Helicobacter pylori-derived outer membrane vesicles: Pathogenic roles, microbiota interactions, and biomedical applications

BACKGROUND: Helicobacter pylori (Hp) is a gram-negative, microaerophilic bacterium that infects approximate 45% of the global population. It is a key contributor to chronic gastritis, peptic ulcers, and gastric cancer. Among its secreted products, Hp-derived outer membrane vesicles (Hp-OMVs) are nanoscale proteoliposomal structures that play crucial roles in host-pathogen interactions. AIM OF REVIEW: This review aims to synthesize current knowledge on the formation, composition, and biological functions of Hp-OMVs, with a particular focus on their systemic effects and potential biomedical applications. KEY SCIENTIFIC CONCEPTS OF REVIEW: Hp-OMVs are enriched with virulence-associated proteins and lipids, acting as multifunctional vehicles that facilitate the delivery of toxins, modulation of host immunity, and reshaping of gastrointestinal and oral microbial communities. Emerging preclinical studies suggest that Hp-OMVs may translocate across epithelial barriers and reach distant organs, including the brain, where they have been shown to exacerbate neuroinflammatory responses in murine models of Alzheimer's disease. However, no causal relationship has been demonstrated in humans. More research is urgently needed to confirm such extragastrointestinal connections. In parallel, Hp-OMVs are being explored as versatile platforms for vaccine development, mucosal adjuvants, anti-adhesion therapies, and targeted drug delivery systems, owing to their intrinsic immunogenicity and tissue tropism. CONCLUSION: Hp-OMVs represent a unique vesicular modality in Hp pathogenesis with broad biomedical potential. Future research employing multi-omics, single-vesicle analytics, and clinical validation is needed to define their mechanistic roles and translational value.