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1761622 
Journal Article 
Development of vaccines against Helicobacter pylori 
Del Giudice, G; Malfertheiner, P; Rappuoli, R 
2009 
Yes 
Expert Review of Vaccines
ISSN: 1476-0584 
8 
8 
1037-1049 
19627186 
WOS:000268922800012 
Helicobacter pylori is a Gram-negative, microaerophilic
bacterium adapted to survive in the stomach of humans where it can cause peptide ulcers and
gastric cancer. Although effective antibiotic treatment exists, there is a consensus that
vaccines are necessary to limit the severity of this infection. Great progress has been made
since its discovery 25 years ago in understanding the virulence factors and several aspects of
the pathogenesis of the H. pylori gastric diseases. Several key bacterial factors have been
identified: urease, vacuolating cytotoxin, cytotoxin-associated antigen, the pathogenicity
island, neutrophil-activating protein, and among others. These proteins, in their native or
recombinant forms, have been shown to confer protection against infectious challenge with H.
pylori in experimental animal models. It is not known, however, through which effector mechanisms
this protection is achieved. Nevertheless, a number of clinical trials in healthy volunteers have
been conducted using urease given orally as a soluble protein or expressed in bacterial vectors
with limited results. Recently, a mixture of H. pylori antigens was reported to be highly
immunogenic in H. pylori-negative volunteers following intramuscular administration of the
vaccine with aluminium hydroxide as an adjuvant. These data show that vaccination against this
pathogen is feasible. More research is required to understand the immunological mechanisms
underlying immune-mediate protection. 
adjuvant; antibody response; cellular response; Helicobacter pylori; pathogenesis; recombinant protein; vaccine; vaccine delivery