Effects of Anti–Helicobacter pylori Therapy on Incidence of Autoimmune Diseases, Including Inflammatory Bowel Diseases (original) (raw)
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Low prevalence of Helicobacter pylori infection among patients with inflammatory bowel disease
Alimentary Pharmacology & Therapeutics, 2012
Background There is some preliminary evidence to suggest that patients with inflammatory bowel disease (IBD) are less frequently infected with Helicobacter pylori than the general population. Aim To examine whether the prevalence of Helicobacter pylori (H. pylori) is lower among IBD patients compared with non-IBD individuals based on results from surgical pathology. Methods From a database of surgical pathology reports, we recruited a sample of unique patients who underwent a same-day bidirectional gastrointestinal endoscopy with biopsies. Of the total 65 515 patients, 1061 served as cases with IBD and 64 451 as controls without IBD. The histological presence of H. pylori was correlated with the patients' demographic characteristics and histological presence of any oesophageal disease, Crohn's disease (CD), ulcerative colitis (UC) and indeterminate colitis (IND). Results were expressed as odds ratios (OR), using multivariate logistic regression to adjust for the cofounding influence of comorbidities and demographic characteristics. Results The presence of H. pylori was inversely associated with IBD, the adjusted OR and their 95% confidence intervals being 0.48 (0.27-0.79) for CD, 0.59 (0.39-0.84) for UC and 0.43 (0.15-0.95) for IND. In contradistinction, H. pylorinegative gastritis was positively associated with IBD, the adjusted OR being 11.06 (7.98-15.02) for CD, 2.25 (1.31-3.60) for UC and 6.91 (3.50-12.30) for IND. Conclusions Our study confirms an inverse association between H. pylori and IBD and a positive association between the H. pylorinegative gastritis and IBD. These relationships may open new avenues to study the pathogenesis of IBD.
Inverse correlation between Helicobacter pylori infection and inflammatory bowel disease
Journal of Clinical Pathology, 1996
Aims-To determine the seroprevalence of Helicobacter pylon in patients with Crohn's disease or ulcerative colitis and in controls without inflammatory bowel disease (IBD). Methods-One hundred consecutive patients with Crohn's disease, 100 consecutive patients with ulcerative colitis, and 100 age and sex matched controls were studied. Serum Hpylori IgG and IgA antibody titres were measured by enzyme immunoassay. Results-The seroprevalence of H pylon was 15% in patients with IBD (13% in patients with Crohn's disease and 18% in patients with ulcerative colitis), whereas the corresponding figure for the controls was 43%. When compared with controls, the seroprevalence of H pylon in patients with IBD was considerably lower in all age groups tested. There was no important difference in treatment with sulphasalazine or in any other medical therapy administered to Hpylon positive and negative patients. At the time of blood sampling there was no difference in the level of education or in the employment status between the patients and the controls. Conclusions-Patients with IBD were less likely to be infected with H pylorn than their age and sex matched controls. Neither medical treatment nor socioeconomic factors could explain the difference.
Inverse association between Helicobacter pylori and inflammatory bowel disease: myth or fact?
Acta Bio Medica : Atenei Parmensis, 2018
Background: Inflammatory bowel diseases (IBD), are chronic, relapsing-remitting diseases of the gastrointestinal tract, including Crohn’s disease (CD), Ulcerative colitis (UC) and Unclassified IBD (IBDU). Their pathogenesis involves genes and environment as cofactors in inducing autoimmunity; particularly the interactions between enteric pathogens and immunity is being studied. Helicobacter pylori (HP) is common pathogen causing gastric inflammation. Studies found an inverse prevalence association between HP and IBD, suggesting a potential protecting role of HP from IBD. Methods: A literature search of the PubMed database was performed using the key words‘’helicobacter pylori’’,‘’inflammatory bowel disease’’,‘’crohn disease’’, “ulcerative colitis”. Embase, Medline (OvidSP), Web of Science, Scopus, PubMed publisher, Cochrane and Google Scholar were also searched. Prevalence rate-ratios among HP in IBD patients, HP in CD patients, HP in UC patients, HP in IBDU patients were extracted,...
The negative association between inflammatory bowel disease and Helicobacter pylori seropositivity
2019
Background: The role of Helicobacter pylori (H. pylori) in inflammatory bowel disease is a controversial argument. The initial theory of this study was that Helicobacter is a risk factor for inflammatory bowel disease. In this study, we investigated the coincidence of H. pylori exposure and IBDs. Methods: This case-control study has been done in Babol, teaching Hospitals; 60 newly diagnosed IBD cases without any Helicobacter eradicating treatment and 120 control patients without inflammatory bowel disease evidence in biopsy, investigated for H. pylori exposure by IgA and IgG ELISA tests. Clinical information, demographics and ELISA test results have been analyzed using SPSS.Version.18 (level of significance was less than 0.05). Results: Mean age of case group was 42.27±13.64 years; in control group it was 45.52±13.83 years. There was a significant difference between the case and control groups in IgG study of the following subgroups: age under 30, females, males, urban, higher educa...
The relation between Helicobacter pylori and ulcerative colitis
TURKISH JOURNAL OF MEDICAL SCIENCES, 2014
Introduction Ulcerative colitis (UC), characterized by permanent mucosal inflammatory processes, presents with remission and activating periods (1). Although some environmental and genetic causes are attributed to UC progression, the exact cause of the disease is still unclear (1,2). In the recent years, investigators have focused on some pathogens as causes of UC (3,4). Helicobacter pylori, a pathogen related to chronic gastritis and peptic ulcers, is colonized mainly in the antrum, protecting itself from hyperacidity (5,6). Almost half of the underdeveloped populations are infected by H. pylori. Apart from the gastrointestinal system disorders, H. pylori is also found to be related to several skin diseases, autoimmune disorders, and iron deficiency (7,8). The association between H. pylori and UC is controversial. Some researchers reported that incidence of H. pylori is lower in UC patients than in healthy populations (9-12). Possible causes of this low rate of H. pylori in UC patients are the immunopathological characteristics of UC and the medications used in UC, such as 5-aminosalicylic acid (5-ASA) and antibiotics (9-12). We investigated the incidence of H. pylori in individuals with UC and determined the impact of several characteristics of UC, including extent and severity of UC, on the incidence of H. pylori. 2. Materials and methods Patients who were diagnosed with colitis and admitted to the outpatient gastroenterology clinic of Numune Training and Research Hospital were included in the study. Specifically, 49 patients with UC who had undergone upper gastrointestinal endoscopy with various indications were included in the study. The presence of H. pylori was assessed by taking one biopsy from the antrum in each patient. Patients using antacids or antibiotics in the previous 2 months or who had previously undergone H. pylori eradication treatment were excluded from the study. Prior to the study, all UC patients were required to provide an informed consent form and the study design was submitted to local ethics committee for approval. The density of the colonization of H. pylori was assessed by using Sydney classification (13). The demographic data of the patients in each group were obtained from the Background/aim: Besides some genetic explanations of the native course of ulcerative colitis (UC), the most attributable factors are pathogenic bacterial agents. There are some conflicting data about the relationship between Helicobacter pylori and the rate of UC in the literature. Therefore, we aimed to investigate the rate of H. pylori in UC patients. Materials and methods: Forty-nine individuals diagnosed with UC who had undergone upper gastrointestinal tract endoscopy for different reasons were included in the study. The presence of H. pylori in the stomach was checked by histopathological examination. Results: H. pylori positivity was present in 57.1% of patients with UC. Interestingly, H. pylori positivity was lower (11.1%) in pancolitis patients compared to those presenting with more limited illnesses. There were no relationships among the severity of the underlying disease, medication already used, and H. pylori positivity rate. Conclusion: The extension of UC is important for the positivity rate of H. pylori. It could not be determined whether the low positivity of H. pylori in extended UC cases was due to immunosuppressive drugs or to the UC itself.
Journal of Gastrointestinal and Liver Diseases
Background & Aims: A negative association between H. pylori and inflammatory bowel disease (IBD) has been previously reported. There were also case reports suggesting a new onset of IBD 6-12 months after H. pylori eradication therapy. In a case-control study we investigated whether previous H. pylori eradication therapy was associated with the risk of developing IBD. Methods: IBD outpatients with both Crohn´s disease (CD) and ulcerative colitis (UC) were enrolled. Age-and sex-matched blood donors served as controls in a 1:2 fashion. Information on demographics, medical history, previous H. pylori infection and eradication therapy was recorded. Serum samples for H. pylori serology testing (anti-H. pylori-IgG and anti-CagA-IgG) were obtained. Controls that received H. pylori eradication therapy during the 12 months previous to enrollment were excluded. Results: Overall, 127 IBD patients (CD N= 90; UC N= 37) and 254 controls were enrolled. The prevalence of H. pylori infection (positive H. pylori serology and/or previous eradication) in IBD patients and controls was 11% and 23%, respectively (OR 0.4, 95% CI 0.21-0.74, p<0.003). Four patients (3%) developed IBD (3 MC and 1 CU) after receiving successful H. pylori eradication (latency 6-12 months). The rate of previous H. pylori eradication therapy in patents who successively developed IBD was lower but not statistically different from that observed in the control group (OR 0.43, 95% CI 0.14-1.29, p=0.16). Conclusions: In our study previous H. pylori eradication therapy was not associated with the onset of IBD. Whether in a subgroup of patients, H. pylori eradication therapy may trigger a latent IBD, cannot be excluded.
Association of Helicobacter pylori and gastric autoimmunity: A population-based study
FEMS Immunology and Medical Microbiology, 1995
Based on clinical studies, a negative association between Helicobacter pylori and autoimmune corpus gastritis is described. In the present investigation of an unselected population of 1461 adults we can state, however, that there exists a relationship between H. pylori infection and the development of gastric corpus autoimmunity. As confirmation for the gastric autoantibody development through molecular mimicry, a high homology (72% in 25 amino acid overlap) between the beta subunit of H. pylori urease and that of H + K + ATPase, the gastric parietal cell autoantigen, was revealed.
Helicobacter pylori and autoimmune disease: Cause or bystander
World Journal of Gastroenterology, 2014
Helicobacter pylori (H. pylori ) is the main cause of chronic gastritis and a major risk factor for gastric cancer. This pathogen has also been considered a potential trigger of gastric autoimmunity, and in particular of autoimmune gastritis. However, a considerable number of reports have attempted to link H. pylori infection
Helicobacter pylori serology in autoimmune diseases – fact or fiction?
Clinical Chemistry and Laboratory Medicine, 2000
The pathogenesis of autoimmunity is presumed to be a complex process including genetic predisposition, hormonal balance and environmental factors such as infectious agents . Helicobacter pylori , a common bacterial infectious agent has been associated with a variety of autoimmune disorders. However, this bacteria is also thought to play a protective role in the development of multiple sclerosis (MS), systemic lupus erythematosus (SLE) and inflammatory bowel disease (IBD). We tested various links between anti-H. pylori (anti-HP) antibodies and a wide profile of autoimmune diseases and autoantibodies. Methods: A total of 1290 patients diagnosed with 14 different autoimmune diseases from two geographical areas (Europe and Latin America) and two groups of healthy matching controls (n = 385) were screened for the presence of H. pylori IgG antibodies by " pylori detect " kit. In parallel, a large profile belonging to three groups of autoantibodies was tested in all sera (anti-nuclear antibodies, autoantibodies associated with thrombophilia and gastrointestinal diseases). Results: Our data demonstrate associations between anti-HP antibodies and anti-phospholipid syndrome, giant cell arteritis, systemic sclerosis and primary biliary cirrhosis. Our data also support a previously known negative association between the prevalence of anti-HP antibodies and IBD. Additionally, links were made between seropositivity to H. pylori and the presence of anti-nuclear antibodies, dsDNA, anti-Ro and some thrombophiliaassociated antibodies, as well as negative associations with gastrointestinal-associated antibodies. Conclusions: Whether these links are epiphenomenal or H. pylori does play a causative role in the autoimmune diseases remains uncertain. The negative associations could possibly support the notion that in susceptible individuals infections may protect from the development of autoimmune diseases.
Role of helicobacter pylori infection in autoimmune diseases
Current Opinion in Rheumatology, 2012
Purpose of review-The etiology of most autoimmune diseases remains elusive. Prevailing evidence suggests an environmental trigger in a genetically susceptible individual. Helicobacter pylori (H. pylori) have managed to survive in a hostile environment in its host for long period and have evaded eradication by immune system. Its chronic interaction with the immune system and the ubiquitous presence worldwide makes H. pylori an ideal candidate to study as a trigger of autoimmune phenomena. In this review, we would present data regarding the interplay between H. pylori and various components of the immune system and its association with various autoimmune diseases. Recent findings-Strong associations of H. pylori with some autoimmune diseases such as immune thrombocytopenia have been found; but most other autoimmune disease studies have revealed conflicting data. The chronic survival of H. pylori in humans is possible because of an overall downregulation of the body's immune response. In addition to this overall effect on the immune system, there are clinical and epidemiological data suggestive of H. pylori infection having a protective role in some autoimmune diseases. Summary-Based on our review H. pylori status should be checked and treated only in certain autoimmune diseases such as ITP. For majority of the autoimmune diseases role of H. pylori remains controversial signifying need for further research.