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The first isolation of Helicobacter pylori (H. pylori) in 1980s by Marshall and Warren (Marshall & Warren, 1984) ushered in a new era in gastric microbiology, and, in conjunction with increased interest in the pathogenesis of gastroduodenal diseases, has led to important breakthroughs in medical care (Dunn et al., 1997). H. pylori is a spiral-shaped gram-negative flagellate bacterium that demonstrates bluntly rounded ends in gastric biopsy specimens (Goodwin et al., 1987). H. pylori organisms are 2.5 to 5.0 μm long and 0.5 to 1.0 μm wide, with four to six polar sheathed flagellas, which are essential for bacterial motility (Goodwin & Armstrong, 1990). H. pylori was the first pathogenic microorganism that had its genome sequenced in two different strains. In 1997, H. pylori strain 26695 was firstly isolated from an English patient with chronic gastritis and then sequenced. It had a circular chromosome composed of 1.667.867 base pairs (Tomb et al., 1997). In 1999, strain J99 was isolated from an American patient with duodenal ulcer and then sequenced. This presented a similar, overall genomic organization, gene order and prediction of proteomes when compared to strain 26695 (Alm et al., 1999). In 2006, a chronic atrophic gastritis strain, HPAG1, was isolated and sequenced from a Swedish old patient (Oh et al., 2006). More recently, strain G27 was isolated from an Italian patient and had a similar size to the other three strains (Baltrus et al., 2009). Finally, other strains were sequenced, such as Shi470, B128 and 98-10 (McClain et al., 2009; Thiberge et al., 2010). The finding of strain-specific genes from the comparison of the sequenced strains is in agreement with the earlier studies which demonstrated the high diversity of the H. pylori genome (Akopyanz et al., 1992; Han et al., 2003). Consequently, this high level of genetic diversity can be an important factor in its adaptation to the host stomach and also for the clinical outcome of the infection, an aspect that remains unclear. However, it is thought to involve an interplay between the virulence of the infecting strain, host genetics and environmental factors (Kabir, 2009) and experience with other bacterial pathogens suggests that H. pylori-specific factors may exist that influence the microorganism pathogenicity.

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Virulence Factors of Helicobacter pylori and Their Relationship with the Development of Early and Advanced Distal Intestinal Type Gastric Adenocarcinoma