{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T07:01:22Z","timestamp":1791874882964,"version":"4.3.4"},"reference-count":122,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T00:00:00Z","timestamp":1693180800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Gastric cancer ranks as the fifth-leading contributor to global cancer incidence and the fourth-highest in terms of cancer-related mortality. Helicobacter pylori (H. pylori) infection leads to inflammation and ulceration, atrophic and chronic gastritis, and eventually, increases the risk of developing gastric adenocarcinoma. In this paper, we delve into the combined impact of a high-salt diet (HSD) and concurrent H. pylori infection, which act as predisposing factors for gastric malignancy. A multitude of mechanisms come into play, fostering the development of gastric adenocarcinoma due to the synergy between an HSD and H. pylori colonization. These encompass the disruption of mucosal barriers, cellular integrity, modulation of H. pylori gene expression, oxidative stress induction, and provocation of inflammatory responses. On the whole, gastric cancer patients were reported to have a higher median sodium intake with respect to healthy controls. H. pylori infection constitutes an additional risk factor, with a particular impact on the population with the highest daily sodium intake. Consequently, drawing from epidemiological discoveries, substantial evidence suggests that diminishing salt intake and employing antibacterial therapeutics could potentially lower the susceptibility to gastric cancer among individuals.<\/jats:p>","DOI":"10.3390\/jpm13091325","type":"journal-article","created":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T10:46:00Z","timestamp":1693305960000},"page":"1325","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["High-Salt Diet Exacerbates H. pylori Infection and Increases Gastric Cancer Risks"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9502-0885","authenticated-orcid":false,"given":"Vyshnavy","family":"Balendra","sequence":"first","affiliation":[{"name":"Saint James School of Medicine, Park Ridge, IL 60068, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Amoroso","sequence":"additional","affiliation":[{"name":"Gastroenterology and Endoscopy Unit, Fondazione IRCCS C\u00e0 Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Galassi","sequence":"additional","affiliation":[{"name":"Oncology Unit, Fondazione IRCCS C\u00e0 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9012-3044","authenticated-orcid":false,"given":"Josephine","family":"Esposto","sequence":"additional","affiliation":[{"name":"Department of Environmental and Life Sciences, Trent University, Peterborough, ON K9L0G2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Bareggi","sequence":"additional","affiliation":[{"name":"Oncology Unit, Fondazione IRCCS C\u00e0 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennie","family":"Luu","sequence":"additional","affiliation":[{"name":"The University of the Incarnate Word School of Osteopathic Medicine, San Antonio, TX 78235, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9460-3296","authenticated-orcid":false,"given":"Lucia","family":"Scaramella","sequence":"additional","affiliation":[{"name":"Gastroenterology and Endoscopy Unit, Fondazione IRCCS C\u00e0 Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5435-1218","authenticated-orcid":false,"given":"Michele","family":"Ghidini","sequence":"additional","affiliation":[{"name":"Oncology Unit, Fondazione IRCCS C\u00e0 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"101404","DOI":"10.1016\/j.eclinm.2022.101404","article-title":"The current and future incidence and mortality of gastric cancer in 185 countries, 2020\u20132040: A population-based modelling study","volume":"47","author":"Morgan","year":"2022","journal-title":"eClinicalMedicine"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1097\/CM9.0000000000002626","article-title":"Global burden prediction of gastric cancer during demographic transition from 2020 to 2040","volume":"136","author":"Yan","year":"2023","journal-title":"Chin. Med. J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1111\/apt.12814","article-title":"Review article: The epidemiology and prevention of gastric cancer","volume":"40","author":"Fock","year":"2014","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"4483","DOI":"10.3748\/wjg.v20.i16.4483","article-title":"Characteristics of gastric cancer in Asia","volume":"20","author":"Rahman","year":"2014","journal-title":"World J. Gastroenterol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"917","DOI":"10.7314\/APJCP.2016.17.3.917","article-title":"Helicobacter pylori Infection and Dietary Factors Act Synergistically to Promote Gastric Cancer","volume":"17","author":"Raei","year":"2016","journal-title":"Asian Pac. J. Cancer Prev. APJCP"},{"key":"ref_6","first-page":"182","article-title":"Morphology of Helicobacter pylori as a result of peptidoglycan and cytoskeleton rearrangements","volume":"13","year":"2018","journal-title":"Prz. Gastroenterol."},{"key":"ref_7","first-page":"219","article-title":"Peptic Ulcer Disease and Helicobacter pylori infection","volume":"115","author":"Narayanan","year":"2018","journal-title":"Mo. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"12619","DOI":"10.1073\/pnas.95.21.12619","article-title":"Free recombination within Helicobacter pylori","volume":"95","author":"Suerbaum","year":"1998","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1038\/nrmicro1658","article-title":"Helicobacter pylori evolution and phenotypic diversification in a changing host","volume":"5","author":"Suerbaum","year":"2007","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Garc\u00eda-Ort\u00edz, M.V., Marsin, S., Arana, M.E., Gasparutto, D., Gu\u00e9rois, R., Kunkel, T.A., and Radicella, J.P. (2011). Unexpected role for Helicobacter pylori DNA polymerase I as a source of genetic variability. PLoS Genet., 7.","DOI":"10.1371\/journal.pgen.1002152"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"6262","DOI":"10.1038\/onc.2016.158","article-title":"Pathogenic Helicobacter pylori strains translocate DNA and activate TLR9 via the cancer-associated cag Type IV secretion system","volume":"1","author":"Varga","year":"2016","journal-title":"Oncogene"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1146\/annurev-micro-090110-102931","article-title":"Recombination and DNA repair in Helicobacter pylori","volume":"65","author":"Dorer","year":"2011","journal-title":"Annu. Rev. Microbiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"9","DOI":"10.4137\/CGast.S13760","article-title":"Virulence Factors of Helicobacter pylori: A Review","volume":"7","author":"Roesler","year":"2014","journal-title":"Clin. Med. Insights Gastroenterol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"92","DOI":"10.3389\/fcimb.2012.00092","article-title":"Vacuolating cytotoxin A (VacA), a key toxin for Helicobacter pylori pathogenesis","volume":"2","author":"Palframan","year":"2012","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.canlet.2008.11.016","article-title":"Helicobacter pylori virulence factors in gastric carcinogenesis","volume":"282","author":"Wen","year":"2009","journal-title":"Cancer Lett."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e00032-20","DOI":"10.1128\/IAI.00032-20","article-title":"Functional Properties of Helicobacter pylori VacA Toxin m1 and m2 Variants","volume":"88","author":"Caston","year":"2020","journal-title":"Infect. Immun."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2671","DOI":"10.1128\/IAI.00349-16","article-title":"CagA Phosphorylation in Helicobacter pylori-Infected B Cells Is Mediated by the Nonreceptor Tyrosine Kinases of the Src and Abl Families","volume":"84","author":"Krisch","year":"2016","journal-title":"Infect. Immun."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Ansari, S., and Yamaoka, Y. (2020). Helicobacter pylori Virulence Factor Cytotoxin-Associated Gene A (CagA)-Mediated Gastric Pathogenicity. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21197430"},{"key":"ref_19","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_20","doi-asserted-by":"crossref","first-page":"e1500315","DOI":"10.1126\/sciadv.1500315","article-title":"Structural basis of Lewis(b) antigen binding by the Helicobacter pylori adhesin BabA","volume":"1","author":"Hage","year":"2015","journal-title":"Sci. Adv."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1821","DOI":"10.1007\/s10096-020-03948-y","article-title":"Virulence of Helicobacter pylori outer membrane proteins: An updated review","volume":"39","author":"Xu","year":"2020","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis. Off. Publ. Eur. Soc. Clin. Microbiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"3782","DOI":"10.1128\/IAI.00364-09","article-title":"Outer membrane protein expression profile in Helicobacter pylori clinical isolates","volume":"77","author":"Odenbreit","year":"2009","journal-title":"Infect. Immun."},{"key":"ref_23","first-page":"146","article-title":"Role of food in environmental transmission of Helicobacter pylori","volume":"8","author":"Zamani","year":"2017","journal-title":"Casp. J. Intern. Med."},{"key":"ref_24","first-page":"26","article-title":"Epidemiology of gastric cancer: Global trends, risk factors and prevention","volume":"14","author":"Rawla","year":"2019","journal-title":"Prz. Gastroenterol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1038\/sj.bjc.6601511","article-title":"Salt and salted food intake and subsequent risk of gastric cancer among middle-aged Japanese men and women","volume":"90","author":"Tsugane","year":"2004","journal-title":"Br. J. Cancer"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"m2440","DOI":"10.1136\/bmj.m2440","article-title":"Sodium and health-concordance and controversy","volume":"369","author":"Cook","year":"2020","journal-title":"BMJ"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1017\/S000711452000032X","article-title":"Sources of dietary sodium and implications for a statewide salt reduction initiative in Victoria, Australia","volume":"123","author":"Bolton","year":"2020","journal-title":"Br. J. Nutr."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1007\/978-3-642-38007-5_6","article-title":"Dietary salt intake and risk of gastric cancer","volume":"159","author":"Galletti","year":"2014","journal-title":"Cancer Treat. Res."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Yoo, J.Y., Cho, H.J., Moon, S., Choi, J., Lee, S., Ahn, C., Yoo, K.Y., Kim, I., Ko, K.P., and Lee, J.E. (2020). Pickled Vegetable and Salted Fish Intake and the Risk of Gastric Cancer: Two Prospective Cohort Studies and a Meta-Analysis. Cancers, 12.","DOI":"10.3390\/cancers12040996"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"801228","DOI":"10.3389\/fnut.2021.801228","article-title":"Dietary Salt Intake and Gastric Cancer Risk: A Systematic Review and Meta-Analysis","volume":"8","author":"Wu","year":"2021","journal-title":"Front. Nutr."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"5980","DOI":"10.1038\/s41598-022-10014-4","article-title":"The burden and trend of gastric cancer and possible risk factors in five Asian countries from 1990 to 2019","volume":"12","author":"Ning","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"103374","DOI":"10.1016\/j.jprot.2019.05.002","article-title":"Effect of environmental salt concentration on the Helicobacter pylori exoproteome","volume":"202","author":"Caston","year":"2019","journal-title":"J. Proteom."},{"key":"ref_33","first-page":"4823","article-title":"High-salt induces gastric epithelial hyperplasia and parietal cell loss, and enhances Helicobacter pylori colonization in C57BL\/6 mice","volume":"59","author":"Fox","year":"1999","journal-title":"Cancer Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1093\/carcin\/17.3.401","article-title":"Cause and effect between concentration-dependent tissue damage and temporary cell proliferation in rat stomach mucosa by NaCl, a stomach tumor promoter","volume":"17","author":"Furihata","year":"1996","journal-title":"Carcinogenesis"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"669","DOI":"10.4161\/cbt.4.6.1734","article-title":"Intestinal metaplasia with a high salt diet induces epithelial proliferation and alters cell composition in the gastric mucosa of mice","volume":"4","author":"Xiao","year":"2005","journal-title":"Cancer Biol. Ther."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2397","DOI":"10.1097\/00004872-200412000-00023","article-title":"Salt intake and Helicobacter pylori infection","volume":"22","author":"Kountouras","year":"2004","journal-title":"J. Hypertens."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1097\/00008469-199403030-00003","article-title":"Helicobacter pylori: The link with gastric cancer","volume":"3","author":"Buset","year":"1994","journal-title":"Eur. J. Cancer Prev. Off. J. Eur. Cancer Prev. Organ. (ECP)"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.1158\/1055-9965.EPI-16-1024","article-title":"High Salt Intake Is Associated with Atrophic Gastritis with Intestinal Metaplasia","volume":"26","author":"Song","year":"2017","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.4049\/jimmunol.1700356","article-title":"Dietary Salt Exacerbates Experimental Colitis","volume":"199","author":"Tubbs","year":"2017","journal-title":"J. Immunol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.etap.2004.10.010","article-title":"Cytochrome P450 expression in rat gastric epithelium with intestinal metaplasia induced by high dietary NaCl levels","volume":"20","year":"2005","journal-title":"Environ. Toxicol. Pharmacol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1097\/MOG.0000000000000875","article-title":"Diet and carcinogenesis of gastric cancer","volume":"38","author":"Maddineni","year":"2022","journal-title":"Curr. Opin. Gastroenterol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1016\/0278-6915(91)90180-F","article-title":"Mean daily intake of volatile N-nitrosamines from foods and beverages in West Germany in 1989\u20131990","volume":"29","author":"Tricker","year":"1991","journal-title":"Food Chem. Toxicol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1079\/PHN2005884","article-title":"Intake and food sources of nitrites and N-nitrosodimethylamine in Spain","volume":"9","author":"Jakszyn","year":"2006","journal-title":"Public Health Nutr."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"4911","DOI":"10.3390\/nu7064911","article-title":"NO-Rich Diet for Lifestyle-Related Diseases","volume":"7","author":"Kobayashi","year":"2015","journal-title":"Nutrients"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1558","DOI":"10.1002\/ijc.21810","article-title":"High salt diets dose-dependently promote gastric chemical carcinogenesis in Helicobacter pylori-infected Mongolian gerbils associated with a shift in mucin production from glandular to surface mucous cells","volume":"119","author":"Kato","year":"2006","journal-title":"Int. J. Cancer"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Kim, S.R., Kim, K., Lee, S.A., Kwon, S.O., Lee, J.K., Keum, N., and Park, S.M. (2019). Effect of Red, Processed, and White Meat Consumption on the Risk of Gastric Cancer: An Overall and Dose-Response Meta-Analysis. Nutrients, 11.","DOI":"10.3390\/nu11040826"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"9872","DOI":"10.3390\/nu7125505","article-title":"Dietary Nitrates, Nitrites, and Nitrosamines Intake and the Risk of Gastric Cancer: A Meta-Analysis","volume":"7","author":"Song","year":"2015","journal-title":"Nutrients"},{"key":"ref_48","first-page":"1788","article-title":"Association Between Nitrite and Nitrate Intake and Risk of Gastric Cancer: A Systematic Review and Meta-Analysis","volume":"25","author":"Zhang","year":"2019","journal-title":"Med. Sci. Monit. Int. Med. J. Exp. Clin. Res."},{"key":"ref_49","first-page":"302","article-title":"Risk factors in gastric cancer","volume":"14","author":"Compare","year":"2010","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Toh, J.W.T., and Wilson, R.B. (2020). Pathways of Gastric Carcinogenesis, Helicobacter pylori Virulence and Interactions with Antioxidant Systems, Vitamin C and Phytochemicals. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21176451"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.niox.2017.06.001","article-title":"Effect of diet and gut environment on the gastrointestinal formation of N-nitroso compounds: A review","volume":"73","author":"Kobayashi","year":"2018","journal-title":"Nitric Oxide Biol. Chem."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"3646","DOI":"10.1016\/j.fct.2012.07.062","article-title":"Ingested nitrate and nitrite and stomach cancer risk: An updated review","volume":"50","author":"Bryan","year":"2012","journal-title":"Food Chem. Toxicol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1080\/01635589709514503","article-title":"Case-control study on influence of methionine, nitrite, and salt on gastric carcinogenesis in northern Italy","volume":"27","author":"Negri","year":"1997","journal-title":"Nutr. Cancer"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1093\/jnci\/55.1.101","article-title":"Effects in rats of sodium chloride on experimental gastric cancers induced by N-methyl-N-nitro-N-nitrosoguanidine or 4-nitroquinoline-1-oxide","volume":"55","author":"Tatematsu","year":"1975","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_55","first-page":"593","article-title":"Synergistic upregulation of inducible nitric oxide synthase and cyclooxygenase-2 in gastric mucosa of Mongolian gerbils by a high-salt diet and Helicobacter pylori infection","volume":"23","author":"Toyoda","year":"2008","journal-title":"Histol. Histopathol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1172\/JCI12672","article-title":"Helicobacter pylori genetic diversity and risk of human disease","volume":"107","author":"Blaser","year":"2001","journal-title":"J. Clin. Investig."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"e01869-15","DOI":"10.1128\/mBio.01869-15","article-title":"Helicobacter pylori Divers. Gastric Cancer Risk","volume":"7","author":"Cover","year":"2016","journal-title":"mBio"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"e00626-17","DOI":"10.1128\/IAI.00626-17","article-title":"High-Salt Conditions Alter Transcription of Helicobacter pylori Genes Encoding Outer Membrane Proteins","volume":"86","author":"Loh","year":"2018","journal-title":"Infect. Immun."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"4871","DOI":"10.1128\/IAI.00918-15","article-title":"Helicobacter pylori adaptation in vivo in response to a high-salt diet","volume":"83","author":"Loh","year":"2015","journal-title":"Infect. Immun."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"4100","DOI":"10.1128\/JB.01728-07","article-title":"Sodium chloride affects Helicobacter pylori growth and gene expression","volume":"190","author":"Gancz","year":"2008","journal-title":"J. Bacteriol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"4709","DOI":"10.1158\/0008-5472.CAN-06-4746","article-title":"Regulation of Helicobacter pylori cagA expression in response to salt","volume":"67","author":"Loh","year":"2007","journal-title":"Cancer Res."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"e4803","DOI":"10.7717\/peerj.4803","article-title":"Helicobacter pylori genetic diversification in the Mongolian gerbil model","volume":"6","author":"Beckett","year":"2018","journal-title":"PeerJ"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"e0042022","DOI":"10.1128\/iai.00420-22","article-title":"A Positively Selected fur-R88H Mutation Enhances Helicobacter pylori Fitness in a High-Salt Environment and Alters Fur-Dependent Regulation of Gene Expression","volume":"91","author":"Loh","year":"2023","journal-title":"Infect. Immun."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1228","DOI":"10.1002\/ijc.33678","article-title":"Exploring the interactions between Helicobacter pylori (Hp) infection and other risk factors of gastric cancer: A pooled analysis in the Stomach cancer Pooling (StoP) Project","volume":"149","author":"Collatuzzo","year":"2021","journal-title":"Int. J. Cancer"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"193","DOI":"10.5152\/eurasianjmed.2018.17397","article-title":"Reactive Oxygen Species: The Dual Role in Physiological and Pathological Conditions of the Human Body","volume":"50","author":"Bardaweel","year":"2018","journal-title":"Eurasian J. Med."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"8416763","DOI":"10.1155\/2017\/8416763","article-title":"Oxidative Stress: Harms and Benefits for Human Health","volume":"2017","author":"Pizzino","year":"2017","journal-title":"Oxidative Med. Cell. Longev."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"e13250","DOI":"10.1111\/cpr.13250","article-title":"The modulatory effect of high salt on immune cells and related diseases","volume":"55","author":"Li","year":"2022","journal-title":"Cell Prolif."},{"key":"ref_68","first-page":"89","article-title":"Salt is an oxidative stressor for gastric epithelial cells","volume":"64","author":"Tamura","year":"2013","journal-title":"J. Physiol. Pharmacol. Off. J. Pol. Physiol. Soc."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1016\/j.jcmgh.2017.02.002","article-title":"Oxidative Stress Resulting From Helicobacter pylori Infection Contributes to Gastric Carcinogenesis","volume":"3","author":"Butcher","year":"2017","journal-title":"Cell. Mol. Gastroenterol. Hepatol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"811258","DOI":"10.3389\/fmicb.2022.811258","article-title":"Helicobacter pylori-Mediated Oxidative Stress and Gastric Diseases: A Review","volume":"13","author":"Han","year":"2022","journal-title":"Front. Microbiol."},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Baj, J., Forma, A., Sitarz, M., Portincasa, P., Garruti, G., Krasowska, D., and Maciejewski, R. (2020). Helicobacter pylori Virulence Factors-Mechanisms of Bacterial Pathogenicity in the Gastric Microenvironment. Cells, 10.","DOI":"10.3390\/cells10010027"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1038\/s41598-018-37095-4","article-title":"VacA promotes CagA accumulation in gastric epithelial cells during Helicobacter pylori infection","volume":"9","author":"Abdullah","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1007\/s00535-009-0014-1","article-title":"Helicobacter pylori and gastric carcinogenesis","volume":"44","author":"Hatakeyama","year":"2009","journal-title":"J. Gastroenterol."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"434","DOI":"10.4103\/sjg.sjg_114_22","article-title":"Oxidative stress and the importance of H. pylori eradication in patients with functional dyspepsia","volume":"28","author":"Ebik","year":"2022","journal-title":"Saudi J. Gastroenterol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"4465","DOI":"10.1038\/s41388-020-1304-6","article-title":"Spermine oxidase mediates Helicobacter pylori-induced gastric inflammation, DNA damage, and carcinogenic signaling","volume":"39","author":"Sierra","year":"2020","journal-title":"Oncogene"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.1023\/A:1015399204069","article-title":"Helicobacter pylori-induced oxidative stress and DNA damage in a primary culture of human gastric mucosal cells","volume":"47","author":"Bagchi","year":"2002","journal-title":"Dig. Dis. Sci."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"3149","DOI":"10.1128\/IAI.70.6.3149-3155.2002","article-title":"Role of tumor necrosis factor alpha in Helicobacter pylori gastritis in tumor necrosis factor receptor 1-deficient mice","volume":"70","author":"Thalmaier","year":"2002","journal-title":"Infect. Immun."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"8192","DOI":"10.3748\/wjg.v19.i45.8192","article-title":"Helicobacter pylori and interleukin-8 in gastric cancer","volume":"19","author":"Lee","year":"2013","journal-title":"World J. Gastroenterol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"2648065","DOI":"10.1155\/2021\/2648065","article-title":"Autophagy in Gastric Mucosa: The Dual Role and Potential Therapeutic Target","volume":"2021","author":"Lu","year":"2021","journal-title":"BioMed Res. Int."},{"key":"ref_80","first-page":"942","article-title":"CagA and VacA inhibit gastric mucosal epithelial cell autophagy and promote the progression of gastric precancerous lesions","volume":"47","author":"Zhang","year":"2022","journal-title":"Zhong Nan Da Xue Xue Bao. Yi Xue Ban = J. Cent. South Univ. Med. Sci."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"13636","DOI":"10.1038\/s41598-017-14028-1","article-title":"Helicobacter pylori \u03b3-glutamyl transferase contributes to colonization and differential recruitment of T cells during persistence","volume":"7","author":"Anderl","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1128\/CMR.00011-10","article-title":"Helicobacter pylori and gastric cancer: Factors that modulate disease risk","volume":"23","author":"Wroblewski","year":"2010","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"2258","DOI":"10.1128\/IAI.01271-12","article-title":"High dietary salt intake exacerbates Helicobacter pylori-induced gastric carcinogenesis","volume":"81","author":"Gaddy","year":"2013","journal-title":"Infect. Immun."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"1862613","DOI":"10.1080\/19490976.2020.1862613","article-title":"Immunostimulatory membrane proteins potentiate H. pylori-induced carcinogenesis by enabling CagA translocation","volume":"13","author":"Varga","year":"2021","journal-title":"Gut Microbes"},{"key":"ref_85","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_86","doi-asserted-by":"crossref","first-page":"4617","DOI":"10.1038\/sj.onc.1210251","article-title":"Helicobacter pylori CagA interacts with E-cadherin and deregulates the beta-catenin signal that promotes intestinal transdifferentiation in gastric epithelial cells","volume":"26","author":"Kurashima","year":"2007","journal-title":"Oncogene"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"20584","DOI":"10.1073\/pnas.1208651109","article-title":"CDX1 confers intestinal phenotype on gastric epithelial cells via induction of stemness-associated reprogramming factors SALL4 and KLF5","volume":"109","author":"Fujii","year":"2012","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.1136\/gutjnl-2014-307295","article-title":"Bacterial CagA protein induces degradation of p53 protein in a p14ARF-dependent manner","volume":"64","author":"Wei","year":"2015","journal-title":"Gut"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1038\/nm1566","article-title":"Helicobacter pylori infection triggers aberrant expression of activation-induced cytidine deaminase in gastric epithelium","volume":"13","author":"Matsumoto","year":"2007","journal-title":"Nat. Med."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1080\/15384101.2018.1560121","article-title":"Inhibition of polarity-regulating kinase PAR1b contributes to Helicobacter pylori inflicted DNA Double Strand Breaks in gastric cells","volume":"18","author":"Zamperone","year":"2019","journal-title":"Cell Cycle"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"1836","DOI":"10.1053\/j.gastro.2009.12.042","article-title":"CpG methylation and reduced expression of O6-methylguanine DNA methyltransferase is associated with Helicobacter pylori infection","volume":"138","author":"Sepulveda","year":"2010","journal-title":"Gastroenterology"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1002\/jcb.24389","article-title":"Role of the Helicobacter pylori-induced inflammatory response in the development of gastric cancer","volume":"114","author":"Lamb","year":"2013","journal-title":"J. Cell. Biochem."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"7927054","DOI":"10.1155\/2020\/7927054","article-title":"The Role of Gastric Mucosal Immunity in Gastric Diseases","volume":"2020","author":"Nie","year":"2020","journal-title":"J. Immunol. Res."},{"key":"ref_94","doi-asserted-by":"crossref","unstructured":"Kumar, S., Patel, G.K., and Ghoshal, U.C. (2021). Helicobacter pylori-Induced Inflammation: Possible Factors Modulating the Risk of Gastric Cancer. Pathogens, 10.","DOI":"10.3390\/pathogens10091099"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"5","DOI":"10.3389\/fmicb.2018.00005","article-title":"Helicobacter pylori and Gastric Cancer: Adaptive Cellular Mechanisms Involved in Disease Progression","volume":"9","author":"Bravo","year":"2018","journal-title":"Front. Microbiol."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"2959","DOI":"10.3892\/or.2017.5942","article-title":"Interaction with neutrophils promotes gastric cancer cell migration and invasion by inducing epithelial-mesenchymal transition","volume":"38","author":"Zhang","year":"2017","journal-title":"Oncol. Rep."},{"key":"ref_97","doi-asserted-by":"crossref","unstructured":"Dewayani, A., Fauzia, K.A., Alfaray, R.I., Waskito, L.A., Doohan, D., Rezkitha, Y.A.A., Abdurachman, A., Kobayashi, T., I\u2019tishom, R., and Yamaoka, Y. (2021). The Roles of IL-17, IL-21, and IL-23 in the Helicobacter pylori Infection and Gastrointestinal Inflammation: A Review. Toxins, 13.","DOI":"10.3390\/toxins13050315"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/j.mucimm.2023.03.006","article-title":"iNKT cell-neutrophil crosstalk promotes colorectal cancer pathogenesis","volume":"16","author":"Lattanzi","year":"2023","journal-title":"Mucosal Immunol."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.micres.2018.09.011","article-title":"Helicobacter pylori evasion strategies of the host innate and adaptive immune responses to survive and develop gastrointestinal diseases","volume":"218","author":"Karkhah","year":"2019","journal-title":"Microbiol. Res."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1007\/s00284-022-03089-9","article-title":"Helicobacter pylori and Gastric Cancer Progression","volume":"79","author":"Senchukova","year":"2022","journal-title":"Curr. Microbiol."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1038\/s41572-023-00431-8","article-title":"Helicobacter pylori infection","volume":"9","author":"Malfertheiner","year":"2023","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1093\/jac\/39.1.5","article-title":"The stability of amoxycillin, clarithromycin and metronidazole in gastric juice: Relevance to the treatment of Helicobacter pylori infection","volume":"39","author":"Erah","year":"1997","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1111\/j.1365-2036.2008.03807.x","article-title":"Meta-analysis: High-dose proton pump inhibitors vs. standard dose in triple therapy for Helicobacter pylori eradication","volume":"28","author":"Villoria","year":"2008","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1053\/j.gastro.2016.04.006","article-title":"The Toronto Consensus for the Treatment of Helicobacter pylori Infection in Adults","volume":"151","author":"Fallone","year":"2016","journal-title":"Gastroenterology"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1136\/gutjnl-2020-321372","article-title":"Hp-EuReg Investigators European Registry on Helicobacter pylori management (Hp-EuReg): Patterns and trends in first-line empirical eradication prescription and outcomes of 5 years and 21,533 patients","volume":"70","author":"Nyssen","year":"2021","journal-title":"Gut"},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1016\/S0140-6736(11)60020-2","article-title":"Pylera Study Group Helicobacter pylori eradication with a capsule containing bismuth subcitrate potassium, metronidazole, and tetracycline given with omeprazole versus clarithromycin-based triple therapy: A randomised, open-label, non-inferiority, phase 3 trial","volume":"377","author":"Malfertheiner","year":"2011","journal-title":"Lancet"},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1136\/gutjnl-2016-312288","article-title":"Management of Helicobacter pylori infection-the Maastricht V\/Florence Consensus Report","volume":"66","author":"Malfertheiner","year":"2017","journal-title":"Gut"},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1007\/s11938-020-00300-3","article-title":"Update on the Management of Helicobacter pylori Infection","volume":"18","author":"Saleem","year":"2020","journal-title":"Curr. Treat. Options Gastroenterol."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"1465","DOI":"10.1136\/gut.2010.215350","article-title":"Empirical levofloxacin-containing versus clarithromycin-containing sequential therapy for Helicobacter pylori eradication: A randomised trial","volume":"59","author":"Romano","year":"2010","journal-title":"Gut"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"1815","DOI":"10.1136\/gutjnl-2021-324032","article-title":"European Helicobacter pylori Antimicrobial Susceptibility Testing Working Group Helicobacter pylori resistance to antibiotics in Europe in 2018 and its relationship to antibiotic consumption in the community","volume":"70","author":"Megraud","year":"2021","journal-title":"Gut"},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"2355","DOI":"10.1016\/S0140-6736(16)31409-X","article-title":"Taiwan Gastrointestinal Disease and Helicobacter Consortium Concomitant, bismuth quadruple, and 14-day triple therapy in the first-line treatment of Helicobacter pylori: A multicentre, open-label, randomised trial","volume":"388","author":"Liou","year":"2016","journal-title":"Lancet"},{"key":"ref_112","doi-asserted-by":"crossref","unstructured":"Guillemard, E., Poirel, M., Sch\u00e4fer, F., Quinquis, L., Rossoni, C., Keicher, C., Wagner, F., Szajewska, H., Barbut, F., and Derrien, M. (2021). A Randomised, Controlled Trial: Effect of a Multi-Strain Fermented Milk on the Gut Microbiota Recovery after Helicobacter pylori Therapy. Nutrients, 13.","DOI":"10.1101\/2021.01.14.21249458"},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"1120789","DOI":"10.3389\/fcimb.2023.1120789","article-title":"Comparative effectiveness of different probiotics supplements for triple Helicobacter pylori eradication: A network meta-analysis","volume":"13","author":"Wang","year":"2023","journal-title":"Front. Cell. Infect. Microbiol."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"10644","DOI":"10.3748\/wjg.v21.i37.10644","article-title":"Are probiotics useful in Helicobacter pylori eradication?","volume":"21","author":"Homan","year":"2015","journal-title":"World J. Gastroenterol."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1097\/MCG.0000000000000007","article-title":"Lactobacillus reuteri strain combination in Helicobacter pylori infection: A randomized, double-blind, placebo-controlled study","volume":"48","author":"Francavilla","year":"2014","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_116","doi-asserted-by":"crossref","unstructured":"Srisuphanunt, M., Wilairatana, P., Kooltheat, N., Duangchan, T., Katzenmeier, G., and Rose, J.B. (2023). Molecular Mechanisms of Antibiotic Resistance and Novel Treatment Strategies for Helicobacter pylori Infections. Trop. Med. Infect. Dis., 8.","DOI":"10.3390\/tropicalmed8030163"},{"key":"ref_117","doi-asserted-by":"crossref","unstructured":"Nikoli\u0107, I., Chua, E.G., Tay, A.C.Y., Kostre\u0161evi\u0107, A., Pavlovi\u0107, B., and Jon\u010di\u0107 Savi\u0107, K. (2023). Savory, Oregano and Thyme Essential Oil Mixture (HerbELICO\u00ae) Counteracts Helicobacter pylori. Molecules, 28.","DOI":"10.3390\/molecules28052138"},{"key":"ref_118","doi-asserted-by":"crossref","unstructured":"Salehi, B., Sharopov, F., Martorell, M., Rajkovic, J., Ademiluyi, A.O., Sharifi-Rad, M., Fokou, P.V.T., Martins, N., Iriti, M., and Sharifi-Rad, J. (2018). Phytochemicals in Helicobacter pylori Infections: What Are We Doing Now?. Int. J. Mol. Sci., 19.","DOI":"10.3390\/ijms19082361"},{"key":"ref_119","doi-asserted-by":"crossref","unstructured":"Wu, X., Chen, L., Cheng, J., Qian, J., Fang, Z., and Wu, J. (2022). Effect of Dietary Salt Intake on Risk of Gastric Cancer: A Systematic Review and Meta-Analysis of Case-Control Studies. Nutrients, 14.","DOI":"10.3390\/nu14204260"},{"key":"ref_120","first-page":"808120","article-title":"Association between Habitual Dietary Salt Intake and Risk of Gastric Cancer: A Systematic Review of Observational Studies","volume":"2012","author":"Ge","year":"2012","journal-title":"Gastroenterol. Res. Pr."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1038\/sj.bjc.6605993","article-title":"Salt intake and gastric cancer risk according to Helicobacter pylori infection, smoking, tumour site and histological type","volume":"104","author":"Peleteiro","year":"2011","journal-title":"Br. J. Cancer"},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"2481","DOI":"10.7314\/APJCP.2012.13.6.2481","article-title":"Sodium intake, salt taste and gastric cancer risk according to helicobacter pylori infection, smoking, histological type and tumor sit in China","volume":"13","author":"Zhong","year":"2012","journal-title":"Asian Pac. J. Cancer Prev."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/13\/9\/1325\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:41:13Z","timestamp":1760128873000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/13\/9\/1325"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,28]]},"references-count":122,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2023,9]]}},"alternative-id":["jpm13091325"],"URL":"https:\/\/doi.org\/10.3390\/jpm13091325","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,28]]}}}