Letter: does Helicobacter pylori infection limit the health effects of the Mediterranean diet?

EDITORS, In the recent thorough systematic review on the gastric microbiota in health and disease by Rajilic-Stojanovic et al, Helicobacter pylori infection remains the dominant risk factor for chronic gastritis, peptic ulcer and gastric adenocarcinoma.1 While the burden of these Helicobacter pylori-related diseases is substantial and developing antibiotic resistance increasingly risks hampering Helicobacter pylori eradication, vaccine development is not, at the moment, a strategic priority of the pharmaceutical industry.2 The recent in-depth study by Kumar et al., strongly limits the concern that eradication of the infection might increase the risk of oesophageal and proximal gastric adenocarcinoma.3 At the same time, evidence is emerging for a role of Helicobacter pylori in the pathophysiology of a much wider spectrum of diseases. This statement is illustrated in the following paragraph with a few selected references. [...