Tovey, FI;
Hobsley, M;
Holton, J;
(2006)
Helicobacter pylori virulence factors in duodenal ulceration: A primary cause or a secondary infection causing chronicity.
World journal of gastroenterology
, 12
(1)
pp. 6-9.
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Abstract
Reports from countries with a high prevalence of Helicobacter pylori. (H pylori) infection do not show a proportionately high prevalence of duodenal ulceration, suggesting the possibility that H pylori cannot be a primary cause of duodenal ulceration. It has been mooted that this discrepancy might be explained by variations in the prevalence of virulence factors in different populations. The aim of this paper is to determine whether the published literature gives support to this possibility. The relevant literature was reviewed and analyzed separately for countries with a high and low prevalence of H pylori infection and virulence factors. Although virulent strains of H pylori were significantly more often present in patients with duodenal ulcer than without the disease in countries with a low prevalence of H pylori infection in the population, there was no difference in the prevalence of virulence factors between duodenal ulcer, non - ulcer dyspepsia or normal subjects in many countries, where the prevalence of both H pylori infection and of virulence factors was high. In these countries, the presence of virulence factors was not predictive the clinical outcome. To explain the association between virulence factors and duodenal ulcer in countries where H pylori prevalence is low, only two papers were found that give little support to the usual model proposed, namely that organisms with the virulence factors are more likely than those without them to initiate a duodenal ulcer. We offer an alternative hypothesis that suggests virulence factors are more likely to interfere with the healing of a previously produced ulcer. The presence of virulence factors only correlates with the prevalence of duodenal ulcer in countries where the prevalence of H pylori is low. There is very little evidence that virulence factors initiate duodenal ulceration, but they may be related to failure of the ulcer to heal.
| Type: | Article |
|---|---|
| Title: | Helicobacter pylori virulence factors in duodenal ulceration: A primary cause or a secondary infection causing chronicity |
| Open access status: | An open access version is available from UCL Discovery |
| Publisher version: | http://www.wjgnet.com/1007-9327/12/6.asp |
| Language: | English |
| Additional information: | © 1995-2013 Baishideng Publishing Group Co., Limited. Articles published by the World Journal of Gastroenterology are distributed under the terms of the Creative Commons Attribution Non-commercial License (CC BY-NC), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. |
| Keywords: | Duodenal ulceration, Helicobacter pylori virulence factors, Cag pathogenicity island, Peptic-ulcer, Gastric-cancer, Gastroduodenal diseases, Nonulcer dyspepsia, High prevalence, Anti-caga, Asymptomatic subjects, Clinical-relevance, Developing-country |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Surgical Biotechnology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/38999 |
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