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Infeção por Helicobacter pylori e suas consequências clínicas
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Abstract(s)
A bactéria Helicobacter pylori ao longo das últimas décadas tornou-se muito importante devido à sua elevada capacidade de colonizar o estômago humano e levar ao desenvolvimento de patologias gástricas como a gastrite crónica, úlceras pépticas, linfoma de MALT e o adenocarcinoma gástrico. A patogénese de H. pylori é multifatorial e por isso vários fatores estão envolvidos, como fatores genéticos, ambientais, entre outros. O álcool, o tabaco, a alimentação e as diferentes condições socioeconómicas são também fatores que permitem o desenvolvimento de patologias gástricas.
A transmissão desta infeção é feita de diferentes formas, como gastro-oral, ora-oral, fecal-oral, iatrogénica e zoonóticas. Existem diversos fatores de risco para que ocorra a transmissão como a sobrelotação habitacional, infeção de outros membros família, ingestão de água contaminada ou alimentos, entre outros.
A bactéria H. pylori apresenta dois fatores de virulência, como o CagA e VacA que são responsáveis pelas possíveis alterações celulares e consequentemente desenvolvimento de células cancerígenas.
O diagnóstico e rastreio da infeção por H. pylori pode ser realizado através de dois métodos, ou seja, através de métodos invasivos (endoscopia) ou métodos não invasivos (teste respiratório da ureia), sendo de extrema importância a precisão do diagnóstico.
A imprevisibilidade das consequências de longo prazo da infeção por H. pylori e o desafio económico em erradicá-la é a razão pela qual a identificação em indivíduos de alto risco é crucial. Embora a erradicação da H. pylori seja uma das opções, a taxa de resistências a antibióticos tem vindo a aumentar, tornando-se assim no fator principal de falência do tratamento.
The bacterium Helicobacter pylori over the last decades has become very important due to its high capacity to colonize the human stomach and lead to the development of gastric pathologies such as chronic gastritis, peptic ulcers, MALT lymphoma and gastric adenocarcinoma. The pathogenesis of H. pylori is multifactorial and, therefore, several factors are involved, such as genetic and environmental factors, among others. Alcohol, tobacco, diet and different socioeconomic conditions are also factors that allow the development of gastric pathologies. The transmission of this infection is done in different ways, such as gastro-oral, oral-oral, fecal-oral, iatrogenic and zoonotic. There are several risk factors for transmission to occur, such as overcrowding in housing, infection of other family members, ingestion of contaminated water or food, among others. The H. pylori bacterium has two virulence factors, such as CagA and VacA, which are responsible for possible cell alterations and consequently the development of cancer cells. The diagnosis and screening of H. pylori infection can be carried out using two methods, that is, through invasive methods (endoscopy) or non-invasive methods (urea breath test), with diagnostic accuracy being of utmost importance. The unpredictability of the long-term consequences of H. pylori infection and the economic challenge of eradicating it is why identification in high-risk individuals is crucial. Although eradication of H. pylori is one of the options, the rate of antibiotic resistance has been increasing, making it the main factor in treatment failure.
The bacterium Helicobacter pylori over the last decades has become very important due to its high capacity to colonize the human stomach and lead to the development of gastric pathologies such as chronic gastritis, peptic ulcers, MALT lymphoma and gastric adenocarcinoma. The pathogenesis of H. pylori is multifactorial and, therefore, several factors are involved, such as genetic and environmental factors, among others. Alcohol, tobacco, diet and different socioeconomic conditions are also factors that allow the development of gastric pathologies. The transmission of this infection is done in different ways, such as gastro-oral, oral-oral, fecal-oral, iatrogenic and zoonotic. There are several risk factors for transmission to occur, such as overcrowding in housing, infection of other family members, ingestion of contaminated water or food, among others. The H. pylori bacterium has two virulence factors, such as CagA and VacA, which are responsible for possible cell alterations and consequently the development of cancer cells. The diagnosis and screening of H. pylori infection can be carried out using two methods, that is, through invasive methods (endoscopy) or non-invasive methods (urea breath test), with diagnostic accuracy being of utmost importance. The unpredictability of the long-term consequences of H. pylori infection and the economic challenge of eradicating it is why identification in high-risk individuals is crucial. Although eradication of H. pylori is one of the options, the rate of antibiotic resistance has been increasing, making it the main factor in treatment failure.
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Keywords
Helicobacter pylori Patologias gástricas Neoplasia gástrica Infeção Tratamento Helicobacter pylori Gastric pathologies Gastric neoplasia Infection Diagnosis Treatment