Chapter 13 : Helicobacter pylori and Gastroduodenal Disorders

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Ebook: Choose a downloadable PDF or ePub file. Chapter is a downloadable PDF file. File must be downloaded within 48 hours of purchase

Buy this Chapter
Digital (?) $15.00

Preview this chapter:
Zoom in

Helicobacter pylori and Gastroduodenal Disorders, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555816940/9781555811211_Chap13-1.gif /docserver/preview/fulltext/10.1128/9781555816940/9781555811211_Chap13-2.gif


In 1982, researchers were able to culture and characterize species organisms, which they called and which are now known as . is now known to also play an etiological role in peptic ulcer disease as well as in the development of distal gastric adenocarcinomas and gastric lymphomas. As such, a previously obscure organism has now been associated with many of the most important gastroduodenal diseases. were initially classified as belonging to the genus . Epidemiological studies have used techniques like restriction fragment length polymorphism and randomly amplified polymorphic DNA PCR to exploit the heterogeneity, for example, for studies of transmission of infection. Thus, is an "emerging infection" with respect to our knowledge about it, but at the same time it is disappearing from the population in developed countries. The main indication for treatment of is the occurrence of peptic ulcer disease. As such, infection has probably been the most important emerging infection of the past decade, and the recognition of its role in peptic ulcer disease has had a major impact on health care worldwide. Several investigators have recently claimed that chronic gastritis is associated with a variety of extragastrointestinal disorders, such as delayed growth and malnutrition in children in developed countries. The major noninvasive methods, not requiring endoscopy, are serology and breath testing.

Citation: Kuipers E, Blaser M. 1998. Helicobacter pylori and Gastroduodenal Disorders, p 191-206. In Scheld W, Armstrong D, Hughes J (ed), Emerging Infections 1. ASM Press, Washington, DC. doi: 10.1128/9781555816940.ch13

Key Concept Ranking

Peptic Ulcer
Restriction Fragment Length Polymorphism
Gastric Lymphoma
Highlighted Text: Show | Hide
Loading full text...

Full text loading...


1. Akopyanz, N.,, N. O. Bukanov,, T. U. Westhlom,, S. Kresovich,, and D. E. Berg. 1992. DNA diversity among clinical isolates of Helicobacter pylori detected by PCR-based RAPD fingerprinting. Nucleic Acids Res. 20:51375142.
2. Appelmelk, B. J.,, I. Simoons-Smit,, R. Negrini,, A. P. Moran,, G. O. Aspinall,, J. Forte,, T. de Vries,, H. Quan,, T. Verboom,, J. J. Maaskant,, P. Ghiara,, E. J. Kuipers,, E. BIoemena,, T. M. Tadema,, R. R. Townsend,, K. Tyagarajan,, J. M. Crothers, Jr.,, M. A. Monteiro,, A. Savio,, and J. De Graff. 1996. Potential role of molecular mimicry between Helicobacter pylori lipopolysaccharide and host Lewis blood group antigens in autoimmunity. Infect. Immun. 64:20312040.
3. Aspinall, G. 0., and M. A. Monteiro. 1996. Lipopolysaccharide of the Helicobacter pylori type strain NCTC 11637 (ATCC 43504): structure of the 0 antigen and core oligosaccharide regions. Biochemistry 35:24892504.
4. Atherton, J. c.,, P. Cao,, R. M. Peek,, M. K. R. Tnmmuru,, M. J. Blaser,, and T. L. Cover. 1995. Mosaicism in vacuolating cytotoxin alleles of Helicobacter pylori. J. Biol. Chern. 270:1777117777.
5. Atherton, J.C.,, R. M. Peek,, K. T. Tham,, T. L. Cover,, and M. J. Blaser. 1997. Clinical and pathological importance of heterogeneity in vacA, the vacuolating cytotoxin gene of Helicobacter pylori. Gastroenterology 112:9299.
6. Azuma, T.,, Y. Ohtaki,, Y. Ito,, H. Miyaji,, Y. Yamazaki,, F. Sato,, S. Ito,, M. Kuriyama,, Y. Keida,, and Y. Kohli. 1996. HLA-DQA gene contributes to the host's response against Helicobacter pylori infection: host's genetic analysis in two areas in Japan with contrasting gastric cancer risks. Gastroenterology 110(4):A54.
7. Banatvala, N.,, K. Mayo,, F. Megraud,, R. Jennings,, J. J. Deeks,, and R. A. Feldman. 1993. The cohort effect and Helicobacter pylori. J. Infect. Dis. 168:219221.
8. Bayerdorffer, E.,, S. Miehlke,, A. Neuhauer,, and M. Stolte. 1997. Gastric MALT-lymphoma and Helicobacter pylori infection. Aliment. Pharmacol. Ther. 11(Suppl. 1):8994.
9. Beales, I. L. P.,, N. J. Davey,, C. D. Pusey,, R. I. Lechler,, and J. Calam. 1995. Long-term sequelae of Helicobacter pylori gastritis. Lancet 346:381382.
10. Blaser, M. J., 1996. Genetic bases for heterogeneity of Helicobacter pylori, p. 3339. In R. H. Hunt, and G. N. J. Tytgat (ed.) Helicobacter pylori: Basic Mechanisms to Clinical Cure. Kluwer Academic Publishers, Dordrecht, The Netherlands.
11. Blaser, M. J. 1997. All Helicobacters pylori are not created equal: should all be eliminated? Lancet 349:10201022.
12. Blaser, M. J.,, P. H. Chyou,, and A. Nomura. 1995. Age at establishment of Helicobacter pylori infection and gastric carcinoma, gastric ulcer, and duodenal ulcer risk. Cancer Res. 55:562565.
13. Blaser, M. J.,, G. I. Pérez-Pérez,, H. KIeanthous,, T. L. Cover,, R. M. Peek,, P. H. Chyou,, G. N. Stemmerman,, and A. Nomura. 1995. Infection with Helicobacter pylori strains possessing cagA is associated with an increased risk of developing adenocarcinoma of the stomach. Cancer Res. 55:21112115.
14. Censini, S.,, C. Lange,, Z. Xiang,, J. E. Crabtree,, P. Ghiara,, M. Borodovsky,, R. Rappuoli,, and A. Covacei. 1996. Cog. a pathogenicity island of Helicohacter pylori. encodes type [-specific and disease-associated virulence factors. Proc. Natl. Acad. Sci. USA 93: 1464814653.
15. Covacci, A.,, S. Censini,, M. Bugnoli,, R. Petracca,, D. Burroni,, G. Macchia,, A. Massone,, E. Papini,, Z. Xiang,, N. Figura,, and R. Rappuoli. 1993. Molecular characterization of the 128-kDa immunodominant antigen of Helicobacter pylori associated with cytotoxicity and duooenal ulcer. Proc. Natl. Acad. Sci. USA 90:57915795.
16. Cuenca, R.,, T. G. Blanchard,, S. J. Czinn,, J. G. Nedrud,, T. P. Monath,, C. K. Lee,, and R. W. Redline. 1996. Therapeutic immunization against Helicobacter mustelae in naturally infected ferrets. Gastroenterology 110:17701775.
17. Danon, S. J.,, J. L. O'Rourke,, N. D. Moss,, and A. Lee. 1995. The importance of local acid production in the distribution of Helicobacter felis in the mouse stomach. Gastroenterology 108: 13861395.
18. Dixon, M. F. 1991. Helicobacter pylori and peptic ulceration; hislopalhological aspects. J. Gastroenterol. Hepatol. 6:125130.
19. Doglioni, C.,, A. C. Wotherspoon,, A. Moschini,, M. de Boni,, and P. G. [saacson. 1992. High incidence of primary gastric lymphoma in northeastern Italy. Lancet 339:834835.
20. Dooley, C. P.,, H. Cohen,, P. L. Fitzgibbons,, M. Bauer,, M. D. Appleman,, G. I. Pérez-Pérez,, and M. J. Blaser. 1989. Prevalence of Helicobacter pylori infection and histologic gastritis in asymptomatic persons. N. Engl. J. Med. 321:15621566.
21. Dubois, A.,, D. E. Berg,, E. T. Inceeik,, N. Fiala,, L. M. Heman-Ackah,, G. I. Pérez-Pérez,, and M. J. Blaser. 1996. Transient and persistent ex.perimental infection of nonhuman primates with Helicobacter pylori: implications for human disease. Infect. Immun. 64:28852891.
22. Eissele, R.,, G. Brunner,, B. Simon,, E. Solcia,, and R. Arnold. 1997. Gastric mucosa during treatment with lansoprazole: Helicobacter pylori is a risk factor for argyrophil-cell hyperplasia. Gastroenterology 112:707717.
23.The Eurogast Study Group. 1993. An international association between Helicobacter pylori infection and gastric cancer. Lancet 341:13591362.
24. Figura, N. 1996. Mouth-to-mouth resuscitation and Helicubacter pylori infection. Lancet 347:1342.
25. Filipe, M. I.,, N. Muñoz,, I. Matko,, I. Kato. V. Pompe-Kirn, A. Jutersek, S. Teuchmann, M. Benz, and T. Prijon. 1994. Intestinal metaplasia types and the risk of gastric cancer: a cohort study in Slovenia. Int. J. Cancer 57:324329.
26. Fiocca, R.,, L. Villani,, O. Luinetti,, A. Gianatti,, M. Perego,, C. Alvisi,, F. Turpini,, and E. Solcia. 1992. Helicobacter colonization and histopathological profile of chronic gastritis in patients with or without dyspepsia, mucosal erosion and peptic ulcer: a morphological approach to the study of ulcerogenesis in man. Virchows Arch. A 420:489498.
27. Forman, D.,, N. G. Newell,, F. Fullerton,, J. W. G. Yarnell,, A. R. Stacey,, N. Wald,, and F. Sitas. 1991 . Association between infection with Helicobacter pylori and risk of gastric cancer: evidence from a prospective investigation. Br. Med. J. 302:13021305.
28. Forman, D.,, F. Sitas,, D. G. Newell,, A. R. Stacey,, J. Boreham,, R. Peto,, T. C. Campbell,, J. Li,, and J. Chen. 1990. Geographic association of Helicobacter pylori antibody prevalence and gastric cancer mortality in rural China. Int. J. Cancer 46:608611.
29. Forman, D.,, P. Webb,, and J. Parsonnet. 1994. Helicobacter pylori and gastric cancer. Lancet 343:243244.
30. Fox, J. G.,, M. Batchelder,, R. Marini,, L. Yan,, L. Handt,, X. Li,, B. Shames,, A. Hayward,, J. Campbell,, and J. C. Murphy. 1995. Helicobacter pylori-induced gastritis in the domestic Infect. Immun. 63:26742681.
31. Go, M. F.,, V. Kapur,, D. Y. Graham,, and J. M. Musser. 1996. Population genetic analysis of Helicobacter pylori by multilocus enzyme electrophoresis: extensive allelic diversity and recombinational population structure. J. Bacterial. 178:39343938.
32. Goodwin, C. S.,, J. A. Armstrong,, T. Chilvers,, M. Peters,, M. D. Collins,, L. Sly,, W. McConnell,, and W. E. S. Harper. 1989. Transfer of Campylobacter pylori and Campylobacter mustelae to Helicobacter gen. nov. as Helicobacter pylori comb. nov. and Helicobacter mustelae(le comb. nov., respectively. Int. J. Syst. Bacteriol. 39:397405.
33. Groisman, G. M.,, J. George,, D. Berman,, and N. Harpaz. 1994. Resolution of protein-losing hypertrophic lymphocytic gastritis with therapeutic eradication of Helicobacter pylori. Am. J. Gastroenterol. 89:15481551.
34. Hansson, L. E.,, O. Nyrén,, A. W. Hsing,, R. Bergström,, S. Josefsson,, W. H. Chow,, J. F. Fraumeni,, and H. O. Adami. 1996. The risk of stomach cancer in patients with gastric or duodenal ulcer disease. N. Engl. J. Med. 335:242249.
34.a. Hazell, S. L.,, H. M. Mitchell,, M. Hedges,, X. Shi,, P. J. Hu,, Y. Y. Li,, A. Lee,, and E. Reiss-Levy. 1994. Hepatitis A and evidence against the community dissemination of Helicobacter pylori via feces. J. Infect. Dis. 170:689694.
35. Höötik-Nikanne, J.,, M. K. R. Tummuru,, D. Kcrsulyte,, D. Berg,, and M. J. Blaser. 1996. IS605, a novel chimaeric transposable element, suitable for typing Helicobacter pylori infection in vivo as assessed by quantitative culture and histology. Gastroenterology 110(4):A135.
36. Hopkins, R. J-, L. S. Girardi, and E. A. Turney. 1996. Relationship between anti-Helicobacter pylori eradication and reduced duodenal and gastric ulcer recurrence. Gastroenterology 110:12441252.
37. Hopkins, R. J.,, P. A. Vial,, C. Ferreccio,, J. Ovalle,, P. Prado,, V. Sotomayer,, R. G. Russell,, S. S. Wasserman,, and J. G. Morris. 1993. Seroprevalence of Helicohacter pylori in Chile: vegetables may serve as one route of transmission. J. Infect. Dis. 168:222226.
38.International Agency for Research on Cancer. 1994. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, vol. 61. Schistosomes, Liver Flukes, and Helicobacter pylori. International Agency for Research on Cancer, Lyon, France.
39. Jiang, Q.,, K. Hiratsuka,, and D. E. Taylor. 1996. Variability of gene order in different Helicobacter pylori strains contributes to genome diversity. Mol. Microbiol. 20:833842.
40. Jones, D. M.,, A. M. Lessells,, and J. Eldridge. 1984. Campylobacter-like organisms on the gastric mucosa: culture, histological. and serological studies. J. Clin. Pathol. 37:10021007.
41. . Kansau, I.,, J. Raymond,, E. Bingen,, P. Courcoux,, N. Kalach,, M. Bergeret,, N. Briami,, C. Dupont,, and A. Labigne. 1996. Genotyping of Helicobacter pylori isolates by sequencing of PCR products and comparison with the RAPD technique. Res. Microbial. 147:661669.
42. Karnes, W. E.,, I. M. Samloff,, M. Siurala,, M. Kekki,, P. Sipponen,, S. W. R. Kim,, and J. H. Walsh. 1991. Positive serum antibody and negative tissue staining for Helicobacter pylori in subjects with atrophic gastritis. Gastroenterology 101:167174.
43. Kleanthous, H.,, C. L. Clayton,, and S. Tabaqchali. 1991. Characterization of a plasmid from Helicobacter pylori encoding a replication protein common to plasmids in gram-positive bacteria. Mol. Microbiol. 5:23772389.
44. Klein, P. D.,, D. Y. Graham,, A. Gaillour,, A. R. Opekun,, and E. O. Smith. 1991. Water source as risk factor for Helicobacter pylori infection in Peruvian children. Lancet 337:15031506.
45. Kuipers, E. J.,, D. A. Israel,, J. Weel,, A. Van der Ende,, S. A. Thompson,, J. Höök-Nikanne,, and M. J. Blaser. 1997. Evidence for quasispecies development of H. pylori by study of paired isolates obtained years apart in the same host. Gastroenterology 112(4):A185.
46. Kuipers, E. J.,, A. Lee,, E. C. Klinkenberg.Knol, and S. G. M. Meuwissen. 1995. The development of atrophic gastritis-Helicobacter pylori and the effects of acid suppressive therapy. Aliment. Pharmacol. Ther. 9:331340.
47. Kuipers, E. J.,, L. Lundell,, E. C. Klinkenberg-Knol,, N. Havu,, H. P. M. Festen,, B. Liedman,, C. B. H. W. Lamers,, J. B. M. J. Jansen,, J . Dalenbäck,, P. Snel,, G. F. Nelis,, and S. G. M. Meuwissen. 1996. Atrophic gastritis and Helicobacter pylori infection in patients with reHux esophagitis treated with omeprazole or fundoplication. N. Engl. J. Med. 334:10181022.
48. Kuipers, E. J.,, G. I. Pérez-Pérez,, S. G. M. Meuwissen,, and M. J. Blaser. 1995. Helicobacter pylori and atrophic gastritis; importance of the cagA status. J. Natl. Cancer Inst. 87:17771780.
49. Kuipers, E. J.,, A. M. Uyterlinde,, A. S. Peña,, H. J. A. Hazenberg,, E. B1oemena,, J. Lindeman,, E. C. Klinkenberg-Knol,, and S. G. M. Meuwissen. 1995. Increase of Helicobacter pylori associated corpus gastritis during acid suppressive therapy: implications for long-term safety. Am. J. Gastroenterol. 90:14011406.
50. Kuipers, E. J.,, A. M. Uyterlinde,, A. S. Pena,, R. Roosendaal,, G. Pals,, G. F. Nelis,, H. P. M. Festen,, and S. G. M. Meuwissen. 1995. Long term sequelae of Helicobacter pylori gastritis. Lancet 345:15251528.
51.. Langenberg, M. L.,, G. N. J. Tytgat,, M. E. I. Schipper,, P. J. G. M. Rietstra,, and H. C. Zanen. 1984. Campylobacter-like organisms in the stomach of patients and healthy individuals. Lancet i:1348.
52. Leunk, R. D.,, P. T. Johnson,, B. C. David,, W. G. Kraft,, and D. R. Morgan. 1988. Cytotoxic activity in broth-culture filtrates of Campylobacter pylori. J. Med. Microbiol. 26:9399.
53. Logan, R. P. H.,, and D. E. Berg. 1996. Genetic diversity of Helicobacter pylori. Lancet 348:14621463.
54. Logan, R. P. H.,, M. M. Walker,, J. J. Misiewicz,, P. A. Gummelt,, Q. N. Karim,, and J. H. Baron. 1995. Changes in the intragastric distribution of Helicobacter pylori during treatment with omeprazole. Gut 36:1216.
55. Marshall, B. J.,, J. A. Armstrong. D. B. McGechie, and R. J. Glancy. 1985. Attempt to fulfil Koch's postulates for pyloric Campylobacter. Med. J. Aust. 142:436439.
56. McNulty, C. A. M.,, and D. M. Watson. 1984. Spiral bacteria of the gastric antrum. Lancet i:10681069.
57. Mégraud, F. 1995. Transmission of Helicobacter pylori: faecal-oral versus oral-oral. Aliment. Pharmacol. Ther. 9(Suppl. 2):8591.
58. Mendall, M. A.,, P. M. Goggin,, N. Molineaux,, J. Levy,, T. Toosy,, D. Strachan,, and T. C. North-field. 1992. Childhood living conditions and Helicobacter seropositivity in adult life. Lancet 339: 896897.
59. Morris, A.,, and G. Nicholson. 1987. Ingestion of Campylobacter pyloridis causes gastritis and raised fasting gastric pH. Am. J. Gastroenterol. 82:192199.
60. Negrini, R.,, A. Savio,, C. Poiesi,, B. J. Appelmelk,, F. Buffoli,, A. Paterlini,, P. Cesari,, M. Graffeo,, D. Vaira,, and G. Franzin. 1996. Antigenic mimicry between Helicobacter pylori and gastric mucosa in the pathogenesis of body atrophic gastritis. Gastroenterology 111:655665.
61.NIH Consensus Conrerence. 1994. Helicobacter pylori in peptic ulcer disease. JAMA 272:6569.
62. Nilius, M.,, A. Strohle,, G. Bode,, and P. Malfertheiner. 1993. Coccoid like forms (CLF) of Helicobacter pylori. Enzyme activity and antigenicity. Zentralbl. Bakteriol. Ser. A280:258272.
63. Nomura, A.,, G. N. Stemmermann,, P. Chyou,, K. Ikuki,, G. I. Pérez-Pérez,, and M. J. Blaser. 1991. Helicobacter pylori infection and gastric carcinoma among Japanese Americans in Hawaii. N. Engl. J. Med. 325:11321136.
64. Parsonnet, J. 1995. The incidence of Helicobacter pylori infection. Aliment. Pharmacol. Ther. 9(Suppl. 2):4551.
65. Parsonnet, J.,, G. D. Friedman,, N. Orentreich,, and H. Vogelman. 1997. Risk for gastric cancer in people with CagA positive or CagA negative Helicobacter pylori infection. Gut 40:29730l.
66. Parsonnet, J.,, G. D. Friedman,, D. P. Vandersteen,, Y. Chang,, J. H. Vogelman,, N. Orentreich,, and R. K. Sibley. 1991. Helicobacter pylori infection and the risk of gastric carcinoma. N. Engl. J. Med. 325:11271131.
67. Parsonnet, J.,, S. Hansen,, L. Rodriguez,, A. B. Gelb,, R. A. Warnke,, E. Jellum,, N. Orentreich,, J. H. Vogelman,, and G. D. Friedman. 1994. Helicobacter pylori infection and gastric lymphoma. N. Engl. J. Med. 330:12671271.
68. Parsonnet, J.,, R. A. Harris,, H. M. Hack,, and D. K. Owens. 1996. Modelling cost-effectiveness of Helicobacter pylori screening to prevent gastric cancer: a mandate for clinkal trials. Lancet 348:150154.
69. Patel, P.,, M. A. Mendall,, D. Carrington,, D. P. Strachan,, E. Leatham,, N. Molineaux,, J. Levy,, C. Blakeston,, C. A. Seymour,, A. J. Camm,, and T. C. Northfield. 1995. Association of Helicobacter pylori and Chlamydia pneumoniae infections with coronary artery disease and cardiovascular risk factors. Br. Med. J. 311:711714.
70. Peek, R. M.,, G. G. Miller,, K. T. Tham,, G. I. Pérez-Pérez,, X. M. Zhao,, J. C. Atherton,, and M. J. Blaser. 1995. Heightened inflammatory response and cytokine expression in vivo to cagA+ Helicobacter pylori strains. Lab. Invest. 73:760770.
71. Peek, R. M.,, S. A. Thompson,, J. C. Atherton,, M. J. Blaser,, and G. G. Miller. 1996. Expression of ice A, a novel ulcer-associated H. pylori gene, is induced by contact with gastric epithelia] cells and is associated with enhanced mucosal IL-8. Gut 39(Suppl. 2):A71.
72. Pel, P. K. 1899. Diseases of the stomach. De Erven Bohn, Amsterdam, The Netherlands. (In Dutch.)
73. Polish, L. B.,, J. M. Douglas, Jr.,, A. J. Davidson,, G. I. Pérez-Pérez,, and M. J. Blaser. 1991. Characterization of risk factors for Helicobacter pylori infection among men attending a sexually transmitted disease clinic: lack of evidence for sexual transmission. J. Clin. Microbiol. 29:21392143.
74. Rauws, E. A. J.,, W. Langenberg,, H. J. HoutholT,, H. C. Zanen,, and G. N. J. TytgaL 1988. Campylobacter pyloridis-associated chronic active antral gastritis. A prospective study of its prevalence and the effects of antibacterial and antiulcer treatment. Gastroenterology 94:3340.
75. Rauws, E. A. J.,, and G. N. J. Tytgat. 1990. Cure of duodenal ulcer associated with eradication of Helicobacter pylori. Lancet 335:12331235.
76. Riccardi, V. M.,, and J. I. Rotter. 1994. Familial Helicobacter pylori infection. Societal factors, human genetics. and bacterial genetics. Ann. Intern. Med. 120:10431045.
77. Ridker, P. M.,, M. Cushman,, M. J. Stampfer,, R. P. Tracy,, and C. H. Hennekeos. 1997. Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N. Engl. J. Med. 336:973979.
78. Roosendaal, R.,, E. J. Kuipers,, S. G. M. Meuwissen,, and C. M. J. E. Vandenbroucke-Grauls. 1996. Helicobacter pylori and the birth-cohort effect: evidence for continuous decrease of infection rates in childhood. Gastroenterology 110(4):A242.
79. Simoons-Smit, I. M.,, B. J. Appelmelk,, T. Verboom,, R. Negrini,, J. L. Penner,, G. O. Aspinall,, A. P. Moran,, S. F. Fei,, S. Bi-Shan,, W. Rudnica,, A. Savio,, and J. de GraalT. 1996. Typing of Helicobacter pylori with monoclonal antibodies against Lewis antigens in lipopolysaccharide. J. Clin. Microbiol. 34:21962200.
80. Sipponen, P.,, M. Kekki,, J. Haapakoski,, T. Ihamäki,, and M. Siurala. 1985. Gastric cancer risk in chronic atrophic gastritis: statistical calculations of cross-sectional data. Int. J. Cancer 35:173177.
81. Stolte, M.,, C. H. Batz,, E. BayerdorlTer,, and S. Eidt. 1995. Helicobacler pylori eradication in the treatment and differential diagnosis of giant folds in the corpus and fundus of the stomach. Z. Gastroenlerol. 33:198201.
82. Thomas, J. E.,, G. R. Gibson,, M. K. Darboe,, A. Dale,, and L. T. Weaver. 1992. Isolation of Helicobacter pylori from human feces. Lancet 340:11941195.
83. Tsuda, M.,, M. Karita,, and T. Nakazawa. 1993. Genetic transformation in Helicobacter pylori. Microbiol. Immunol. 37:8589.
84. Thmmuru, M. K. R.,, T. L. Cover,, and M. J. Blaser. 1993. Cloning and expression of a highmolecular- mass major antigen of Helicobacter pylori: evidence of linkage to cytotoxin production. Infect. Immun. 61:17991809.
85. Tummuru, M. K. R.,, S. A. Sharma,, and M. J. Blaser. 1995. Helicobacter pylori picB, a homolog of the Bordetella pertussis toxin secretion protein, is required for the induction of IL¥8 in gastric epithelial cells. Mol. Microbial. 18:867876.
86. Tytgat, G. N. J. 1995. Endoscopic transmission of Helicobacter pylori. Aliment. Pharmacol. Ther. 9(Suppl 2):105110.
87. Valle, J.,, M. Kekki,, P. Sipponen,, T. Ihamäki,, and M. Siurala. 1996. Long-term course and consequences of Helicobacter pylori gastritis. Scand. J. Gastroenterol. 31:546550.
88. van der Hulst, R. W. M.,, B. Köycü,, J. J. Keller,, M. Feller,, E. A. J. Rauws,, J. Dankert,, G. N. J. Tytgat,, and A. van de Ende. 1996. H. pylori reinfection after successful eradication analyzed by RAPD or RFLP. Gastroenterology 110(4):A284.
89. Warren, J. R.,, and B. J. Marshall. 1983. Unidentified curved bacilli on gastric epithelium in active chronic gastritis. Lancet i:12731275.
90. Weel, J. F. L.,, R. W. M. van der Hulst,, Y. Gerrits,, P. Roorda,, M. Feller,, J. Dankert,, G. N. J. Tytgat,, and A. vanderEnde. 1996. The interrelationship between cytotoxin-associated gene A, vacuolating cytotoxin, and Helicobacter pylorirelated diseases. J. Infect. Dis. 173:11711175.
91. Werdmuller, B. F. M.,, and R. J. L. F. Loffeld. 1997. Helicobacter pylori infection has no role in the pathogenesis of reflux esophagitis. Dig. Dis. Sci. 42:103105.
92. Wirth, H. P. M.,, M. Yang,, M. Karita,, and M. J. Blaser. 1996. Expression of the human cell surface gJycoconjugates Lewis X and Lewis Y by Helicobacter pylori isolates is related to cagA status. Infect. Immun. 64:45984605.
93. Wotherspoon, A. c.,, C. Ortiz-Hidalgo,, M. R. Falcon,, and P. G. Isaacson. 1991. Helicobacter pylori-associated gastritis and primary B-cell gastric lymphoma. Lancet 342:575577.

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error