Abstract
Abstract
The human gastric pathogen
Helicobacter pylori
infects the human gastric mucus layer of approximately half of the world's population. Colonization with this bacterium results in superficial gastritis without clinical symptoms, but can progress into gastric or duodenal ulcers, gastric malignancies and mucosa-associated lymphoid tissue-lymphomas. Disease outcome is affected by a complex interplay between host, environmental and bacterial factors. Irrespective of disease outcome, the majority of
H. pylori
infected individuals remain colonized for life. Changing conditions in the human gastric mucosa may alter gene expression and/or result in the outgrowth of more fit
H. pylori
variants. As such,
H. pylori
is a highly flexible organism that is optimally adapted to its host. the heterogeneity in
H. pylori
populations make predictions on
H. pylori
-related pathogenesis difficult. In this review, we discuss host, environmental and bacterial factors that are important in disease progression. Moreover,
H. pylori
adaptive mechanisms, which allow its life-long survival and growth in the gastric mucosa are considered.