Key host–pathogen interactions for designing novel interventions against Helicobacter pylori

Helicobacter pylori can persist in the stomach of infected individuals for life, in the face of chronic inflammation and low pH. Efforts to develop vaccines have largely failed and, in the wake of emerging antibiotic resistance, novel therapeutic approaches must be considered. This review will discuss recent salient findings of host factors that modulate inflammatory responses to H. pylori with the aim of harnessing this knowledge for developing novel therapeutics. In addition, new approaches to vaccine development will be reviewed. Ultimately, the development of efficacious therapeutic interventions will likely need to consider host–pathogen interactions to enhance host immunity and circumvent bacterial evasion strategies.

► Complex host–pathogen interactions determine Helicobacter pylori disease outcome.
► Novel therapies should target multiple molecules to increase efficacy.
► The best drugs or vaccines will also reduce inflammation associated with infection.
► Development of novel, immunomodulatory adjuvants will lead to improved vaccines.