{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T22:00:55Z","timestamp":1784757655433,"version":"3.55.0"},"reference-count":70,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T00:00:00Z","timestamp":1706745600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Instituto Oncol\u00f3gico Fundaci\u00f3n Arturo L\u00f3pez P\u00e9rez","award":["ANID-FONDECYT Regular 1221415"],"award-info":[{"award-number":["ANID-FONDECYT Regular 1221415"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Helicobacter pylori (H. pylori) is responsible for causing chronic gastritis, which can cause peptic ulcer and premalignant lesions such as atrophic gastritis, intestinal metaplasia, and dysplasia, with the risk of developing gastric cancer. Recent data describe that H. pylori colonizes the gastric mucosa of more than 50% of the world\u2019s population; however, this bacterium has been described as infecting the human population since its prehistory. This review focuses on the populations and subpopulations of H. pylori, differentiated by the polymorphisms present in their constitutive and virulence genes. These genes have spread and associated with different human populations, showing variability depending on their geographical distribution, and have evolved together with the human being. The predominant genotypes worldwide, Latin America and Chile, are described to understand the genetic diversity and pathogenicity of H. pylori in different populations and geographic regions. The high similarity in the sequence of virulence genes between H. pylori strains present in Peruvian and Spanish natives in Latin America suggests a European influence. The presence of cagA-positive strains and vacA s1 m1 allelic variants is observed with greater prevalence in Chilean patients with more severe gastrointestinal diseases and is associated with its geographical distribution. These findings highlight the importance of understanding the genetic diversity of H. pylori in different regions of the world for a more accurate assessment of the risk of associated diseases and their potential impact on health.<\/jats:p>","DOI":"10.3390\/ijms25031761","type":"journal-article","created":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T08:44:08Z","timestamp":1706777048000},"page":"1761","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Historical and Molecular Perspectives on the Presence of Helicobacter pylori in Latin America: A Niche to Improve Gastric Cancer Risk Assessment"],"prefix":"10.3390","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6345-7054","authenticated-orcid":false,"given":"Roxana","family":"Gonz\u00e1lez-Stegmaier","sequence":"first","affiliation":[{"name":"Traslational Medicine Laboratory, Instituto Oncol\u00f3gico Fundaci\u00f3n Arturo L\u00f3pez P\u00e9rez, Santiago 7500000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Aguila-Torres","sequence":"additional","affiliation":[{"name":"Laboratorio de Microbiolog\u00eda Molecular, Escuela de Tecnolog\u00eda M\u00e9dica, Universidad Austral de Chile, Puerto Montt 5480000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0080-2444","authenticated-orcid":false,"given":"Franz","family":"Villarroel-Esp\u00edndola","sequence":"additional","affiliation":[{"name":"Traslational Medicine Laboratory, Instituto Oncol\u00f3gico Fundaci\u00f3n Arturo L\u00f3pez P\u00e9rez, Santiago 7500000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1208","DOI":"10.1002\/jcp.27114","article-title":"Global estimate of gastric cancer in Helicobacter pylori-infected population: A systematic review and meta-analysis","volume":"234","author":"Pormohammad","year":"2019","journal-title":"J. Cell. Physiol."},{"key":"ref_2","unstructured":"IARC (1994). Schistosomes, Liver Flukes and Helicobacter pylori, IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, No. 61."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/S1470-2045(09)70096-8","article-title":"A review of human carcinogens\u2014Part B: Biological agents","volume":"10","author":"Bouvard","year":"2009","journal-title":"Lancet Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1097\/00008480-199802000-00005","article-title":"Helicobacter pylori infection in children","volume":"10","author":"Jones","year":"1998","journal-title":"Curr. Opin. Pediatr."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/S0140-6736(75)90498-5","article-title":"A model for gastric cancer epidemiology","volume":"2","author":"Correa","year":"1975","journal-title":"Lancet"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1111\/j.1751-2980.2011.00550.x","article-title":"The gastric precancerous cascade","volume":"13","author":"Correa","year":"2012","journal-title":"J. Dig. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.humpath.2004.12.008","article-title":"Staging and grading of chronic gastritis","volume":"36","author":"Rugge","year":"2005","journal-title":"Hum. Pathol."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Battista, S., Ambrosio, M.R., Limarzi, F., Gallo, G., and Saragoni, L. (2021). Molecular Alterations in Gastric Preneoplastic Lesions and Early Gastric Cancer. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22136652"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Jones, K.R., Whitmire, J.M., and Merrell, D.S. (2010). A Tale of Two Toxins: Helicobacter Pylori CagA and VacA Modulate Host Pathways that Impact Disease. Front. Microbiol., 1.","DOI":"10.3389\/fmicb.2010.00115"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"955","DOI":"10.2217\/fmb.15.32","article-title":"Composition, structure and function of the Helicobacter pylori cag pathogenicity island encoded type IV secretion system","volume":"10","author":"Backert","year":"2015","journal-title":"Future Microbiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"14428","DOI":"10.1073\/pnas.222375399","article-title":"Biological activity of the Helicobacter pylori virulence factor CagA is determined by variation in the tyrosine phosphorylation sites","volume":"99","author":"Higashi","year":"2002","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1046\/j.1365-2958.2002.02781.x","article-title":"c-Src\/Lyn kinases activate Helicobacter pylori CagA through tyrosine phosphorylation of the EPIYA motifs","volume":"43","author":"Stein","year":"2002","journal-title":"Mol. Microbiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1016\/j.chom.2014.02.008","article-title":"Helicobacter pylori CagA and gastric cancer: A paradigm for hit-and-run carcinogenesis","volume":"15","author":"Hatakeyama","year":"2014","journal-title":"Cell Host Microbe"},{"key":"ref_14","first-page":"2111","article-title":"Infection with Helicobacter pylori strains possessing cagA is associated with an increased risk of developing adenocarcinoma of the stomach","volume":"55","author":"Blaser","year":"1955","journal-title":"Cancer Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1636","DOI":"10.1053\/j.gastro.2003.08.033","article-title":"Meta-analysis of the relationship between cagA seropositivity and gastric cancer","volume":"125","author":"Huang","year":"2003","journal-title":"Gastroenterology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1016\/j.micinf.2011.03.011","article-title":"Pathophysiological functions of the CagA oncoprotein during infection by Helicobacter pylori","volume":"13","year":"2011","journal-title":"Microbes Infect."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Thi Huyen Trang, T., Thanh Binh, T., and Yamaoka, Y. (2016). Relationship between vacA Types and Development of Gastroduodenal Diseases. Toxins, 8.","DOI":"10.3390\/toxins8060182"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"17771","DOI":"10.1074\/jbc.270.30.17771","article-title":"Mosaicism in vacuolating cytotoxin alleles of Helicobacter pylori. Association of specific vacA types with cytotoxin production and peptic ulceration","volume":"270","author":"Atherton","year":"1995","journal-title":"J. Biol. Chem."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"3278","DOI":"10.1128\/JB.182.11.3278-3280.2000","article-title":"Natural diversity in the N terminus of the mature vacuolating cytotoxin of Helicobacter pylori determines cytotoxin activity","volume":"182","author":"Letley","year":"2000","journal-title":"J. Bacteriol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1111\/j.1469-0691.2009.02769.x","article-title":"The association of vacA genotype and Helicobacter pylori-related disease in Latin American and African populations","volume":"15","author":"Sugimoto","year":"2009","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1002\/ijc.33588","article-title":"Cancer statistics for the year 2020: An overview","volume":"149","author":"Ferlay","year":"2021","journal-title":"Int. J. Cancer"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. Clin."},{"key":"ref_23","unstructured":"GLOBOCAN (2023, December 19). Cancer Incidence and Mortality Worldwide: IARC International Agency for Research on Cancer. Available online: https:\/\/gco.iarc.fr\/today\/data\/factsheets\/populations\/152-chile-fact-sheets.pdf."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Moodley, Y., Linz, B., Bond, R.P., Nieuwoudt, M., Soodyall, H., Schlebusch, C.M., Bernh\u00f6ft, S., Hale, J., Suerbaum, S., and Mugisha, L. (2012). Age of the association between Helicobacter pylori and man. PLoS Pathog., 8.","DOI":"10.1371\/journal.ppat.1002693"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1038\/nature05562","article-title":"An African origin for the intimate association between humans and Helicobacter pylori","volume":"445","author":"Linz","year":"2007","journal-title":"Nature"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1582","DOI":"10.1126\/science.1080857","article-title":"Traces of human migrations in Helicobacter pylori populations","volume":"299","author":"Falush","year":"2003","journal-title":"Science"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1126\/science.1166083","article-title":"The peopling of the Pacific from a bacterial perspective","volume":"323","author":"Moodley","year":"2009","journal-title":"Science"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"3210","DOI":"10.1128\/JB.182.11.3210-3218.2000","article-title":"Differences in genotypes of Helicobacter pylori from different human populations","volume":"182","author":"Kersulyte","year":"2000","journal-title":"J. Bacteriol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1016\/S0016-5085(99)70065-X","article-title":"Geographic distribution of vacA allelic types of Helicobacter pylori","volume":"116","author":"Figueiredo","year":"1999","journal-title":"Gastroenterology"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Camorlinga-Ponce, M., Perez-Perez, G., Gonzalez-Valencia, G., Mendoza, I., Pe\u00f1aloza-Espinosa, R., Ramos, I., Kersulyte, D., Reyes-Leon, A., Romo, C., and Granados, J. (2011). Helicobacter pylori genotyping from American indigenous groups shows novel Amerindian vacA and cagA alleles and Asian, African and European admixture. PLoS ONE, 6.","DOI":"10.1371\/journal.pone.0027212"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Kersulyte, D., Kalia, A., Gilman, R.H., Mendez, M., Herrera, P., Cabrera, L., Velapati\u00f1o, B., Balqui, J., Paredes Puente de la Vega, F., and Rodriguez Ulloa, C.A. (2010). Helicobacter pylori from Peruvian amerindians: Traces of human migrations in strains from remote Amazon, and genome sequence of an Amerind strain. PLoS ONE, 5.","DOI":"10.1371\/journal.pone.0015076"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Mu\u00f1oz-Ram\u00edrez, Z.Y., Mendez-Tenorio, A., Kato, I., Bravo, M.M., Rizzato, C., Thorell, K., Torres, R., Aviles-Jimenez, F., Camorlinga, M., and Canzian, F. (2017). Whole Genome Sequence and Phylogenetic Analysis Show Helicobacter pylori Strains from Latin America Have Followed a Unique Evolution Pathway. Front. Cell Infect. Microbiol., 7.","DOI":"10.3389\/fcimb.2017.00050"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Thorell, K., Hosseini, S., Palacios Gonz\u00e1les, R.V., Chaotham, C., Graham, D.Y., Paszat, L., Rabeneck, L., Lundin, S.B., Nookaew, I., and Sj\u00f6ling, \u00c5. (2016). Identification of a Latin American-specific BabA adhesin variant through whole genome sequencing of Helicobacter pylori patient isolates from Nicaragua. BMC Evol. Biol., 16.","DOI":"10.1186\/s12862-016-0619-y"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"3001","DOI":"10.1128\/JCM.37.9.3001-3004.1999","article-title":"Colonization of Mexican patients by multiple Helicobacter pylori strains with different vacA and cagA genotypes","volume":"37","author":"Cravioto","year":"1999","journal-title":"J. Clin. Microbiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1038\/s41396-020-00758-0","article-title":"A 500-year tale of co-evolution, adaptation, and virulence: Helicobacter pylori in the Americas","volume":"15","author":"Pascoe","year":"2021","journal-title":"ISME J."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"6366","DOI":"10.3748\/wjg.v11.i40.6366","article-title":"Helicobacter pylori vacA s1a and s1b alleles from clinical isolates from different regions of Chile show a distinct geographic distribution","volume":"11","author":"Diaz","year":"2005","journal-title":"World J. Gastroenterol."},{"key":"ref_37","first-page":"981","article-title":"Genotipificaci\u00f3n de aislados cl\u00ednicos de Helicobacter pylori en base a genes asociados a virulencia cagA, vacA y babA2. Primer aislamiento de una cepa babA2 positiva en pacientes chilenos [Genotypying of clinical isolates of Helicobacter pylori by cagA, vacA and babA2 virulence associated genes. First detection of a babA2 positive strain in Chilean patients]","volume":"134","author":"Barra","year":"2006","journal-title":"Rev. Med Chil"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2597","DOI":"10.1128\/JCM.36.9.2597-2603.1998","article-title":"Expanding allelic diversity of Helicobacter pylori vacA","volume":"36","author":"Figueiredo","year":"1998","journal-title":"J. Clin. Microbiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1128\/iai.63.1.94-98.1995","article-title":"Analysis of expression of CagA and VacA virulence factors in 43 strains of Helicobacter pylori reveals that clinical isolates can be divided into two major types and that CagA is not necessary for expression of the vacuolating cytotoxin","volume":"63","author":"Xiang","year":"1995","journal-title":"Infect. Immun."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"15107","DOI":"10.1073\/pnas.242574599","article-title":"East Asian genotypes of Helicobacter pylori strains in Amerindians provide evidence for its ancient human carriage","volume":"99","author":"Ghose","year":"2002","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2274","DOI":"10.1128\/JCM.37.7.2274-2279.1999","article-title":"Relationship between Helicobacter pylori iceA, cagA, and vacA status and clinical outcome: Studies in four different countries","volume":"37","author":"Yamaoka","year":"1999","journal-title":"J. Clin. Microbiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/S0014-5793(02)02617-0","article-title":"Helicobacter pylori in North and South America before Columbus","volume":"517","author":"Yamaoka","year":"2002","journal-title":"FEBS Lett."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Thorell, K., Yahara, K., Berthenet, E., Lawson, D.J., Mikhail, J., Kato, I., Mendez, A., Rizzato, C., Bravo, M.M., and Suzuki, R. (2017). Rapid evolution of distinct Helicobacter pylori subpopulations in the Americas. PLoS Genet., 13.","DOI":"10.1371\/journal.pgen.1006730"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"8184","DOI":"10.1038\/s41467-023-43562-y","article-title":"The Helicobacter pylori Genome Project: Insights into H. pylori population structure from analysis of a worldwide collection of complete genomes","volume":"14","author":"Thorell","year":"2023","journal-title":"Nat. Commun."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Faundez, G., Troncoso, M., and Figueroa, G. (2002). cagA and vacA in strains of Helicobacter pylori from ulcer and non-ulcerative dyspepsia patients. BMC Gastroenterol., 2.","DOI":"10.1186\/1471-230X-2-20"},{"key":"ref_46","first-page":"1147","article-title":"Helicobacter pylori: An\u00e1lisis de cagA y genotipificaci\u00f3n de vacA en Chile. Detecci\u00f3n de una cepa s2\/m1 [Helicobacter pylori: cagA analysis and vacA genotyping in Chile. Detection of a s2\/m1 strain]","volume":"129","author":"Kawaguchi","year":"2001","journal-title":"Rev. Med Chil"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"652","DOI":"10.3109\/00365548.2011.572909","article-title":"High prevalence of virulence-associated genotypes in Helicobacter pylori clinical isolates in the Region del Maule, Chile","volume":"43","author":"Romero","year":"2011","journal-title":"Scand. J. Infect. Dis."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1007\/BF02098478","article-title":"Prevalence of immunoglobulin G antibodies to Helicobacter pylori in Chilean individuals","volume":"12","author":"Figueroa","year":"1993","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1093\/dote\/10.1.38","article-title":"Prevalence of Helicobacter pylori infection in 190 control subjects and in 236 patients with gastroesophageal reflux, erosive esophagitis or Barrett\u2019s esophagus","volume":"10","author":"Csendes","year":"1997","journal-title":"Dis. Esophagus"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"259","DOI":"10.4067\/S0034-98872000000300002","article-title":"Helicobacter pylori y gastritis cr\u00f3nica: Relaci\u00f3n entre infecci\u00f3n y actividad inflamatoria en poblaci\u00f3n de alto riesgo de c\u00e1ncer g\u00e1strico [Helicobacter pylori and chronic gastritis: Relationship between infection and inflammatory activity in a high risk population for gastric cancer]","volume":"128","author":"Araya","year":"2000","journal-title":"Rev. Med Chil"},{"key":"ref_51","first-page":"189","article-title":"Prevalencia de la infecci\u00f3n por Helicobacter pylori seg\u00fan ensayo de la ureasa en pacientes derivados a la Unidad de Endoscop\u00eda del Hospital Cl\u00ednico de la Universidad de Chile","volume":"18","author":"Toledo","year":"2007","journal-title":"Rev. Hosp. Cl\u00edn Univ. Chile"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"529","DOI":"10.4067\/S0034-98872010000500001","article-title":"Infecci\u00f3n por Helicobacter pylori en pacientes sintom\u00e1ticos con patolog\u00eda gastroduodenal benigna: An\u00e1lisis de 5.664 pacientes [Helicobacter pylori infection in symptomatic patients with benign gastroduodenal diseases: Analysis of 5.664 cases]","volume":"138","author":"Ortega","year":"2010","journal-title":"Rev. Med Chil"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1590\/1806-9282.60.04.008","article-title":"Helicobacter pylori infection and gastrointestinal symptoms on Chilean pregnant women","volume":"60","author":"Poveda","year":"2014","journal-title":"Rev. Assoc. Med Bras."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"596","DOI":"10.4067\/s0034-98872018000500596","article-title":"Prevalencia de cepas cagA-positivo en la regi\u00f3n de Coquimbo, determinada mediante nested-qPCR en muestras fecales [Frequency of CagA-positive Helicobacter pylori strains in 160 patients subjected to endoscopy]","volume":"146","author":"Wormwood","year":"2018","journal-title":"Rev. Med Chil"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Oporto, M., Pavez, M., Troncoso, C., Cerda, A., Hofmann, E., Sierralta, A., Rios, E., Coppelli, L., and Barrientos, L. (2019). Prevalence of Infection and Antibiotic Susceptibility of Helicobacter pylori: An Evaluation in Public and Private Health Systems of Southern Chile. Pathogens, 8.","DOI":"10.3390\/pathogens8040226"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Troncoso, C., Pavez, M., Cerda, A., Oporto, M., Villarroel, D., Hofmann, E., Rios, E., Sierralta, A., Copelli, L., and Barrientos, L. (2020). MALDI-TOF MS and 16S RNA Identification of Culturable Gastric Microbiota: Variability Associated with the Presence of Helicobacter pylori. Microorganisms, 8.","DOI":"10.3390\/microorganisms8111763"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1158\/1055-9965.EPI-06-0514","article-title":"Gastric cancer is related to early Helicobacter pylori infection in a high-prevalence country","volume":"16","author":"Ferreccio","year":"2007","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_58","first-page":"207","article-title":"Aumento de detecci\u00f3n de lesiones g\u00e1stricas premalignas mediante protocolo Sydney en comparaci\u00f3n con biopsias no protocolizadas","volume":"27","author":"Latorre","year":"2016","journal-title":"Gastroenterol. Latinoam."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1007\/s12253-018-0532-3","article-title":"Assessment of Gastritis and Gastric Cancer Risk in the Chilean Population Using the OLGA System","volume":"25","author":"Bellolio","year":"2019","journal-title":"Pathol. Oncol. Res."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Herrero, R., Heise, K., Acevedo, J., Cook, P., Gonzalez, C., Gahona, J., Cort\u00e9s, R., Collado, L., Beltr\u00e1n, M.E., and Cikutovic, M. (2020). Regional variations in Helicobacter pylori infection, gastric atrophy and gastric cancer risk: The ENIGMA study in Chile. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0237515"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1038\/nrc1433","article-title":"Oncogenic mechanisms of the Helicobacter pylori CagA protein","volume":"4","author":"Hatakeyama","year":"2004","journal-title":"Nat. Rev. Cancer"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1128\/JCM.36.4.944-948.1998","article-title":"Diversity of Helicobacter pylori vacA and cagA genes and relationship to VacA and CagA protein expression, cytotoxin production, and associated diseases","volume":"36","author":"Rudi","year":"1998","journal-title":"J. Clin. Microbiol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1038\/s41423-019-0339-5","article-title":"Molecular anatomy and pathogenic actions of Helicobacter pylori CagA that underpin gastric carcinogenesis","volume":"17","author":"Knight","year":"2020","journal-title":"Cell. Mol. Immunol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.1172\/JCI61143","article-title":"c-Src and c-Abl kinases control hierarchic phosphorylation and function of the CagA effector protein in Western and East Asian Helicobacter pylori strains","volume":"122","author":"Mueller","year":"2012","journal-title":"J. Clin. Investig."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1111\/j.1574-695X.1994.tb00438.x","article-title":"Suppression of human mononuclear cell response by Helicobacter pylori: Effects on isolated monocytes and lymphocytes","volume":"8","author":"Knipp","year":"1994","journal-title":"FEMS Immunol. Med. Microbiol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"4303","DOI":"10.1128\/IAI.68.7.4303-4311.2000","article-title":"Helicobacter pylori modulates lymphoepithelial cell interactions leading to epithelial cell damage through Fas\/Fas ligand interactions","volume":"68","author":"Wang","year":"2000","journal-title":"Infect. Immun."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1126\/science.1086871","article-title":"Helicobacter pylori vacuolating cytotoxin inhibits T lymphocyte activation","volume":"301","author":"Gebert","year":"2003","journal-title":"Science"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1084\/jem.187.1.135","article-title":"Selective inhibition of Ii-dependent antigen presentation by Helicobacter pylori toxin VacA","volume":"187","author":"Molinari","year":"1998","journal-title":"J. Exp. Med."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"3000","DOI":"10.4049\/jimmunol.176.5.3000","article-title":"Expression of B7-H1 on gastric epithelial cells: Its potential role in regulating T cells during Helicobacter pylori infection","volume":"176","author":"Das","year":"2006","journal-title":"J. Immunol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1111\/j.1365-2249.2010.04217.x","article-title":"Increased programmed death-ligand-1 expression in human gastric epithelial cells in Helicobacter pylori infection","volume":"161","author":"Wu","year":"2010","journal-title":"Clin. Exp. Immunol."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/25\/3\/1761\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:52:58Z","timestamp":1760104378000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/25\/3\/1761"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,1]]},"references-count":70,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,2]]}},"alternative-id":["ijms25031761"],"URL":"https:\/\/doi.org\/10.3390\/ijms25031761","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,1]]}}}