Published online Feb 21, 2021. doi: 10.3748/wjg.v27.i7.545
Peer-review started: December 5, 2020
First decision: December 27, 2020
Revised: December 28, 2020
Accepted: January 21, 2021
Article in press: January 21, 2021
Published online: February 21, 2021
This review considers the data on Helicobacter pylori (H. pylori), which have been accumulated over 40 years since its description as an etiological factor in gastrointestinal diseases. The majority of modern publications are devoted to the study of the pathogenic properties of the microorganism in the development of chronic gastritis, peptic ulcer disease, and gastric cancer, as well as methods for its eradication. However, in recent years, there have been more and more studies which have suggested that H. pylori has a beneficial, or potentially positive, effect on the human body. The authors have attempted to objectively analyze the information accumulated in the literature on H. pylori. Some studies consider it as one of the recently identified human bacterial pathogens, and special attention is paid to the evidence suggesting that it is probably part of the composition of the human microbiome as a commensal (commensal from French to English is a table companion) or even a symbiont. The presented data discussing the presence or absence of the effect of H. pylori on human health suggest that there is an apparent ambiguity of the problem. The re-assessment of the data available on H. pylori infection is important in order to answer the question of whether it is necessary to create a program of mass H. pylori eradication or to apply a more personalized approach to treating patients with H. pylori-associated gastrointestinal diseases and to perform eradication therapy.
Core Tip: This review provides data on Helicobacter pylori (H. pylori) as one of the recently identified human bacterial pathogens. On the one hand, its role as a human pathogenic bacterium that is commonly found in patients with chronic gastritis, peptic ulcer disease, and gastric cancer is discussed. On the other hand, the high prevalence of H. pylori in the population and its asymptomatic coexistence with humans in most of the world’s population indicates its persistence in the body as a representative of the microbiome and as a nonpathogenic microorganism. The presented data suggest that there is an apparent ambiguity of the problem and a need for an analytically developed, comprehensive approach to study the effect of H. pylori infection on human health and to perform eradication therapy.