Abstract
The persistence of Helicobacter pylori infection plays a fundamental role in the development of H. pylori-associated complications. Since the majority of infected persons acquire the bacteria during early childhood, an examination of the immunobiology of H. pylori infection in children compared with that of adults may help identify host factors that contribute to persistent infection. Therefore, we begin our review of the role of persistence in H. pylori disease with an assessment of the clinical features of H. pylori infection in children. We next review the bacterial factors that promote colonization and evasion of host defense mechanisms. We then focus our attention on the early host immunological factors that promote persistence of the infection and its complications in humans and mouse models. We also highlight topics in which further research is needed. An examination of how immunological factors cause divergent manifestations of H. pylori infection in children compared with adults may provide new insight for therapeutic modification or prevention of persistent H. pylori infection and its complications.
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Disclosure of Potential Conflicts of Interest
No potential conflict of interest was disclosed.
Acknowledgments
Work supported in part by Fondecyt grant 1130387 (PRH); NIH grants DK 064000 and DK 084063 and the Research Service of the Veterans Administration (PDS); Broad Medical Research Institute grant (IBD-0361) (LES); and NIH grants DK 090989 and GM 063270 (GPP).