Published online Jan 28, 2022. doi: 10.3748/wjg.v28.i4.402
Peer-review started: March 20, 2021
First decision: June 14, 2021
Revised: June 21, 2021
Accepted: January 13, 2022
Article in press: January 13, 2022
Published online: January 28, 2022
Processing time: 307 Days and 10.4 Hours
The inflammatory pattern during Helicobacter pylori (H. pylori) infection is changeable and complex. During childhood, it is possible to observe a predominantly regulatory response, evidenced by high concentrations of key cytokines for the maintenance of Treg responses such as TGF-β1 and IL-10, in addition to high expression of the transcription factor FOXP3. On the other hand, there is a predominance of cytokines associated with the Th1 and Th17 responses among H. pylori-positive adults. In the last few years, the participation of the Th17 response in the gastric inflammation against H. pylori infection has been highlighted due to the high levels of TGF-β1 and IL-17 found in this infectious scenario, and growing evidence has supported a close relationship between this immune response profile and unfavorable outcomes related to the infection. Moreover, this cytokine profile might play a pivotal role in the effectiveness of anti-H. pylori vaccines. It is evident that age is one of the main factors influencing the gastric inflammatory pattern during the infection with H. pylori, and understanding the immune response against the bacterium can assist in the development of alternative prophylactic and therapeutic strategies against the infection as well as in the comprehension of the pathogenesis of the outcomes related to that microorganism.
Core Tip: Helicobacter pylori (H. pylori) is a bacterium acquired mainly in childhood that increases the risk of developing certain gastric diseases. However, the main complications are noticed predominantly in adulthood. This can be explained based on the gastric inflammatory pattern against the pathogen, which changes as long as the infected individual gets older, favoring, during childhood, the persistence of the infection and then, in adulthood, the gastric damage. This article discusses the factors that can influence the gastric inflammatory pattern in individuals infected with H. pylori.