Update on colonization, survival and antibiotic resistance of Helicobacter pylori at the molecular level

Genomic analyses have revolutionized research on human health and infectious diseases. These techniques led to the discovery of new virulence determinants in different pathogens in turn providing new potential therapeutic targets. Helicobacter pylori (H. pylori) is a human-specific gastric pathogen which is responsible for various diseases. H. pylori infects around a half of the world population and its infection entails an inflammatory response that may promote the formation of peptic ulcer and, in some cases, may led to the development of gastric cancer. However, not all infected subjects develop lesions more severe than gastritis due to the different nature of the disease that depends not only on the bacterium, but also on host characteristics such as genetic predisposition and environmental factors. Analysis of H. pylori genome has revealed a coevolution between the pathogen itself and the host, and any perturbation of this equilibrium disrupts the hostpathogen interaction promoting the oncogenic effects. In this review, we have summarized new molecular insights concerning the pivotal steps of H. pylori infection focusing on colonization, survival and antibiotic resistance, with the aim of translating this knowledge to the clinical setting for the development of new therapeutic strategies.