<i>Helicobacter pylori</i>-Induced Inflammation: Possible Factors Modulating the Risk of Gastric Cancer

• Main Authors: Sushil Kumar, Girijesh Kumar Patel, Uday C. Ghoshal
• Format: Article
• Language: English
• Published: MDPI AG 2021-08-01
• Series: Pathogens
• Subjects: chronic inflammation; intestinal helminth; gastric carcinogenesis; <i>Helicobacter pylori</i>; gut microbiota; exosomes
• Online Access: https://www.mdpi.com/2076-0817/10/9/1099

Chronic inflammation and long-term tissue injury are related to many malignancies, including gastric cancer (GC). <i>Helicobacter pylori</i> (<i>H. pylori</i>), classified as a class I carcinogen, induces chronic superficial gastritis followed by gastric carcinogenesis. Despite a high prevalence of <i>H. pylori</i> infection, only about 1–3% of people infected with this bacterium develop GC worldwide. Furthermore, the development of chronic gastritis in some, but not all, <i>H. pylori</i>-infected subjects remains unexplained. These conflicting findings indicate that clinical outcomes of aggressive inflammation (atrophic gastritis) to gastric carcinogenesis are influenced by several other factors (in addition to <i>H. pylori</i> infection), such as gut microbiota, co-existence of intestinal helminths, dietary habits, and host genetic factors. This review has five goals: (1) to assess our current understanding of the process of <i>H. pylori</i>-triggered inflammation and gastric precursor lesions; (2) to present a hypothesis on risk modulation by the gut microbiota and infestation with intestinal helminths; (3) to identify the dietary behavior of the people at risk of GC; (4) to check the inflammation-related genetic polymorphisms and role of exosomes together with other factors as initiators of precancerous lesions and gastric carcinoma; and (5) finally, to conclude and suggest a new direction for future research.