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J Clin Pathol 63:424-430 doi:10.1136/jcp.2009.072595
  • Review

Ureases as a target for the treatment of gastric and urinary infections

  1. C Follmer
  1. Department of Physical Chemistry, Institute of Chemistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
  1. Correspondence to Cristian Follmer, Department of Physical Chemistry, Institute of Chemistry, Federal University of Rio de Janeiro, Rio de Janeiro 21941-909, Brazil; follmer{at}iq.ufrj.br
  • Accepted 9 December 2009

Abstract

Urease is known to be a major contributor to pathologies induced by Helicobacter pylori and Proteus species. In H pylori, urease allows the bacteria to survive in an acidic gastric environment during colonisation, playing an important role in the pathogenesis of gastric and peptic ulcers. Ureolytic activity also results in the production of ammonia in close proximity to the gastric epithelium, causing cell damage and inflammation. In the case of Proteus species (notably Proteus mirabilis) infection, stones are formed due to the presence of ammonia and carbon dioxide released by urease action. In addition, the ammonia released is able to damage the glycosaminoglycan layer, which protects the urothelial surface against bacterial infection. In this context, the administration of urease inhibitors may be an effective therapy for urease-dependent pathogenic bacteria. This is a review of the role of ureases in H pylori and Proteus species infections, focussing on the biochemical and clinical aspects of the most promising and/or potent urease inhibitors for the treatment of gastric and urinary tract infections.

Footnotes

  • Funding National Council for Scientific and Technological Development (CNPq) Research Foundation of the State of Rio de Janeiro (FAPERJ).

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.