Vaccine development against Helicobacter pylori: from ideal antigens to the current landscape

ABSTRACT

Introduction: The interest of the world scientific community for an effective vaccine against Helicobacter pylori infection arises from its high prevalence and association with many diseases. Moreover, with an immunological response that is not always effective for the eradication of the bacteria and an increasing antibiotic resistance in the treatment of this infection, the search for a vaccine and new therapeutic modalities to control this infection is urgent.

Areas covered: We bring an overview of the infection worldwide, discussing its prevalence, increasing resistance to antibiotics used in its therapy, in addition to the response of the immune system to the infection registered so far. Moreover, we address the most used antigens and their respective immunological responses expected or registered up to now. Finally, we address the trials and their partial results in development for such vaccines.

Expert opinion: Although several studies for the development of an effective vaccine against this pathogen are taking place, many are still in the preclinical phase or even without updated information. In this sense, taking into account the high prevalence and association with important comorbidities, the interest of the pharmaceutical industry in developing an effective vaccine against this pathogen is questioned.

KEYWORDS:

• Helicobacter pylori
• vaccines
• immunization
• immunology
• bacterial vaccines
• antigens

Article highlights

• Bacterial resistance to antibiotics is an increasing challenge around the world. This has become a problem for treatment against H. pylori.

• H. pylori has the ability to evade immune mechanisms and to modulate the host defense system in order to favor its persistence in the gastric mucosa.

• The main antigens related to the production of a vaccine against H. pylori are urease, catalase, CagA, VacA, BabA, HspA, the FliD protein and multivalent epitopes.

• At the moment, most vaccines under development are at a very early stage (phase I or even preclinical).

• Due to the highly complex immune responses involved in H. pylori infection, various aspects of this issue remain obscure and must be better elucidated for development of an adequate vaccine.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

MS, HM, VG, BB, FS acquired, analyzed, and interpreted data. IV, NS, FP, AT, DC, BS, MO, GR, DQ and FM helped interpreting data and revised the article. All authors attest they meet the ICMJE criteria for authorship.

Additional information

Funding

This paper was not funded.