Russian Journal of Infection and ImmunityRussian Journal of Infection and ImmunityИнфекция и иммунитет2220-76192313-7398SPb RAACI77710.15789/2220-7619-2018-3-273-283REVIEWSОБЗОРЫMECHANISMS OF INTERRACTION OF HELICOBACTER PYLORI WITH EPITHELIUM OF GASTRIC MUCOSA. I. PATHOGENIC FACTORS PROMOTING SUCCESSFUL COLONIZATIONМЕХАНИЗМЫ ВЗАИМОДЕЙСТВИЯ HELICOBACTER PYLORI C ЭПИТЕЛИЕМ СЛИЗИСТОЙ ОБОЛОЧКИ ЖЕЛУДКА. I. ФАКТОРЫ ПАТОГЕННОСТИ, СПОСОБСТВУЮЩИЕ УСПЕШНОЙ КОЛОНИЗАЦИИPozdeevО. К.ПоздеевО. К.
Russian Federation

PhD, MD (Medicine), Professor, Head of the Department of Microbiology.

420012, Russian Federation, Kazan, Butlerova str., 36.

Phone: +7 919 693-02-04 (mobile).

д.м.н., профессор, зав. кафедрой микробиологии.

420012, Россия, г. Казань, ул. Бутлерова, 36.

Тел.: 8 919 693-02-04 (моб.).

pozdeevoskar@rambler.ruPozdeevaА. О.ПоздееваА. О.
Russian Federation

Assistant of the Department of Therapy and Family Medicine.

Kazan.

ассистент кафедры терапии и семейной медицины.

Казань.ValeevaYu. V.ВалееваЮ. В.
Russian Federation

PhD (Medicine), Associate Professor, Department Emergency Medical Care and Simulatory Medicine.

Kazan.

к.м.н., доцент кафедры неотложной медицинской помощи и симуляционной медицины.

Казань.GulyaevP. E.ГуляевП. Е.
Russian Federation

Assistant of the Department of Microbiology.

Kazan.

ассистент кафедры микробиологии.

Казань.

Kazan State Medical Academy — Branch Campus of the Russian Medical Academy of Continuous Professional Education.Казанская государственная медицинская академия — филиал ФГБОУ ДПО Российская медицинская академия непрерывного профессионального образования МЗ РФ.Kazan (Volga region) Federal University.ФГАОУ ВО Казанский (Приволжский) федеральный университет.Kazan State Medical University.ФГБОУ ВО Казанский государственный медицинский университет МЗ РТ.04112018832732830111201801112018Copyright ©; 2018, Pozdeev О.К., Pozdeeva А.О., Valeeva Y.V., Gulyaev P.E.Copyright ©; 2018, Поздеев О.К., Поздеева А.О., Валеева Ю.В., Гуляев П.Е.2018Pozdeev О.К., Pozdeeva А.О., Valeeva Y.V., Gulyaev P.E.Поздеев О.К., Поздеева А.О., Валеева Ю.В., Гуляев П.Е.https://creativecommons.org/licenses/by/4.0https://iimmun.ru/iimm/article/view/777

H. pylori is a Gram-negative, crimp and motile bacterium that colonizes the hostile microniche of the human stomach roughly one half of the human population. Then persists for the host’s entire life, but only causes overt gastric disease in a subset of infected hosts. To the reasons contributing to the development of diseases, usually include: concomitant infections of the gastrointestinal tract, improper sterilization of medical instruments, usually endoscopes, nonobservance of personal hygiene rules, prolonged contact with infected or carriers, including family members and a number of other factors. Clinically, H. pylori plays a causative role in the development of a wide spectrum of diseases including chronic active gastritis, peptic and duodenal ulceration, gastric adenocarcinoma, and gastric mucosa-associated lymphoid tissue lymphoma. Due to the global distribution of H. pylori, we are able to conclude that smart strategies are contributing to adaptation of the bacterium in an aggressive environment of a stomach and lifelong permanent circulation in its host. Thirty-four years after the discovery of this bacterium, there are still many unanswered questions. For example, which strategies help the bacterium to survive in this inhospitable conditions? Understanding the mechanisms governing H. pylori persistence will improve identification of the increased risk of different gastric diseases in persons infected with this bacterium. A well-defined and long-term equilibrium between the human host and H. pylori allows bacterial persistence in the gastric microniche; although this coexistence leads to a high risk of severe diseases the diseases which are listed above. In this review, we discuss the pathogenesis of this bacterium and the mechanisms it uses to promote persistent colonization of the gastric mucosa, with a focus on recent insights into the role of some virulence factors like urease, LPS, outer membrane proteins, cytotoxins, factors, promoting invasion. Information on the mechanisms related to H. pylori persistence can also provide the direction for future research concerning effective therapy and management of gastroduodenal disorders. The topics presented in the current review are important for elucidating the strategies used by H. pylori to help the bacterium persist in relation to the many unfavorable features of living in the gastric microniche.

Helicobacter pylori — грамотрицательная, извитая, подвижная бактерия, способная колонизировать слизистую оболочку желудка (СОЖ) человека и выживать в этих крайне неблагоприятных условиях у более чем половины населения нашей планеты. Показано, что микроорганизм может обитать на СОЖ в течение всей жизни хозяина, но при этом вызывает клинически выраженные заболевания лишь у незначительной группы инфицированных лиц. К причинам, способствующим развитию заболеваний, как правило, относят: сопутствующие инфекции желудочно-кишечного тракта, неправильную стерилизацию медицинских инструментов (как правило эндоскопов), несоблюдение правил личной гигиены, длительный контакт с инфицированными или носителями, в том числе с членами семьи, и ряд других факторов. Хорошо известно, что персистирование H. pylori имеет этиологическое значение в развитии широкого спектра болезней желудочно-кишечного тракта, включая хронический гастрит, язвенную болезнь желудка и двенадцатиперстной кишки, аденокарциному желудка и MALT-лимфомы. Глобальное распространение носительства H. pylori позволяет предположить наличие у бактерии «умных» стратегий, способствующих ее адаптации к агрессивной среде желудка и пожизненному персистированию в организме человека. Даже спустя 34 года после открытия микроорганизма остается множество вопросов, не имеющих своего ответа, в том числе о роли факторов патогенности, способствующих выживанию микроорганизма в суровых условиях микробиома СОЖ. Изучение и понимание механизмов, способствующих колонизации и персистированию H. pylori, позволит оптимизировать прогноз повышенного риска тяжелых заболеваний у лиц, колонизированных этим микроорганизмом. Сложившийся в ходе эволюции долгосрочный баланс между человеком и H. pylori определяет микробное постоянство в микробиоме желудка, но в ряде случаев это совместное сосуществование приводит к риску развития вышеперечисленных тяжелых патологий. В данном обзоре предпринято обсуждение характера взаимоотношений H. pylori с эпителием, участие факторов патогенности бактерии (уреазы, ЛПС, комплекса поверхностных белков, токсинов и протеаз, способствующих инвазии) в колонизации и длительном персистировании на СОЖ. Приведенная информация о механизмах, связанных с колонизацией эпителия желудка H. pylori позволяет создать предпосылки для более эффективной терапии заболеваний гастродуоденальной зоны. Cведения, представленные в данном обзоре, важны для объяснения стратегий, используемых H. pylori для выживания в крайне неблагоприятных условиях микробиома желудка.

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