In the rapidly evolving field of Helicobacter infection new data on pathogenetic and pathophysiological mechanism have appeared. New methods which will be more sensitive and specific in the diagnosis of the infection are being developed and in this proceedings the first attempt using PCR technology is published. From the clinical point of view, a challenging aspect that needs clarification, is the observation which suggests an appearance of a correlation between the presence of the bacteria and abdominal pain and other symptoms in children whereas in old age no such correlation is evident. The relationship of H. pylori and gastric cancer is studied with histopathological data and epidemiological approaches. On the treatment side schemes using short courses and new antibiotic combinations are being investigated and preliminary data are reported.

In the rapidly evolving field of Helicobacter infection new data on pathogenetic and pathophysiological mechanism have appeared. New methods which will be more sensitive and specific in the diagnosis of the infection are being developed and in this proceedings the first attempt using PCR technology is published. From the clinical point of view, a challenging aspect that needs clarification, is the observation which suggests an appearance of a correlation between the presence of the bacteria and abdominal pain and other symptoms in children whereas in old age no such correlation is evident. The relationship of H. pylori and gastric cancer is studied with histopathological data and epidemiological approaches. On the treatment side schemes using short courses and new antibiotic combinations are being investigated and preliminary data are reported.

A century ago the Italian pathologist Bizzozero described the relationships between spiral bacteria and the mammalian gastro intestinal tract. Since 1982, when Helicobacter pylori was discovered, gastroduodenal disease have been completely revised as a con sequence of the results of basic and clinical research in this field. Progress in understanding the pathogenesis of this bacterium has been made by studying H. pylori infection in animal models. More specific diagnostic tools have been developed using new molecular biology techniques. Future trends are directed towards preparing a specific H. pylori vaccine. A new classification for gastritis, the Sydney System, including H. pylori gastritis, was proposed in 1990. As concerns the clinical approach to peptic ulcer disease in the 1990's, the majority of authors agree on the importance of H. pylori eradication. Moreover, recent clinical studies suggest that H. pylori infection can be associated with other gastroduodenal diseases, such as non ulcer dyspepsia and gastric cancer. Multicenter trials to standardize serological methods and evaluate the efficacy of new antimicrobial therapy schedules are planned throughout different European countries. The fourth Workshop of the European Helicobacter Pylori Study Group was held in Bologna, Italy, in November 1991. Two years before Bologna University celebrated its ninth centennial, giving evidence of being the oldest University in the modern world. Thus the H. pylori story that has continued for more than a century has been discussed once again at the University with the oldest tradition in the world.

This book gathers a wealth of contributions on the virulence factors and pathogenic mechanism of Helicobacter pylori, prepared by leading international experts. In addition, it explores the epidemiology, diagnosis, treatment with drugs and probiotics, and prophylaxis by vaccination, reflecting the latest advances. H. pylori is a Gram negative microaerophilic bacterium that can produce various gastric diseases including gastritis, gastroduodenal ulceration, gastric cancer and gastric MALT lymphoma. Although efforts to combat H. pylori using a combination of proton pump inhibitor and several antimicrobial drugs have significantly decreased the burden of these gastric diseases, the microbial epidemiology and gastric pathogenesis following H. pylori infection are still not fully understood. Given its scope, the book offers a valuable resource not only for basic microbiologists, but also for researchers in the fields of pathology, biochemistry and genomics, as well as medical students/scientists.

I am delighted to be able to write the foreword for this new book on Helicobacter pylori by three pioneers in the field, Vlf West blom, Steven Czinn and John Nedrud. Because of their long experience in both basic and clinical aspects of H. pylori, the editors have been able to produce a volume which is authoritative and up to date in the science of H. pylori, while still being concise and interesting for the practicing physician or H. pylori novice. To achieve this, they have collected a very distinguished group of authors from within the Vnited States and around the world. The chapters are sequenced in approximately the same order as developments in H. pylori science over the past 15 years. The first chapter on the discovery of H. pylori is by Cliodna McNulty, who was the first person to culture the organism in Europe. The epidemiology is then described followed by the main clinical as sociations, which are gastritis and dyspepsia, peptic ulcers, can cers and lymphoma. This naturally leads to discussion of the laboratory aspects of H. pylori, especially the microbiology, in cluding essential information on antibiotic resistance patterns. Next, virulence and pathogenicity of H. pylori are explained as defined in studies using animal models, then by discussion of the metabolism of the organism. Finally, the interaction of the bac terium with the host immune systems is dealt with, including the implications of these findings as they relate to the development of future vaccines.

This book provides a detailed review of the most recent pathogenetic, diagnostic and therapeutic approaches in connection with Helicobacter pylori, along with priority areas in research and trends in clinical practice to address this significant pathogen acknowledged as the causative agent in a wide range of diseases, including gastric adenocarcinoma, MALT lymphoma and immune thrombocytopenic purpura (ITP). Medical authorities worldwide now recommend a “test and treat” strategy for this bacterial infection. Eradication therapy approaches range from general mass eradication therapy to tailor-made therapy for antibiotic-resistant refractory infection. In regions with high prevalence of H. pylori infection, the infection itself would be considered a major parameter to predict the risk of gastric adenocarcinoma development. The main interest has shifted recently to the risk stratification strategy for gastric cancer development and to the wide-ranging application of its serological prevention program. This book will benefit all gastroenterologists, hematologists, dermatologists, primary care doctors, epidemiologists, physicians who related with community hygiene, as well as basic scientists, particularly microbiologists, bacteriologists, pathologists, molecular biologists, biochemists, immunologists and oncologists.