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헬리코박터 파일로리 감염의 역학과 병태생리

Epidemiology and Pathophysiology of Helicobacter Pylori Infections in Korea

김재규|김범진
대한내과학회 (The Korean Association Of Internal Medicine)|2015.08|대한내과학회지 (The Korean Journal of Medicine)|제89권 제2호|pp. 133-141|DOI http://dx.doi.org/10.3904/kjm.2015.89.2.133

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키워드

EpidemiologyImmunity면역반응Virulence factors감염역학Helicobacter pyloriSeroepidemiologic studies혈청 유병률독성인자
주제분류내과학

초록

우리나라 H. pylori 항체에 대한 혈청학적 유병률은 약50%로 국민의 반수가 감염되어 있는 것으로 생각되며 특히16세 이상의 성인에서는 약 2/3가 감염되어 있다. 우리나라의 H. pylori 감염률은 경제성장과 생활환경의 개선 등으로향후 감소할 것으로 예상된다. 그러나 전국적 규모의 역학연구가 정기적으로 시행되어 보다 객관적인 자료를 바탕으로H. pylori에 대한 진료 지침을 만들 필요가 있다. H. pylori에감염되면 세균 독성인자의 유전적 다형성과 이에 대한 숙주의 면역반응이 상호 작용을 하여 여러 가지 위장 질환을 일으킨다. 이러한 상호 작용에 대한 연구는 위선암 등 질병 발생의 기전을 이해하고 질병 발생을 억제할 수 있는 치료법의 개발에 있어 매우 중요하다. 아울러 우리나라에서도 향후효과적인 제균치료와 예방 백신 개발에 노력한다면 H. pylori 와 관련된 상부위장관 질환의 예방은 물론 이와 관련된 의료비 절감에도 크게 기여할 것으로 기대한다.

Abstract

Helicobacter pylori (H. pylori) commonly infects humans worldwide. However, only limited proportions of infected populations develop clinical manifestations ranging from asymptomatic gastritis to gastric cancer. A Korean nationwide survey revealed that the overall H. pylori seroprevalence was 66.9% in 1998, and significantly decreased in later years in all age groups to 59.6% in 2005 and 54.4% in 2011. In terms of geographical regions, the seroprevalence trended significantly downward in most areas over time, except in Kyungsang and Kangwon. The various outcomes of H. pylori infection are caused by imbalances between bacterial virulence factors, host factors including genetic diversity, and environmental influences. H. pylori infection triggers responses by almost all forms of innate and acquired immunity. In the present review, we describe the epidemiology and pathophysiology of H. pylori infection in Korea. A better understanding of the prevalence trend and the mechanisms of immune responses to H. pylori infection will allow public health authorities to develop novel therapeutic strategies.

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