Marshall · Gastroenterology 1990 · In vitro laboratory experiment · n=?

Urea protects Helicobacter (Campylobacter) pylori from the bactericidal effect of acid.

Cited 400 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

In vitro bench experiment without human subjects

PubMed 2379775 · doi:10.1016/0016-5085(90)90957-3 · record verified 2026-08-30

What was done

Authors tested the pH susceptibility of Helicobacter pylori, Proteus mirabilis, and urease-negative Campylobacter jejuni in vitro in the presence and absence of urea to determine whether urease-mediated ammonia generation protects H. pylori from gastric acid.

What was found

Without urea, all three bacteria were highly susceptible to acid. The addition of 5 mmol/L urea completely protected H. pylori from pH levels as low as 1.5, while P. mirabilis and C. jejuni were not protected. Urea protected H. pylori at concentrations down to 0.05 mmol/L. Specific quantitative survival counts and variance values were not reported in the abstract.

Why it matters

It demonstrates a direct mechanism by which H. pylori exploits urea and high urease activity to survive bactericidal gastric acid.

Limits

This is an in vitro bench study without human or animal subjects, lacking in vivo physiological complexity such as gastric mucosal barriers. The abstract does not report sample sizes, replicate counts, or precise quantitative bacterial survival rates.

Cited by