IMMUNOLOGICAL BASIS OF CANCER ASSOCIATED WITH HELICOBACTER PYLORI

Helicobacter pylori (H.pylori) is a gram negative, helical shaped, flagellated, urease positive,
catalase positive, microaerophilic bacteria. It is considered as the main human gastric pathogen
which everyone acquires it at infancy and the only difference is that some people are
asymptomatic while others are symptomatic.
It is commonly associated with inflammation and irritation of the gastric mucosa (gastritis),
peptic ulcers in the stomach or duodénum and gastric cancer in long-term infection, however
this is rare.
Transmission of the bacteria is through oral-to-oral contact (kissing), ingestion of contaminated
food or water and contact with infested vomit or stool.
Symptoms of H.pylori include:dull or burning stomach pain, nausea and in severe cases,
vomiting blood or dysentery.

H. pylori: From Ulcers to Cancer

H. pylori becomes symptomatic once it starts to interfere with the integrity of the gastric mucosa.
Its spiral shape and flagella allow it to burrow into the stomach lining, triggering chronic
inflammation. This inflammation weakens the stomach mucosa, allowing gastric acid to further
erode it, ultimately leading to the formation of ulcers in the stomach or duodenum.

H. pylori further enhances the damage by neutralizing stomach acid with substances it
produces. This creates an environment where the acid, though weakened, remains potent
enough to erode the stomach tissue, causing ulceration. Additionally, the body's immune
response to the bacterial infection contributes to the damage by producing reactive oxygen
species which further damage the stomach lining.

The Path Towards Cancer:

Despite ulcers being a significant consequence of H. pylori infection, the long-term inflammation
it induces poses a much more threat of leading to the development of stomach cancer. Chronic
inflammation disrupts the normal cell turnover process in the stomach lining, increasing the risk
of mutations. These mutations can accumulate, leading to the development of cancerous cells.

In addition, H. pylori produces toxins that directly damage the DNA of stomach cells, further
accelerating the potential for cancerous transformation. The constant cycle of damage and
healing within the stomach lining, fueled by H. pylori, creates a fertile ground for errors in cell
division, ultimately increasing the risk of cancer development.

Important Considerations:

It's crucial to note that not everyone infected with H. pylori develops ulcers or cancer. Specific
strains of the bacteria are more likely to be associated with cancer risk. Additionally, other
factors, such as diet, smoking, and genetics, play a significant role in cancer development.