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The Puzzle of Coccoid Forms of Helicobacter pylori: Beyond Basic Science
Helicobacter pylori (H. pylori) may enter a non-replicative, non-culturable, low metabolically active state, the so-called coccoid form, to survive in extreme environmental conditions. Since coccoid forms are not susceptible to antibiotics, they could represent a cause of therapy failure even in the...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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MDPI
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7345126/ https://www.ncbi.nlm.nih.gov/pubmed/32486473 http://dx.doi.org/10.3390/antibiotics9060293 |
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author | Ierardi, Enzo Losurdo, Giuseppe Mileti, Alessia Paolillo, Rosa Giorgio, Floriana Principi, Mariabeatrice Di Leo, Alfredo |
author_facet | Ierardi, Enzo Losurdo, Giuseppe Mileti, Alessia Paolillo, Rosa Giorgio, Floriana Principi, Mariabeatrice Di Leo, Alfredo |
author_sort | Ierardi, Enzo |
collection | PubMed |
description | Helicobacter pylori (H. pylori) may enter a non-replicative, non-culturable, low metabolically active state, the so-called coccoid form, to survive in extreme environmental conditions. Since coccoid forms are not susceptible to antibiotics, they could represent a cause of therapy failure even in the absence of antibiotic resistance, i.e., relapse within one year. Furthermore, coccoid forms may colonize and infect the gastric mucosa in animal models and induce specific antibodies in animals and humans. Their detection is hard, since they are not culturable. Techniques, such as electron microscopy, polymerase chain reaction, loop-mediated isothermal amplification, flow cytometry and metagenomics, are promising even if current evidence is limited. Among the options for the treatment, some strategies have been suggested, such as a very high proton pump inhibitor dose, high-dose dual therapy, N-acetycysteine, linolenic acid and vonoprazan. These clinical, diagnostic and therapeutic uncertainties will represent fascinating challenges in the future. |
format | Online Article Text |
id | pubmed-7345126 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-73451262020-07-09 The Puzzle of Coccoid Forms of Helicobacter pylori: Beyond Basic Science Ierardi, Enzo Losurdo, Giuseppe Mileti, Alessia Paolillo, Rosa Giorgio, Floriana Principi, Mariabeatrice Di Leo, Alfredo Antibiotics (Basel) Review Helicobacter pylori (H. pylori) may enter a non-replicative, non-culturable, low metabolically active state, the so-called coccoid form, to survive in extreme environmental conditions. Since coccoid forms are not susceptible to antibiotics, they could represent a cause of therapy failure even in the absence of antibiotic resistance, i.e., relapse within one year. Furthermore, coccoid forms may colonize and infect the gastric mucosa in animal models and induce specific antibodies in animals and humans. Their detection is hard, since they are not culturable. Techniques, such as electron microscopy, polymerase chain reaction, loop-mediated isothermal amplification, flow cytometry and metagenomics, are promising even if current evidence is limited. Among the options for the treatment, some strategies have been suggested, such as a very high proton pump inhibitor dose, high-dose dual therapy, N-acetycysteine, linolenic acid and vonoprazan. These clinical, diagnostic and therapeutic uncertainties will represent fascinating challenges in the future. MDPI 2020-05-31 /pmc/articles/PMC7345126/ /pubmed/32486473 http://dx.doi.org/10.3390/antibiotics9060293 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Ierardi, Enzo Losurdo, Giuseppe Mileti, Alessia Paolillo, Rosa Giorgio, Floriana Principi, Mariabeatrice Di Leo, Alfredo The Puzzle of Coccoid Forms of Helicobacter pylori: Beyond Basic Science |
title | The Puzzle of Coccoid Forms of Helicobacter pylori: Beyond Basic Science |
title_full | The Puzzle of Coccoid Forms of Helicobacter pylori: Beyond Basic Science |
title_fullStr | The Puzzle of Coccoid Forms of Helicobacter pylori: Beyond Basic Science |
title_full_unstemmed | The Puzzle of Coccoid Forms of Helicobacter pylori: Beyond Basic Science |
title_short | The Puzzle of Coccoid Forms of Helicobacter pylori: Beyond Basic Science |
title_sort | puzzle of coccoid forms of helicobacter pylori: beyond basic science |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7345126/ https://www.ncbi.nlm.nih.gov/pubmed/32486473 http://dx.doi.org/10.3390/antibiotics9060293 |
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