Helicobacter pylori (H. pylori) is a worldwide spread bacterium, co-evolving with humans for at least 100 000 years. Despite the uncertainty about the mode of H. pylori transmission, the development of intra-gastric and extra-gastric diseases is attributed to this bacterium. The morphological transformation and production of heterogenic virulence factors enable H. pylori to overcome the harsh stomach environment. Using numerous potent disease-associated virulence factors makes H. pylori a prominent pathogenic bacterium. These bacterial determinants are adhesins (e.g., blood group antigen-binding adhesin (BabA)/sialic acid-binding adhesin (SabA)), enzymes (e.g., urease), toxins (e.g., vacuolating cytotoxin A (VacA)), and effector proteins (e.g., cytotoxin-associated gene A (CagA)) involved in colonisation, immune evasion, and disease induction. H. pylori not only cleverly evades the immune system but also robustly induces immune responses. This insidious bacterium employs various strategies to evade human innate and adaptive immune responses, leading to a life-long infection. Owing to the alteration of surface molecules, innate immune receptors couldn't recognise this bacterium; moreover, modulation of effector T cells subverts adaptive immune response. Most of the infected humans are asymptomatic and only a few of them present severe clinical outcomes. Therefore, the identification of virulence factors will pave the way for the prediction of infection severity and the development of an effective vaccine. H. pylori virulence factors are hereby comprehensively reviewed and the bacterium evasion from the immune response is properly discussed.

幽门螺杆菌( H. pylori ) 是一种世界范围内传播的细菌，与人类共同进化了至少 10 万年。尽管幽门螺杆菌的传播方式尚不确定，但胃内和胃外疾病的发生都归因于这种细菌。形态转变和异源毒力因子的产生使幽门螺杆菌能够克服恶劣的胃环境。利用大量与疾病相关的强效毒力因子，幽门螺杆菌成为一种重要的致病菌。这些细菌决定簇是粘附素（例如血型抗原结合粘附素（BabA）/唾液酸结合粘附素（SabA））、酶（例如脲酶）、毒素（例如空泡细胞毒素A（VacA））和效应蛋白（例如，细胞毒素相关基因 A (CagA)）参与定植、免疫逃避和疾病诱导。幽门螺杆菌不仅巧妙地逃避免疫系统，而且还强有力地诱导免疫反应。这种阴险的细菌采用各种策略来逃避人类先天性和适应性免疫反应，导致终身感染。由于表面分子的改变，先天免疫受体无法识别这种细菌；此外，效应T细胞的调节会破坏适应性免疫反应。大多数感染者没有症状，只有少数人出现严重的临床结果。因此，毒力因子的鉴定将为预测感染严重程度和开发有效疫苗铺平道路。特此对幽门螺杆菌毒力因子进行全面综述，并适当讨论细菌逃避免疫反应的问题。