Published online Jul 21, 2017. doi: 10.3748/wjg.v23.i27.4867
Peer-review started: April 8, 2017
First decision: April 21, 2017
Revised: May 3, 2017
Accepted: June 18, 2017
Article in press: June 19, 2017
Published online: July 21, 2017
Nearly half of the global population are carriers of Helicobacter pylori (H. pylori), a Gram-negative bacterium that persists in the healthy human stomach. H. pylori can be a pathogen and causes development of peptic ulcer disease in a certain state of the macroorganism. It is well established that H. pylori infection is the main cause of chronic gastritis and peptic ulcer disease (PUD). Decontamination of the gastric mucosa with various antibiotics leads to H. pylori elimination and longer remission in this disease. However, the reasons for repeated detection of H. pylori in recurrent PUD after its successful eradication remain unclear. The reason for the redetection of H. pylori in recurrent PUD can be either reinfection or ineffective anti-Helicobacter therapy. The administration of antibacterial drugs can lead not only to the emergence of resistant strains of microorganisms, but also contribute to the conversion of H. pylori into the resting (dormant) state. The dormant forms of H. pylori have been shown to play a potential role in the development of relapses of PUD. The paper discusses morphological H. pylori forms, such as S-shaped, C-shaped, U-shaped, and coccoid ones. The authors proposes the classification of H. pylori according to its morphological forms and viability.
Core tip: The administration of antisecretory and antibacterial drugs can lead to the conversion of Helicobacter pylori (H. pylori) into the resting (dormant) state. C-shaped and U-shaped forms of H. pylori, most likely, are dormant forms of the bacteria. C-shaped and U-shaped forms of H. pylori are capable of reverse transition into the vegetative replicative state and of causing development of recurrence of peptic ulcer disease (PUD). The induction of process reversion occurs under the influence of specific molecules. The identification and study of these compounds will allow development of new drugs aimed at preventing recurrent PUD associated with dormant forms of H. pylori.