幽门螺杆菌胞内感染机制与临床思考

Mechanisms of Helicobacter pylori Intracellular Infection and Reflections Concerning Clinical Practice

长期以来,幽门螺杆菌(Helicobacter pylori, H. pylori)被认为是一种胞外菌。最近研究表明,H. pylori能进入到宿主细胞内,逃避宿主免疫系统攻击和药物的杀伤,形成稳定的胞内生态位,并可以重新释放到细胞外导致反复感染。H. pylori胞内感染引起细胞信号传导和代谢改变,可能与肿瘤的发生和发展密切相关,为H. pylori的临床根除治疗带来新的挑战。本文从临床的角度对H. pylori实现宿主生物屏障突破、免疫逃逸、抗自噬等胞内感染机制进行了综述,并对H.pylori的临床防治策略、胞内衍化以及对宿主细胞的损伤等问题进行了思考和展望。

Helicobacter pylori(H.pylori),for a long time,has generally been considered an extracellular bacterium.However,recent findings have shown that H.pylori can gain entry into host cells,evade attacks from the host immune system and the killing ability of medication,form stable intracellular ecological niche,and achieve re-release into the extracellular environment,thus causing recurrent infections.H.pylori intracellular infection causes cellular signaling and metabolic alterations,which may be closely associated with the pathogenesis and progression of tumors,thereby presenting new challenges for clinical eradicative treatment of H.pylori.Herein,examining this issue from a clinical perspective,we reviewed reported findings on the mechanisms of how H.pylori achieved intracellular infection,including the breaching of the host cell biological barrier,immune evasion,and resistance to autophagy.In addition,we discussed our reflections and the prospects of important questions concerning H.pylori,including the clinical prevention and control strategy,intracellular derivation,and the damage to host cells.