Helicobacter pylori: prospettive per un vaccino

Helicobacter pylori causes one of the most widespread infections worldwide: it affects more than 50% of the human population, and is responsible for serious gastric pathologies such as chronic gastritis, peptic ulcer, atrophic gastritis and, in some individuals, gastric cancer. Current treatments with antibiotics are efficacious, but encounters several drawbacks at the level of compliance, side effects, antibiotic resistance, etc.The availability of vaccines could contribute in reducing the burden of H. pylori associated diseases. Several bacterial antigens have been identified as virulence factors and proposed as potential vaccine candidates. Some of these antigens have been tested in experimental animal models of challenge with H. pylori. The experiments in animals have shown that prophylactic and therapeutic vaccination against H. pylori is indeed feasible. Several open questions still remain concerning the understanding of the host-microbe relationship and the quality of the immune response which should be induced in order to confer protective immunity in man.The answers to these questions will be crucial in helping the preparation of appropriate vaccine formulations able to efficaciously protect humans both prophylactically and therapeutically. A few clinical trials have been carried out so far with still limited results. Other trials in humans are in progress and are planned for the next few years.The final hope is that these new vaccines will show the expected efficacy against H. pylori and will permit the elimination of this pathogen which has cohabited with humans for more than 100,000 years.