Abstract
Morphological variability is one of the phenotypic features related to adaptation of microorganisms to stressful environmental conditions and increased tolerance to antimicrobial substances. Helicobacter pylori, a gastric mucosal pathogen, is characterized by a high heterogeneity and an ability to transform from a spiral to a coccoid form. The presence of the coccoid form is associated with the capacity to avoid immune system detection and to promote therapeutic failures. For this reason, it seems that the investigation for new, alternative methods combating H. pylori should include research of coccoid forms of this pathogen. The current review aimed at collecting information about the activity of antibacterial substances against H. pylori in the context of the morphological variability of this bacterium. The collected data was discussed in terms of the type of substances used, applied research techniques, and interpretation of results. The review was extended by a polemic on the limitations in determining the viability of coccoid H. pylori forms. Finally, recommendations which can help in future research aiming to find new compounds with a potential to eradicate H. pylori have been formulated.
Highlights
H. pylori strain occurring only as coccoids and, unlike the spiral-shaped parental strain, the former was characterized by mucus overproduction and resistance to all tested antibiotics [36]. These results suggest the importance of expanding awareness about the presence of spherical H. pylori forms and their impact on the activity of antimicrobial substances
In a collection of eight articles [37,38,39,40,41,42,43,44] showing a morphological effect of antibiotics and other substances classically used in H. pylori therapies, microscopic and culture methods were used
These observations are in line with the reports of Faghri et al [42], who noticed that sublethal CLR and MTZ concentrations after 3 days of exposure have a relatively low potential to stimulate transformation of H. pylori into spherical forms (30–40%)
Summary
Helicobacter pylori is a bacterium that colonizes over 60% of people in the world [1]. The presence of this microorganism, is not neutral for the host, and is accompanied by the development of gastritis, which over the years may progress to gastric ulcers or cancers [2]. The appearance of these diseases is driven by an expression of a wide range of virulence factors, both adhesins and toxins [3]. It has been observed that the frequency of resistance to three out of the five commonly used antibiotics (clarithromycin [CLR], metronidazole [MTZ], and levofloxacin [LEV]) has exceeded the 15% threshold within all World Health
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