Genome and population dynamics during chronic infection with Helicobacter pylori

• Published in: Current opinion in immunology 2023-06, Vol.82, p.102304-102304, Article 102304
• Main Authors: Suerbaum, Sebastian, Ailloud, Florent
• Format: Article
• Language: English
• Subjects: Gastritis - complications; Gastritis - microbiology; Helicobacter Infections - complications; Helicobacter Infections - genetics; Helicobacter Infections - microbiology; Helicobacter pylori - genetics; Humans; Persistent Infection; Population Dynamics
• ISSN: 0952-7915; 1879-0372
• DOI: 10.1016/j.coi.2023.102304

Helicobacter pylori is responsible for one of the most prevalent bacterial infections worldwide. Chronic infection typically leads to chronic active gastritis. Clinical sequelae, including peptic ulcers, mucosa-associated lymphoid tissue lymphoma or, most importantly, gastric adenocarcinoma develop in 10–15% of cases. H. pylori is characterized by extensive inter-strain diversity which is the result of a high mutation rate, recombination, and a large repertoire of restriction-modification systems. This diversity is thought to be a major contributor to H. pylori’s persistence and exceptional aptitude to adapt to the gastric environment and evade the immune system. This review covers efforts in the last decade to characterize and understand the multiple layers of H. pylori’s diversity in different biological contexts. •H. pylori diversifies rapidly during early and chronic infections.•The H. pylori genome evolves at a fast rate of 10−5–10−6 mutations per site/year.•Recombination contributes even more to diversity than spontaneous mutation.•DNA methylation provides an additional layer of epigenetic variability to H. pylori.•Genetic variability of H. pylori contributes to host adaptation and immune evasion.