© The Author 2006. Published by Oxford University Press.
EDITORIAL |
Helicobacter pylori Infection: Mainly Foe but Also Friend?
Affiliations of authors: Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (ON); International Epidemiology Institute, Rockville, MD (WJB); Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (WJB)
Correspondence to: Olof Nyrén, MD, PhD, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Box 281, SE-171 77 Stockholm, Sweden (e-mail: olof.nyren@ki.se).
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The discovery of Helicobacter pylori revolutionized peptic ulcer treatment and justifiably led to the awarding of last year's Nobel Prize to Robin Warren and Barry Marshall. H. pylori eradication therapy is associated with three- to fivefold higher success rates in preventing duodenal and gastric ulcer recurrences compared with placebo and is superior to pharmacologic acid suppression in duodenal ulcer healing (1). Consequently, elimination of H. pylori infection in peptic ulcer patients is by no means controversial.
During the past 15 years, numerous observational studies of various designs have also demonstrated a positive association between the presence of anti–H. pylori antibodies and the risk of stomach cancer. The literature on this association has become so extensive that the first review of published meta-analyses is now available (2). Each of the six meta-analyses included in that review showed that serologic evidence of H. pylori infection
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