Epidemiologic studies have revealed that Helicobacter pylori (H. pylori) infection and its associated diseases are common in Taiwan. With improvement of socioeconomic status and introduction of H. pylori eradication, the prevalence of H. pylori infection in adults has been reduced from 54% in 1990 to 40% in 2009 in Taiwan. A nationwide population-based cohort study also showed that the incidence of gastric ulcer and duodenal ulcer has been reduced by 45% and 56%, respectively, between 1997 and 2006. For eradication of Helicobacter pylori, clarithromycin-based triple therapy is still effective as compared to levofloxacin-based triple therapy and sequential therapy has been documented to be equivalent to concomitant quadruple therapy. Recently, we have confirmed that H. pylori eradication could prevent the development of gastric cancer in secondary prevention trial for patients with peptic ulcer.

　　 Moreover, the efficacy of population-based eradication program in primary prevention was demonstrated in the Matzu island. Ethnic diversity, including Chinese and nine aboriginals, is a unique feature in Taiwan which provides us an opportunity to track the history of human migration, and the influence of host genetic and bacterial virulence on various clinical outcomes. Several host genetic factors, such as IL-10, IL-8, TNF-α, CYP2E1, RANTES, and E-cadherin polymorphisms, were shown to be associated with risks of gastric cancer in Taiwan. Using proteomic platform and taking advantage of complete sequences for both the H. pylori and the human genome in available databases, we have identified several crucial proteins that have pathogenic and prognostic potential. Among them, antibodies to AhpC ,GroES and Hsp60 of H. pylori could be utilized for identification of patients who are at high risk of disease complications after H. pylori infection. Our colleagues found that alpha-L-fucosidase 2 plays an important role in the adhesion, growth, and pathogenicity of H. pylori infection. Evolving high-throughput technologies, together with appropriate clinical phenotyping and genotype information should enhance understanding of disease pathogenesis and lead to more precise prediction of variable disease outcomes. To facilitate further in-depth studies of H. pylori infection and relevant gastrointestinal diseases, we have formed Taiwan Clinical trial Consortium for Gastrointestinal Disease and Helicobacter Infection. This consortium will provide an excellent platform for development of novel biomarkers and treatment. .