ABSTRACT
The standard therapy for Helicobacter pylori infection in Korea is a triple-drug regimen consisting of a proton pump inhibitor with two antibiotics such as clarithromycin, amoxicillin, and metronidazole. However, as the eradication rate of this regimen has declined over the past decade, this prompted the formulation of new therapeutic regimens. New therapeutic strategies against H. pylori infection that had been tried all over the world include sequential therapy, concomitant therapy, and tailored therapy This article will review the basic concepts and the results of previous clinical trials on the aforementioned new therapeutic regiments.
Subject(s)
Humans , Amoxicillin/pharmacology , Anti-Bacterial Agents/pharmacology , Clarithromycin/pharmacology , Disease Eradication/trends , Drug Therapy, Combination , Helicobacter Infections/drug therapy , Helicobacter pylori/drug effects , Nitroimidazoles/pharmacology , Proton Pump Inhibitors/pharmacologyABSTRACT
Helicobacter pylori (H. pylori) is one of the most common human infection world-wide. However, only a limited proportion of the infected population developed gastrointestinal diseases such as peptic ulcer disease, gastric adenocarcinoma, and mucosa-associated lymphoid tissue lymphoma. These various outcomes of H. pylori infection may result from bacterial virulence factors, host factors such as genetic diversities, and environmental influences. Bacterial factors such as cagA PAI, vacA, adhesin and outer membrane proteins, and peptidoglycans are known to be associated with specific gastrointestinal diseases such gastric adenocarcinoma. Various cytokines including interleukin (IL)-1beta, IL-10, and tumor necrosis factor-alpha, and host immune reaction to the bacteria are closely related to specific diseases such as gastric adenocarcinoma and duodenal ulcer. In this article, we reviewed each factors and their relevance to the disease outcome.