The scientific journal, Helicobacter, was launched in March 1996, that is, about 30 years ago. The goal was to provide a forum for clinical and basic research related to the bacterium, Helicobacter pylori. As hoped, Helicobacter has evolved into a primary forum for exchange of information regarding H. pylori including its epidemiology, pathology, associated diseases and the management and prevention of the infection. The Journal has also provided a home and forum for research regarding other Helicobacter species. These first 30 years have witnessed the tremendous increase in our understanding of the nature of the H. pylori organism, its role in the pathogenesis of human disease, and its therapy. As a scientific Journal, Helicobacter and facilitated the exchange of new information and ideas as well and in the integration of diverse areas of science resulting in what is now an increasingly comprehensive understanding of the organism and its biology. Scientific publications are also repositories of scientific knowledge and thinking and thought so as such provide newcomers to the field with an efficient method of sharing of new ideas, information, and techniques resulting in an better science while reducing duplication. Prior to the discovery of H. pylori, gastric inflammation (gastritis) was a hot topic of research particularly because of the strong associations between gastritis and peptic ulcers and gastric cancer (reviewed in Ref. 1). There was also a large literature on gastric urease 4. In the mid-1970s, Steer demonstrated an association between gastritis and the presence of bacteria in the stomach 5. In 1983, Marshall et al. reported the presence of an as yet unidentified curved bacilli on gastric epithelium in active chronic gastritis 6 and shortly thereafter the same authors extended the association of that curved bacterium with gastritis and peptic ulcer disease 5, 6. For the first time, the causative organism was cultured and thus available for study in vitro as well as the development of diagnostic tests that could confirm its presence both in vivo and in vitro. These tests allowed investigators interested in gastritis, gastric cancer, and peptic ulcer disease to rapidly perform retrospective analyses of blood and tissue specimens from data banks containing stored serum and gastric mucosal biopsies and thus rapidly confirm the hypotheses that the organism originally named Campylobacter pylori was associated, possibly etiologically, with peptic ulcer disease and gastric cancer. Subsequent treatment studies showed that cure of the infection resulted in healing of the gastritis, healing of peptic ulcers and prevention of ulcer relapse 7. Peptic ulcer went from “once and ulcer, always and ulcer” to a “one-off” disease. By 1996, there were over 1000 papers regarding H. pylori being published per year. Not only was publishing volume high, but as the publications were in many different types of journals, making it difficult for those interested in H. pylori to keep up. The expressed goal of Helicobacter was to “provide a forum that meets the needs of the clinician, epidemiologist, the pathologist, the mucosal immunologist, the animal science community, and the basic research scientist” 8. The ultimate goal of H. pylori research is to promote and assist in the eradication of a major cause of human disease, H. pylori infection. After 30 years, I wish I could say that goal has been or soon will soon be accomplished allowing us to celebrate victory and turn our attention elsewhere. Although, great progress has been made and Helicobacter has played a major role in those successes, there are many issues that remain poorly addressed. The Journal's role has largely be documentation and sharing of information. Possibly, the Journal should also consider an advocacy role. H. pylori is a cause of gastric cancer, and with few exceptions developed countries such as the United States, have yet to undertake programs to identify and eradiate the infection even from well identified high-risk populations. Epidemiology without action. In contrast, a few countries including Taiwan, Japan, China, and Korea are taking positive steps to eliminate the infection and within a few generations they are likely to be largely H. pylori free. In developed Western countries the infection remains prevalent the lower socioeconomic segments and immigrants. The tendency has been to support a few epidemiologic studies of H. pylori prevalence in poor, underserved, immigrant and indigenous populations with littler of no provisions for offering therapy for these found to be infected. Thirty years have passed and much remains to be done. We now recognize that basically, H. pylori is an infectious disease that can be cured using antibiotics. Successful treatment of infectious diseases requires the ability to reliably select an antibiotic or combination of antibiotics that will reliably cure the infection. The development of resistance has resulted in high levels of resistance to clarithromycin, levofloxacin and metronidazole such that they should no longer be prescribed empirically in triple therapies. At least in the United States, susceptibility testing of gastric biopsies is now universally available commercially as a “send-out” using culture or molecular testing. After 30 years, it is difficult to imagine that there could be an infectious disease as important as H. pylori where, despite a high prevalence of clarithromycin resistance, the most recent U.S. gastroenterology society's guidelines recommend empiric use of clarithromycin when combined with vonoprazan. Helicobacter has strived to provide both basic scientists and clinicians with a source of up-to-date information regarding as aspects of Helicobacterology. I look forward to the Journal's progress over the next 30 years. This work was is supported in part by the National Institutes of Health grant K23DK129776 (MT) and NIDDK P30 DK 56338 which funds the Texas Medical Center Digestive Diseases Center (DG) and by the Office of Research and Development Medical Research Service Department of Veterans Affairs. The opinions expressed reflect those of the authors and not necessarily those of the National Institutes of Health, the U.S. government, or Baylor College of Medicine. Dr. Graham has no current conflicts of interest. In the past, Dr. Graham has served as an unpaid consultant for RedHill Biopharma and Phathom Pharmaceuticals regarding novel Helicobacter pylori therapies and has received research support for culture of H. pylori. He was also a consultant with Janssen Research & Development regarding potential gastrointestinal effects of drugs under development and has collaborated with American Molecular Laboratories regarding molecular diagnostics for H. pylori. The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
David Y. Graham (Sun,) studied this question.