Immunotherapeutic Strategies Against H. pylori

Helicobacter pylori infection represents a significant global health burden, affecting approximately half of the world’s population and serving as a major causative factor in a spectrum of gastrointestinal pathologies, including chronic gastritis, peptic ulcers, and gastric cancer. For decades, conventional eradication regimens have primarily relied on antibiotic-based therapies. However, the escalating prevalence of antibiotic resistance has severely compromised their efficacy, leading to increasing treatment failures and underscoring the critical need for novel nonantibiotic alternatives. In recent years, immunotherapy, which aims to harness or modulate the host’s immune system to combat disease, has emerged as a revolutionary paradigm, achieving considerable success in oncology and providing a new strategic perspective for the management of H. pylori infection. This chapter systematically reviews and synthesizes the current applications of immunotherapy against H. pylori, categorizing them into two main pillars: active immunization strategies (e.g., various vaccine platforms) and immunomodulatory approaches (e.g., pattern recognition receptor (PRR) agonists, host defense peptides, and probiotics). We delve into the detailed mechanisms of action, present recent preclinical and clinical research advances, and discuss the challenges and future directions in translating these promising immune-based strategies into clinical practice, with the ultimate goal of overcoming antibiotic resistance.