Resumen
Helicobacter pylori es una bacteria que infecta la mucosa gástrica de alrededor de la mitad de la población mundial y está involucrada en la patogénesis de un gran número de enfermedades gástricas y extragástricas en el huésped. Varios antígenos, adyuvantes y rutas de inmunización han sido evaluados buscando una vacuna que ayude a prevenir o erradicar la infección, consiguiéndose diferentes grados de éxito, si bien la inmunidad esterilizante solo se ha conseguido en algunos modelos animales. Varios mecanismos se han propuesto para explicar los resultados obtenidos con las vacunas potenciales evaluadas y para explicar cómo esta bacteria elude la respuesta inmune inducida por ella misma o por intentos de inmunización. El panorama hasta el momento, si bien no parece sencillo, no deja de ser esperanzador por los favorables resultados que vendrían tras la obtención de una vacuna eficaz y por algunos estudios que motivan a la posibilidad de su consecución. MÉD.UIS. 2017;30(3):111-20.
Referencias
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2. Correa S, Cardona AF, Correa T, Correa LA, García HI, Estrada S. Prevalencia de Helicobacter pylori y características histopatológicas en biopsias gástricas de pacientes con síntomas dispépticos en un centro de referencia de Medellín. Rev Col Gastroenterol. 2016;31(1):9-15.
3. Bravo LE, Cortés A, Carrascal E, Jaramillo R, García LE, Bravo PE, et al. Helicobacter pylori: patología y prevalencia en biopsias gástricas en Colombia. Colomb Med. 2003;34(3):124-31.
4. Otero W, Gómez M, Castro D. Carcinogénesis gástrica. Rev Col Gastroenterol. 2009;24(3):314-29.
5. Urrego J, Otero W, Gómez M. Helicobacter pylori y enfermedades hematológicas. Rev Col Gastroenterol 2013;28(4):329 - 37.
6. Kusters JG, van Vliet AH, Kuipers EJ. Pathogenesis of Helicobacter pylori infection. Clin Microbiol Rev. 2006;19(3):449-90.
7. Malfertheiner P, Megraud F, O’Morain CA, Atherton J, Axon AT, Bazzoli F, et al. Management of Helicobacter pylori infection--the Maastricht IV/ Florence Consensus Report. Gut. 2012;61(5):646-64.
8. Tepes B, O’Connor A, Gisbert JP, O’Morain C. Treatment of Helicobacter pylori infection 2012. Helicobacter. 2012;17 Suppl 1:36-42.
9. Vakil N. Primary and secondary treatment for Helicobacter pylori in the United States. Rev Gastroenterol Disord. 2005;5(2):67-72.
10. Hojo M, Miwa H, Nagahara A, Sato N. Pooled analysis on the efficacy of the second-line treatment regimens for Helicobacter pylori infection. Scand J Gastroenterol. 2001;36(7):690-700.
11. Otero W, Trespalacios A, Mercado M. Tasa de reinfección por Helicobacter pylori en una cohorte de pacientes colombianos tratados exitosamente con seguimiento superior a 2 años. Rev Col Gastroenterol. 2015;30(1):53-9.
12. Every AL, Stent A, Moloney MB, Ng GZ, Skene CD, Edwards SJ, et al. Evaluation of superoxide dismutase from Helicobacter pylori as a protective vaccine antigen. Vaccine. 2011;29(7):1514-8.
13. Chionh YT, Wee JL, Every AL, Ng GZ, Sutton P. M-cell targeting of whole killed bacteria induces protective immunity against gastrointestinal pathogens. Infect Immun. 2009;77(7):2962-70.
14. Garhart CA, Redline RW, Nedrud JG, Czinn SJ. Clearance of Helicobacter pylori Infection and Resolution of Postimmunization Gastritis in a Kinetic Study of Prophylactically Immunized Mice. Infect Immun. 2002;70(7):3529-38.
15. Sutton P, Danon SJ, Walker M, Thompson LJ, Wilson J, Kosaka T, et al. Post-immunisation gastritis and Helicobacter infection in the mouse: a long term study. Gut. 2001;49(4):467-73.
16. Aebischer T, Schmitt A, Walduck AK, Meyer TF. Helicobacter pylori vaccine development: facing the challenge. Int J Med Microbiol. 2005;295(5):343-53.
17. Koch M, Meyer TF, Moss SF. Inflammation, immunity, vaccines for Helicobacter pylori infection. Helicobacter. 2013;18 Suppl 1:18-23.
18. Crabtree JE, Taylor JD, Wyatt JI, Heatley RV, Shallcross TM, Tompkins DS, et al. Mucosal IgA recognition of Helicobacter pylori 120 kDa protein, peptic ulceration, and gastric pathology. Lancet. 1991;338(8763):332-5.
19. Rathbone BJ, Wyatt JI, Worsley BW, Shires SE, Trejdosiewicz LK, Heatley RV, et al. Systemic and local antibody responses to gastric Campylobacter pyloridis in non-ulcer dyspepsia. Gut. 1986;27(6):642-7.
20. Amedei A, Munari F, Della Bella C, Niccolai E, Benagiano M, Bencini L, et al. Helicobacter pylori HP0175 promotes the production of IL-23, IL-6, IL-1β and TGF-β. Eur J Inflamm. 2013;11(1):261-8.
21. Kim DJ, Park JH, Franchi L, Backert S, Núñez G. The Cag pathogenicity island and interaction between TLR2/NOD2 and NLRP3 regulate IL-1β production in Helicobacter pylori infected dendritic cells. Eur J Immunol. 2013;43(10):2650-8.
22. Lagunes-Servin H, Torres J, Maldonado-Bernal C, PérezRodríguez M, Huerta-Yépez S, Madrazo de la Garza A, et al. Tolllike receptors and cytokines are upregulated during Helicobacter pylori infection in children. Helicobacter. 2013;18(6):423-32.
23. de Bernard M, D’Elios MM. The immune modulating activity of the Helicobacter pylori HP-NAP: Friend or foe?. Toxicon. 2010;56(7):1186-92.
24. Codolo G, Fassan M, Munari F, Volpe A, Bassi P, Rugge M, et al. HP-NAP inhibits the growth of bladder cancer in mice by activating a cytotoxic Th1 response. Cancer Immunol Immunother. 2012;61(1):31-40.
25. Karttunen R, Karttunen T, Ekre HP, MacDonald TT. Interferon gamma and interleukin 4 secreting cells in the gastric antrum in Helicobacter pylori positive and negative gastritis. Gut. 1995;36(3):341-5.
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