Abstract
Helicobacter pylori (H. pylori) may enter a non-replicative, non-culturable, low metabolically active state, the so-called coccoid form, to survive in extreme environmental conditions. Since coccoid forms are not susceptible to antibiotics, they could represent a cause of therapy failure even in the absence of antibiotic resistance, i.e., relapse within one year. Furthermore, coccoid forms may colonize and infect the gastric mucosa in animal models and induce specific antibodies in animals and humans. Their detection is hard, since they are not culturable. Techniques, such as electron microscopy, polymerase chain reaction, loop-mediated isothermal amplification, flow cytometry and metagenomics, are promising even if current evidence is limited. Among the options for the treatment, some strategies have been suggested, such as a very high proton pump inhibitor dose, high-dose dual therapy, N-acetycysteine, linolenic acid and vonoprazan. These clinical, diagnostic and therapeutic uncertainties will represent fascinating challenges in the future.
Highlights
Helicobacter pylori (H. pylori) is a Gram-negative bacterium able to colonize the human stomach, where it is the most common cause of chronic active gastritis, peptic ulcer [1], adenocarcinoma [2], mucosal associated lymphoid tissue (MALT) lymphoma [3] and extra-gastric diseases [4]
The first, is not widely available, whilst the second does not offer a conclusive agreement about standardization and reproducibility of the technique
H. pylori is able to modify its morphology to survive in many adverse environmental conditions by entering a “viable but non culturable” state
Summary
Helicobacter pylori (H. pylori) is a Gram-negative bacterium able to colonize the human stomach, where it is the most common cause of chronic active gastritis, peptic ulcer [1], adenocarcinoma [2], mucosal associated lymphoid tissue (MALT) lymphoma [3] and extra-gastric diseases [4]. The spreading of antibiotic resistance is the main reason for the progressive increase of therapy failures, which at the moment represent a hot topic in many countries [5]. In this regard a lot of studies have been focused on novel antibiotic regimens [6] and suitable tests for resistance detection, especially based on molecular methods in the light of technical difficulties of culture-based approaches [7]. Antibiotics 2020, 9, 293 setting of the biology and clinical impact of coccoid forms in the wide scenario of H. pylori infection
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
