DEVELOPMENT OF A VACCINE AGAINST HELICOBACTER-PYLORI - A SHORT OVERVIEW

Aim: Growing evidence that gastric and duodenal disease is caused by H elicobacter pylori infection suggests that this disease may be prevent ed by vaccination. We therefore assessed the possibilities for develop ment of a vaccine. Method: Survey of published studies. Present state of development: Development of a vaccine requires identification of th e factors responsible for bacterial virulence and disease induction an d large-scale production and testing of potential vaccines in animal m odels. So far several factors involved in bacterial adhesion, coloniza tion and virulence have been identified. Among these, the most promisi ng candidates for vaccine development are the adhesins, the vacuolatin g cytotoxin and urease. Urease-based vaccines have shown some promisin g results in protecting mice against H. felis infection. Proposals: Th e unique features of H. pylori infection and disease formation in man suggest that vaccines should be tested in models more relevant to huma ns, and that the vacuolating cytotoxin and the cytotoxin-associated ge ne A (cagA) should be seriously considered as vaccine candidates. This hypothesis is supported by the recent observation that only the subse t of strains that produce the vacuolating cytotoxin and cagA are assoc iated with disease.