The fifth meeting in the successful series Helicobacter pylori: Basic Mechanisms to Clinical Cure took place in Maui, Hawaii, November 2002. The meeting focused on all current aspects of H. pylori research. Internationally acclaimed basic and clinical researchers explored, in depth, the novel information across the spectrum of H. pylori infection, the characteristics of the organism, the inflammatory and tissue modifying consequences, the overall impact of this infection on a global scale, and new therapeutic possibilities.
H. pylori infection, both in man and in the laboratory animal, has become a standard model to investigate fundamental problems in biology, such as microbial-host interactions, intracellular signalling, modulation of inflammation, mucosal atrophic metaplasia, and microbial resistance, to name just a few. The issues addressed in this book are grouped according to their leading theme. Topics include: the new Helicobacters, strain differences of H. pylori and their consequence on microbial-host interactions and the effects of H. pylori infection on the gastric mucosa. The role of H. pylori is explained in relation to: gastric carcinogenesis; gastroesophageal reflux disease; dyspepsia and long-term acid suppression. Eradication therapies are reviewed with respect to their global consequences and problems. The last two sections are devoted to a global update on therapeutic indications and finally on priorities for further research.
These proceedings accurately reflect the state-of-the-art presentations delivered by world experts. This latest volume will further enrich this top-class series on H. pylori infection.

The explosion of information on Helicobacter pylori-related disease, both in the basic sciences and in clinical medicine, has continued to progress at an unprecedented pace. In many instances H. pylori infection, both in man and in the laboratory animal, has become a model to investigate fundamental biological issues such as micro-organism host interactions, intracellular signalling, development of mucosal atrophy, mechanism of microbial resistance, disease modifying factors etc. In view of this bewildering flood of information, another meeting on H. pylori in the successful series "Basic mechanisms to clinical cure" was organized in January 1998 in San Diego, California, to define the "state-of-affairs" in H. pylori research at this time. The main objective was to integrate this information in a series of presentations and discussions between investigators and clinicians addressing all aspects of H. pylori research and to review the current position and future research directions. The format included presentations by world experts heavily involved in H. pylori research followed by in-depth discussion on intriguing or controversial issues. The presentations were grouped according to the leading theme: characteristics of the organism, mode of transmission, mechanisms of H. pylori-induced inflammation, causation of disturbances of gastric secretory and motor function, aspects of clinical presentation and management, problems related to H. pylori-associated gastric adenocarcinoma and MALT-lymphoma, novel aspects of antimicrobial therapy and vaccination. The chapters published in these proceedings accurately reflect the content of the presentations. These proceedings are testimony to the impact on basic science and clinical medicine of the H. pylori discovery.

Section I. Basic Bacteriology of H. pylori.- 1. In vivo models of gastric Helicobacter infections.- 2 H. pylori species heterogenicity.- 3 H. pylori urease.- 4 Basic bacteriology of H. pylori: H. pylori colonization factors.- Section II. Prevalence and Mechanisms of Spread of H. pylori.- 5 Epidemiology of H. pylori in Western countries.- 6 H. pylori in developing countries.- 7 Prevalence/disease correlates of H. pylori.- 8 Reinfection with H. pylori.- Section III. Mechanisms of H. pylori Induced Damage.- 9 Breakdown of the mucus layer by H. pylori.- 10 Decreased hydrophobicity of gastroduodenal mucosa due to H. pylori infection in man.- 11 Adherence and internalization of H. pylori by epithelial cells.- 12 Mechanisms of ammonia-induced gastric mucosal injury: role of glutathione and cysteine proteases.- 13 Lipopolysaccharide (LPS)-related damage by H. pylori.- 14 The cpn60 heat shock protein homologue of H. pylori.- 15 Gastric mucosal injury: interactions of mast cells, cytokines and nitric oxide.- 16 H. pylori supernatant contains a novel chemotactic factor for monocytes different from FMLP.- 17 H. pylori-induced neutrophil activation and production of toxic oxygen radicals.- 18 Polymorphonuclear leukocytes traffic into the gastric mucosa and through the gastric mucosal barrier in H. pylori infection: is that bad?.- 19 H. pylori vacuolating toxin.- 20 H. pylori alcohol dehydrogenase.- Section IV. Hormonal Disturbances in H. pylori Infection.- 21 Effect of H. pylori infection on gastrin and gastric acid secretion.- 22 H. pylori, gastrin and somatostatin.- 23 Parietal cell responsiveness in H. pylori infections.- 24 Role of bacterial amines in H. pylori-associated hypergastrinaemia.- 25 Do gastric mucosal nerves remodel in H. pylori gastritis?.- Section V. Immunological Response to H. pylori.- 26 Overview of the immune response to H. pylori.- 27 Specific H. pylori immune response.- 28 B cell responses in H. pylori infection.- 29 T cell subsets in H. pylori-associated gastritis.- 30 Down-regulation of the immune response to H. pylori.- 31 The clinical value of a saliva diagnostic assay for antibody to H. pylori.- Section VI. Gastroduodenal Inflammation in H. pylori Infection.- 32 Spectrum and implications of inflammation with H. pylori.- 33 'Hypertrophic' gastritis in H. pylori infection.- 34 Long-term consequences of H. pylori infection: time trends in H. pylori gastritis, gastric cancer and peptic ulcer disease.- 35 Determinants of gastritis phenotype in H. pylori infection.- 36 The ulcer-associated cell lineage (UACL): a newly-recognised pathway of gastrointestinal differentiation of importance in the natural healing of peptic ulcer disease.- Section VII. Determinants of Clinical Outcome of H. pylori Infection.- 37 Acute infection with H. pylori.- 38 H. pylori in asymptomatic people.- 39 Determinants of clinical outcome of H. pylori infection: duodenal ulcer.- 40 H. pylori and gastric ulcer disease.- 41 Functional dyspepsia and H. pylori: a controversial link.- 42 H. pylori and NSAIDs: a meta-analysis on interactions of acute gastroduodenal injury, gastric and duodenal ulcers and upper gastrointestinal symptoms.- Section VIII. Relationship of H. pylori Gastric Carcinogenesis and Lymphoma.- 43 H. pylori and gastric cancer: the significance of the problem.- 44 The ascorbic acid story.- 45 Role of bacterial overgrowth in gastric carcinogenesis.- 46 The role of PCR techniques in the epidemiology of H. pylori infections.- 47 Role of H. pylori in atrophic gastritis and intestinal metaplasia.- 48 H. pylori-associated gastric lymphoma.- 49 Animal models for Helicobacter-induced gastric and hepatic cancer.- 50 Flaws in H. pylori-related carcinogenesis hypothesis.- Section IX. Therapy of H. pylori Infection.- 51 Determinants of antimicrobial effectiveness in H. pylori gastritis.- 52 Mucosal antibiotic levels.- 53 H. pylori eradication.- 54 H. pylori resistance to antibiotics.- 55 The role of acid suppression in the treatment of H. p...

The impact of Helicobacter pylori on basic science and the clinical management of patients with the complications of this infection is bewildering. The explosion of new information both in the laboratory and at the bedside has progressed at an unprecedented rate. Our main objective in furthering this progress has been to integrate this new information and organize a series of top quality presentations and discussions between investigators and clinicians on all aspects of H. pylori research and to review the current position and future research directions. To that end, the second meeting Helicobacter pylori: Basic Mechanisms to Clinical Cure was organized in June 1996 in Ottawa, Canada, following the successful format of the first such meeting held in Amelia Island, Florida, in 1993. The meeting again focused on all timely aspects of H. pylori research. Internationally renowned basic and clinical scientists, all experts in their respective fields, explored in depth the spectrum of H. pylori infection and the related complications of gastritis, peptic ulcer, gastric cancer and lymphoma. The presentations covered: the genetic heterogeneity of the organism, including the expression of virulence factors determined by the genetic pathogenicity island; the intricate cascade of chemokines and cytokines leading to mucosal inflammation; the complexities of the mucosal immune response, favoring a slight Th1 over Th2 lymphocyte imbalance; the fundamental issue of the apparent paradox of the induction of both apoptosis and epithelial hyperproliferation; the pathophysiological consequences of gastric mucosal inflammation with respect to the elevation of gastrin and the acid secretory response; themechanisms leading to peptic ulcer disease, gastric carcinoma and gastric mucosa-associated lymphoid tissue (MALT) lymphoma; the established and novel therapeutic approaches to eradication and finally the prospects for successful therapeutic and preventative vaccination. The comprehensive manuscripts in this book of the proceedings of the meeting reflect the most up-to-date information and state of the art approaches to research and management of H. pylori infection and will provide an invaluable reference source.

The fourth meeting in the very successful series Helicobacter pylori: Basic Mechanisms to Clinical Cure was held on the island of Bermuda in late March 2000 and was sponsored by Axcan Pharma. This was only some two years after the third meeting in San Diego, and it seemed hardly possible that there would be so much new information. However, as the contributions in this volume testify, there was plenty of exciting new information with important implications for both understanding this infection and for clinical management. Some of this information was of a fundamental nature, such as the role of the acid sensitive ureI channel in regulating the influx of urea and the formation of transported ammonia back in the microbial perisplasmic space to neutralize acid; the observation of genetic polymorphism of the IL-1beta gene as an explanation of achlorhydria and gastric cancer risk in the first-degree relatives of gastric cancer patients; and the peculiar biochemical and physiological consequences of the genome of the microorganisms. The format of the meeting, with short fifteen-minute state-of-the-art presentations by world experts closely involved in Helicobacter research followed by ample time for panel discussions, was again followed this year. Traditional aspects included detailed study of the microbial characteristics, the novel Helicobacters, the interaction with the human host, the peculiarities of the inflammatory immune response, the short and long-term mucosal consequences, the effects on acid secretion, the problem of gastric malignancy, and the therapeutic possibilities. However, a series of short debates was introduced to highlight controversial issues, such as the pathogenic orcommensal role of the organism, the role of virulence factors, the characteristics of the inflammatory immune response, the reversibility of mucosal atrophy and metaplasia, and the primary or secondary role of quadruple therapy, to name just a few. This provocative approach was very successful and provided fuel for further in-depth discussions. These debates have been included in this book in the form of conventional manuscripts in order to maintain the shortest possible production time for the publication of the proceedings. Helicobacter pylori has come a long way since the first meeting in Amelia Island, in 1993, and the science of this organism and the understanding of the consequences of the infection have advanced our knowledge fundamentally and revolutionized our thinking about gastrointestinal disease. We now recognize the existence of more than thirty Helicobacter species, some of which may play a significant role in human disease. The experience gained through our investigation of H. pylori promises to make a significant contribution to the future exploration of the possible role of Helicobacter species in hepatic, biliary, and intestinal diseases.

Helicobacter pylori has attracted widening interest from basic scientists and clinical investigators and the information on this organism is increasing exponentially. It is now accepted that H. Pylori is the most important cause of chronic active gastritis. Furthermore, data have confirmed a marked reduction in the relapse rate of both duodenal and gastric ulcer after eradication of the organism. These important clinical observations have served as a strong stimulus to the investigation of the basic mechanisms involved in the pathogenesis of H. pylori-associated inflammation and the subsequent alterations of gastroduodenal function and gastric mucosal architecture. The book contains chapters by a multidisciplinary, international group of basic scientists and clinical investigators who focus on various microbiological aspects of H. pylori, on the role of H. pylori in peptic ulcer and gastric cancer, and the current status of therapy. The book contains the proceedings of the conference on `Helicobacter pylori: Basic Mechanisms to Clinical Cure', held at Amelia Island, Florida, U.S.A., on November 3--6, 1993.

The explosion of new information on Helicobacter pylori-related disease, both in the basic sciences and in clinical medicine, has continued to progress at an unprecedented pace. In many instances H. pylori infection, both in man and in the laboratory animal, has become a model to investigate fundamental biological issues such as micro-organism host interactions, intracellular signaling, development of mucosal atrophy, mechanism of microbial resistance, disease modifying factors etc. In view of this bewildering flood of new information, another meeting on H. pylori in the successful series Basic mechanisms to clinical cure' was organized in January 1998 in San Diego, California, to define the state-of-affairs' in H. pylori research at this time. The main objective was to integrate this new information in a series of top-quality presentations and discussions between investigators and clinicians addressing all aspects of H. pylori research and to review the current position and future research directions. The format included state-of-the-art presentations by world experts heavily involved in H. pylori research followed by in-depth discussion on intriguing or controversial issues. The presentations were grouped according to the leading theme: characteristics of the organism, mode of transmission, mechanisms of H. pylori-induced inflammation, causation of disturbances of gastric secretory and motor function, aspects of clinical presentation and management, problems related to H. pylori-associated gastric adenocarcinoma and MALT-lymphoma, novel aspects of antimicrobial therapy and vaccination. The meeting concluded with a synoptic agenda of suggested future studies for the microbiologist, the histopathologist and the clinician. The chapters published in these proceedings accurately reflect the content of the superb presentations. The reader will readily appreciate the excellent level of the cutting-edge' research which was described and discussed. These proceedings are another testimony to the enormous impact on basic science and clinical medicine of the H. pylori discovery. Although much was achieved, it is also readily apparent that many questions remain to be answered and many problems remain to be solved.

The impact of Helicobacter pylori on basic science and the clinical management of patients with the complications of this infection is bewildering. The explosion of new information both in the laboratory and at the bedside has progressed at an unprecedented rate. Our main objective in furthering this progress has been to integrate this new information and organize a series of top-quality presentations and discussions between investigators and clinicians on all aspects of H. pylori research and to review the current position and future research directions. To that end, the second meeting 'Helicobacter pylori: Basic Mechanisms to Clinical Cure' was organized in June 1996 in Ottawa, Canada, following the successful format of the first such meeting held in Amelia Island, Florida, in 1993. The meeting again focused on all timely aspects of H. pylori research. Internationally renowned basic and clinical scientists, all experts in their respective fields, explored in depth the spectrum of H. pylori infection and the related complications of gastritis, peptic ulcer, gastric cancer and lymphoma.

H. pylori infection, both in man and in the laboratory animal, has become a standard model to investigate fundamental problems in biology, such as microbial-host interactions, intracellular signalling, modulation of inflammation, mucosal atrophic metaplasia, and microbial resistance, to name just a few. The issues addressed in this book are grouped according to their leading theme. Topics include: the new Helicobacters, strain differences of H. pylori and their consequence on microbial-host interactions and the effects of H. pylori infection on the gastric mucosa. The role of H. pylori is explained in relation to: gastric carcinogenesis; gastroesophageal reflux disease; dyspepsia and long-term acid suppression. Eradication therapies are reviewed with respect to their global consequences and problems. The last two sections are devoted to a global update on therapeutic indications and finally on priorities for further research.
These proceedings accurately reflect the state-of-the-art presentations delivered by world experts. This latest volume will further enrich this top-class series on H. pylori infection.

The fourth meeting in the very successful series Helicobacter pylori: Basic Mechanisms to Clinical Cure was held on the island of Bermuda in late March 2000. This was only some two years after the third meeting in San Diego and it seemed hardly possible that there would be so much new information. However, as the contributions in this volume testify, there was plenty of exciting new information with important implications for both understanding this infection and for clinical management. Some of this information was of a fundamental nature, such as the role of the acid sensitive urel channel in regulating the influx of urea and the formation of ammonia transported back in the microbial periplasmic space to neutralize acid; the observation of genetic polymorphism of the IL-1 gene as an explanation of achlorhydria and gastric cancer risk in the first-degree relatives of gastric cancer patients; and the peculiar biochemical and physio logical consequences of the genome of the microorganisms. The format of the meeting, with short fifteen-minute state-of-the-art pre sentations by world experts closely involved in Helicobacter research fol lowed by ample time for panel discussions, was again followed this year. Traditional aspects included detailed study of the microbial characteristics, the novel Helicobacters, the interaction with the human host, the peculiarities of the inflammatory immune response, the short and long-term mucosal consequences, the effects on acid secretion, the problem of gastric malignancy and the therapeutic possibilities."