Helicobacter pylori, a human pathogen and type 1 carcinogen, causes gastritis, gastric ulcers and gastric cancer. In vivo, H pylori colonizes only gastric surface cells from the antral and fundal regions of the stomach, and heterotopic or metaplastic gastric epithelium present within the esophagus and duodenum. This review summarizes what is known about the association and consequences of attachment between H pylori and gastric cells in vitro, and compares this to the findings demonstrated in vivo. It has been shown that attachment of H pylori to gastric cells results in cup and pedestal formation and cytoskeleton rearrangement similar to that described for enteropathogenic Escherichia coli. Attachment of H pylori induces additional cellular changes in the host cell, including cytokine responses and induction of signal transduction pathways.
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