironment modification, including reduced acidity, resulting inHelicobacter pylori substitution by a cancer-prone microbiota. This new interpretation might result in a dramatic modification on clinical management ofHelicobacter pylori-related gastric disease.
Source: European Journal of Clinical Microbiology and Infectious Diseases - Category: Microbiology Source Type: research