PEPTIC-ULCER PATHOGENESIS

Helicobacter pylori has been established as a key factor in the multi-factorial complex of ulcer pathogenesis. The most striking argument in favour of this still comes from the clinical observation that eradication of H. pylori infection cures ulcer disease. The pathogenic elements by which H. pylori contributes to ulcer formation are alterations in the gastric physiology (acid secretion), and complex interactions with the mucosal barrier. Most evidence indicates that the final event of ulceration may depend primarily on host-related response mechanisms to the infection. However, strains isolated from patients with duodenal ulcer do appear to have some features with an 'ulcerogenic' potential. Recent findings on H. pylori-induced mucosal injuries and their relationship to ulcer disease are the scope of this review.