Helicobacter pylori infection: what's new.

PURPOSE OF REVIEW: This review is aimed at describing the main findings of 2011 on the aspects of Helicobacter pylori-related gastric disease linked to CagA and to T-regulatory cells (Treg), and on the attempts to improve the treatment efficacy.

RECENT FINDINGS: Recent findings presented in this review are as follows: CagA interferes with tumor suppression; tolerance protects from H. pylori-induced disease; modified H. pylori treatments/regimens can afford higher efficacy than the standard triple therapy.

SUMMARY: H. pylori colonizes the human stomach causing gastritis and severe diseases including gastric cancer. One of the most dangerous H. pylori factors, CagA, has been investigated in relation to gastric cancer: recently this relationship was strongly reinforced by the finding that CagA interacts with the tumor suppressor apoptosis-stimulating protein of p53-2 (ASPP2), promoting p53 degradation. Treg have been proposed to be involved in H. pylori infection and gastric disease: recent findings suggest that Treg-induced tolerance, rather than immunity to H. pylori, may result in less severe disease. The eradication rates achieved with the standard triple therapy dropped below 80%, mainly due to antibiotic resistance, while no vaccines are currently licensed; new treatments/regimens were subjected to clinical trials, in some cases strongly increasing the eradication rates.