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Dore MP, Meloni G, Bassu I, Pes GM. Helicobacter pylori Infection Does Not Protect Against Allergic Diseases: Evidence From a Pediatric Cohort From Northern Sardinia, Italy. Helicobacter 2024; 29:e13107. [PMID: 38943311 DOI: 10.1111/hel.13107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 06/12/2024] [Accepted: 06/13/2024] [Indexed: 07/01/2024]
Abstract
BACKGROUND The "hygiene hypothesis" states that reduced exposure to microbial antigens due to an excessively hygienic environment can increase the risk of developing autoimmune diseases, including atopic disorders and asthma. In recent decades, there has been a progressive decline in the prevalence of numerous microorganisms following improved hygienic-sanitary conditions. More specifically, several studies reported an inverse association between the reduction in Helicobacter pylori infection and the rise of asthma and allergic disorders. AIM To evaluate the prevalence of atopic disorders in a pediatric population in relation to seropositivity against H. pylori. METHODS Children from Northern Sardinia, Italy, referred to the local Children's Hospital for any reason, were investigated to identify risk factors, especially H. pylori infection, associated with atopic disorders. A validated questionnaire, including demographics, house size, history of breastfeeding, residence, school or daycare center attendance, exposure to animals, and a defined diagnosis of atopy-including asthma-was filled out by a trained pediatrician according to parents' answers and child records. A blood sample was collected from each participant and immunoglobulin G against H. pylori was assessed by a locally validated ELISA test. RESULTS The seroprevalence of H. pylori infection was 11.7% among 492 children (240 females). Thirty-two children had a confirmed diagnosis of asthma and 12 of allergy. No one child showed both conditions. Statistically significant differences in H. pylori seropositivity were not detected between children with or without atopy (8.4% vs. 12.6; p = 0.233). Although atopic disorders were more frequent in children exposed to traditional atopic risk factors, none of them showed to be significant after adjusting for all covariates. CONCLUSIONS Serologically assessed H. pylori infection was not significantly associated with a reduced risk of atopic diseases in children.
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Affiliation(s)
- Maria Pina Dore
- Dipartimento di Medicina, Chirurgia e Farmacia, University of Sassari, Sassari, Italy
- Baylor College of Medicine, Houston, Texas, USA
| | - Gianfranco Meloni
- Dipartimento di Medicina, Chirurgia e Farmacia, University of Sassari, Sassari, Italy
| | - Ica Bassu
- Dipartimento di Medicina, Chirurgia e Farmacia, University of Sassari, Sassari, Italy
| | - Giovanni Mario Pes
- Dipartimento di Medicina, Chirurgia e Farmacia, University of Sassari, Sassari, Italy
- Blue Zone Longevity Observatory, Ogliastra, Italy
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Liu M, Wang Y, Du B. Update on the association between Helicobacter pylori infection and asthma in terms of microbiota and immunity. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2024; 20:4. [PMID: 38221621 PMCID: PMC10788013 DOI: 10.1186/s13223-024-00870-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 01/01/2024] [Indexed: 01/16/2024]
Abstract
H. pylori is a gram-negative bacterium that is usually acquired in childhood and can persistently colonize the gastric mucosa of humans, affecting approximately half of the world's population. In recent years, the prevalence of H. pylori infection has steadily reduced while the risk of allergic diseases has steadily climbed. As a result, epidemiological research indicates a strong negative association between the two. Moreover, numerous experimental studies have demonstrated that eradicating H. pylori increases the risk of allergic diseases. Hence, it is hypothesized that H. pylori infection may act as a safeguard against allergic diseases. The hygiene hypothesis, alterations in gut microbiota, the development of tolerogenic dendritic cells, and helper T cells could all be involved in H. pylori's ability to protect against asthma. Furthermore, Studies on mice models have indicated that H. pylori and its extracts are crucial in the management of asthma. We reviewed the in-depth studies on the most recent developments in the relationship between H. pylori infection and allergic diseases, and we discussed potential mechanisms of the infection's protective effect on asthma in terms of microbiota and immunity. We also investigated the prospect of the application of H. pylori and its related components in asthma, so as to provide a new perspective for the prevention or treatment of allergic diseases.
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Affiliation(s)
- Mengmeng Liu
- Department of Gastroenterology and Hepatology, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yong Wang
- Department of Gastroenterology and Hepatology, Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Bing Du
- Department of Gastroenterology and Hepatology, Second Affiliated Hospital of Harbin Medical University, Harbin, China.
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Reuter S, Raspe J, Taube C. Microbes little helpers and suppliers for therapeutic asthma approaches. Respir Res 2024; 25:29. [PMID: 38218816 PMCID: PMC10787474 DOI: 10.1186/s12931-023-02660-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 12/28/2023] [Indexed: 01/15/2024] Open
Abstract
Bronchial asthma is a prevalent and increasingly chronic inflammatory lung disease affecting over 300 million people globally. Initially considered an allergic disorder driven by mast cells and eosinophils, asthma is now recognized as a complex syndrome with various clinical phenotypes and immunological endotypes. These encompass type 2 inflammatory endotypes characterized by interleukin (IL)-4, IL-5, and IL-13 dominance, alongside others featuring mixed or non-eosinophilic inflammation. Therapeutic success varies significantly based on asthma phenotypes, with inhaled corticosteroids and beta-2 agonists effective for milder forms, but limited in severe cases. Novel antibody-based therapies have shown promise, primarily for severe allergic and type 2-high asthma. To address this gap, novel treatment strategies are essential for better control of asthma pathology, prevention, and exacerbation reduction. One promising approach involves stimulating endogenous anti-inflammatory responses through regulatory T cells (Tregs). Tregs play a vital role in maintaining immune homeostasis, preventing autoimmunity, and mitigating excessive inflammation after pathogenic encounters. Tregs have demonstrated their ability to control both type 2-high and type 2-low inflammation in murine models and dampen human cell-dependent allergic airway inflammation. Furthermore, microbes, typically associated with disease development, have shown immune-dampening properties that could be harnessed for therapeutic benefits. Both commensal microbiota and pathogenic microbes have demonstrated potential in bacterial-host interactions for therapeutic purposes. This review explores microbe-associated approaches as potential treatments for inflammatory diseases, shedding light on current and future therapeutics.
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Affiliation(s)
- Sebastian Reuter
- Department of Pulmonary Medicine, University Hospital Essen-Ruhrlandklinik, Tüschener Weg 40, 45239, Essen, Germany.
| | - Jonas Raspe
- Department of Pulmonary Medicine, University Hospital Essen-Ruhrlandklinik, Tüschener Weg 40, 45239, Essen, Germany
| | - Christian Taube
- Department of Pulmonary Medicine, University Hospital Essen-Ruhrlandklinik, Tüschener Weg 40, 45239, Essen, Germany
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Wang S, Wang X, Liu J, Li Y, Sun M, Zhu G, Zhu X. Helicobacter pylori infection attenuates 2,4-dinitrochlorobenzene-induced atopic dermatitis-like skin lesions in C57/BL6 mice. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2023; 19:97. [PMID: 37978564 PMCID: PMC10656826 DOI: 10.1186/s13223-023-00851-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 10/23/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Although numerous studies have suggested a negative correlation between Helicobacter pylori (H. pylori) infection and allergies, there has been limited research on the relationship between H. pylori infections and atopic dermatitis (AD). The present study aimed to investigate the effects of H. pylori infection in an AD mouse model and identify potential mechanisms related to type 2 immunity, skin barrier defects, and pruritus. METHODS A model of AD-like symptoms was established with 2,4-dinitrochlorobenzene (DNCB) after infection of the gastric cavity with H. pylori. Analysis of the expression of key inflammatory cytokines and serum levels of immunoglobulin E (IgE) was based on enzyme-linked immunosorbent assay (ELISA). The expression of filaggrin (FLG) and loricrin (LOR) were analyzed by immunohistochemistry staining. The evaluation of STAT1, STAT3, phosphorylated STAT1 (phospho-STAT1), and phosphorylated STAT3 (phospho-STAT1) expression levels in skin lesions was performed using western blot. RESULTS The present study showed that the H. pylori-positive AD group (HP+AD+) exhibited milder skin lesions, including erythema, erosion, swelling, and scaling, than the H. pylori-negative AD group (HP-AD+). Additionally, HP+AD+ displayed lower levels of IgE in serum, and downregulated expression of interleukins 4 and 31 (IL-4 and IL-31) in serum. Furthermore, HP+AD+ demonstrated higher expression of filaggrin and loricrin than HP-AD+. Notably, H. pylori significantly reduced the amount of phosphorylated STAT1 and STAT3. CONCLUSION Helicobacter pylori infection negatively regulates the inflammatory response by affecting inflammatory factors in the immune response, and repairs the defective epidermal barrier function. In addition, H. pylori infection may reduce IL-31, thereby alleviating pruritus. These effects may be associated with the inhibition of JAK-STAT signaling activation.
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Affiliation(s)
- Shuxian Wang
- Department of Dermatology, Medical College, Yangzhou University, Yangzhou, China
| | - Xiaokang Wang
- Department of Dermatology, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Jiaqi Liu
- Veterinary Medical College, Yangzhou University, Yangzhou, China
| | - Yaqian Li
- Veterinary Medical College, Yangzhou University, Yangzhou, China
| | - Minghui Sun
- Department of Dermatology, Medical College, Yangzhou University, Yangzhou, China
| | - Guoqiang Zhu
- Veterinary Medical College, Yangzhou University, Yangzhou, China
| | - Xiaofang Zhu
- Department of Dermatology, Clinical Medical College, Yangzhou University, Yangzhou, China.
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Chen Y, Zhan X, Wang D. Association between Helicobacter pylori and risk of childhood asthma: a meta-analysis of 18 observational studies. J Asthma 2021; 59:890-900. [PMID: 33630702 DOI: 10.1080/02770903.2021.1892752] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objective: The association between Helicobacter pylori (H. pylori) and childhood asthma is unclear. Thus, the aim of this study was to explore the association between H. pylori and childhood asthma.Methods: A literature search, study selection, and data extraction were performed independently and in duplicate. Data were analyzed using STATA software.Results: Eighteen studies enrolling 17,196 children were analyzed. All studies were of moderate-to-high quality. Four studies subcategorized H. pylori infection according to CagA status. Overall, there was a significant negative association between H. pylori and risk for childhood asthma (OR = 0.68; 95% CI, 0.54-0.87; P = 0.002), with no/marginal publication bias identified by the Egger's test and the Begg's test (P = 0.162 and P = 0.198, respectively). The observed inverse association persisted for CagA(+) strains of H. pylori (OR = 0.58; 95% CI, 0.35-0.96; P = 0.034) but not for CagA(-) strains (OR = 0.52; 95% CI, 0.12-2.28; P = 0.387). There was no significant difference between studies with respect to study design, participant age, geographical region, and method of measuring H. pylori.Conclusion: The evidence suggests that H. pylori infection, particularly CagA(+) H. pylori infection, is inversely associated with the risk of childhood asthma. Supplemental data for this article can be accessed at publisher's website.
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Affiliation(s)
- Yuxia Chen
- Department of Gastroenterology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Xue Zhan
- Department of Gastroenterology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Donghai Wang
- Department of Respiratory Disease, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation base of Child development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, China
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Reshetnyak VI, Burmistrov AI, Maev IV. Helicobacter pylori: Commensal, symbiont or pathogen? World J Gastroenterol 2021; 27:545-560. [PMID: 33642828 PMCID: PMC7901052 DOI: 10.3748/wjg.v27.i7.545] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 12/28/2020] [Accepted: 01/21/2021] [Indexed: 02/06/2023] Open
Abstract
This review considers the data on Helicobacter pylori (H. pylori), which have been accumulated over 40 years since its description as an etiological factor in gastrointestinal diseases. The majority of modern publications are devoted to the study of the pathogenic properties of the microorganism in the development of chronic gastritis, peptic ulcer disease, and gastric cancer, as well as methods for its eradication. However, in recent years, there have been more and more studies which have suggested that H. pylori has a beneficial, or potentially positive, effect on the human body. The authors have attempted to objectively analyze the information accumulated in the literature on H. pylori. Some studies consider it as one of the recently identified human bacterial pathogens, and special attention is paid to the evidence suggesting that it is probably part of the composition of the human microbiome as a commensal (commensal from French to English is a table companion) or even a symbiont. The presented data discussing the presence or absence of the effect of H. pylori on human health suggest that there is an apparent ambiguity of the problem. The re-assessment of the data available on H. pylori infection is important in order to answer the question of whether it is necessary to create a program of mass H. pylori eradication or to apply a more personalized approach to treating patients with H. pylori-associated gastrointestinal diseases and to perform eradication therapy.
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Affiliation(s)
- Vasiliy Ivanovich Reshetnyak
- Department of Propaedeutic of Internal Diseases and Gastroenterology, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow 127473, Russia
| | - Alexandr Igorevich Burmistrov
- Department of Propaedeutic of Internal Diseases and Gastroenterology, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow 127473, Russia
| | - Igor Veniaminovich Maev
- Department of Propaedeutic of Internal Diseases and Gastroenterology, A.I. Yevdokimov Moscow State University of Medicine and Dentistry, Moscow 127473, Russia
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Zuo ZT, Ma Y, Sun Y, Bai CQ, Ling CH, Yuan FL. The Protective Effects of Helicobacter pylori Infection on Allergic Asthma. Int Arch Allergy Immunol 2020; 182:53-64. [PMID: 33080611 DOI: 10.1159/000508330] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 04/30/2020] [Indexed: 12/13/2022] Open
Abstract
As an ancient Gram-negative bacterium, Helicobacter pylori has settled in human stomach. Eradicating H. pylori increases the morbidities of asthma and other allergic diseases. Therefore, H. pylori might play a protective role against asthma. The "disappearing microbiota" hypothesis suggests that the absence of certain types of the ancestral microbiota could change the development of immunology, metabolism, and cognitive ability in our early life, contributing to the development of some diseases. And the Hygiene Hypothesis links early environmental and microbial exposure to the prevalence of atopic allergies and asthma. Exposure to the environment and microbes can influence the growing immune system and protect subsequent immune-mediated diseases. H. pylori can inhibit allergic asthma by regulating the ratio of helper T cells 1/2 (Th1/Th2), Th17/regulatory T cells (Tregs), etc. H. pylori can also target dendritic cells to promote immune tolerance and enhance the protective effect on allergic asthma, and this effect relies on highly suppressed Tregs. The remote regulation of lung immune function by H. pylori is consistent with the gut-lung axis theory. Perhaps, H. pylori also protects against asthma by altering levels of stomach hormones, affecting the autonomic nervous system and lowering the expression of heat shock protein 70. Therapeutic products from H. pylori may be used to prevent and treat asthma. This paper reviews the possible protective influence of H. pylori on allergic asthma and the possible application of H. pylori in treating asthma.
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Affiliation(s)
- Zhi Tong Zuo
- Department of Respiratory Disease, The Hospital Affiliated to Jiangnan University, Wuxi, China,
| | - Ya Ma
- Wuxi Medical College of Jiangnan University, Wuxi, China
| | - Yan Sun
- Department of Respiratory Disease, The Hospital Affiliated to Jiangnan University, Wuxi, China
| | - Cui Qing Bai
- Department of Respiratory Disease, The Hospital Affiliated to Jiangnan University, Wuxi, China
| | - Chun Hua Ling
- Department of Respiratory Disease, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Feng Lai Yuan
- Department of Orthopaedics and Central Laboratory, The Hospital Affiliated to Jiangnan University, Wuxi, China
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Arnold M, Park JY, Camargo MC, Lunet N, Forman D, Soerjomataram I. Is gastric cancer becoming a rare disease? A global assessment of predicted incidence trends to 2035. Gut 2020; 69:823-829. [PMID: 32001553 PMCID: PMC8520492 DOI: 10.1136/gutjnl-2019-320234] [Citation(s) in RCA: 211] [Impact Index Per Article: 52.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 01/16/2020] [Accepted: 01/17/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The incidence of gastric cancer continues to decrease globally, approaching levels that in some populations could define it as a rare disease. To explore this on a wider scale, we predict its future burden in 34 countries with long-standing population-based data. METHODS Data on gastric cancer incidence by year of diagnosis, sex and age were extracted for 92 cancer registries in 34 countries included in Cancer Incidence in Five Continents Plus. Numbers of new cases and age-standardised incidence rates (ASR per 100 000) were predicted up to 2035 by fitting and extrapolating age-period-cohort models. RESULTS Overall gastric cancer incidence rates are predicted to continue falling in the future in the majority of countries, including high-incidence countries such as Japan (ASR 36 in 2010 vs ASR 30 in 2035) but also low-incidence countries such as Australia (ASR 5.1 in 2010 vs ASR 4.6 in 2035). A total of 16 countries are predicted to fall below the rare disease threshold (defined as 6 per 100 000 person-years) by 2035, while the number of newly diagnosed cases remains high and is predicted to continue growing. In contrast, incidence increases were seen in younger age groups (below age 50 years) in both low-incidence and high-incidence populations. CONCLUSIONS While gastric cancer is predicted to become a rare disease in a growing number of countries, incidence levels remain high in some regions, and increasing risks have been observed in younger generations. The predicted growing number of new cases highlights that gastric cancer remains a major challenge to public health on a global scale.
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Affiliation(s)
- Melina Arnold
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Jin Young Park
- Prevention and Implementation Group, Early Detection and Prevention Section, International Agency for Research on Cancer, Lyon, France
| | - M Constanza Camargo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Nuno Lunet
- Departamento Ciências da Saúde Pública e Forenses, e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
- Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal
| | - David Forman
- Section of Epidemiology and Biostatistics, University of Leeds Faculty of Medicine and Health, Leeds, UK
| | - Isabelle Soerjomataram
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
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Akiner U, Yener HM, Gozen ED, Kuzu SB, Canakcioglu S. Helicobacter pylori in allergic and non-allergic rhinitis does play a protective or causative role? Eur Arch Otorhinolaryngol 2019; 277:141-145. [DOI: 10.1007/s00405-019-05659-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 09/14/2019] [Indexed: 02/07/2023]
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10
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Patrucco F, Venezia L, Gavelli F, Solidoro P. Helicobacter pylori and respiratory diseases: update for pneumologist. ACTA ACUST UNITED AC 2018. [DOI: 10.23736/s0026-4954.18.01824-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Bravo D, Hoare A, Soto C, Valenzuela MA, Quest AFG. Helicobacter pylori in human health and disease: Mechanisms for local gastric and systemic effects. World J Gastroenterol 2018; 24:3071-3089. [PMID: 30065554 PMCID: PMC6064966 DOI: 10.3748/wjg.v24.i28.3071] [Citation(s) in RCA: 109] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 05/17/2018] [Accepted: 06/27/2018] [Indexed: 02/06/2023] Open
Abstract
Helicobacter pylori (H. pylori) is present in roughly 50% of the human population worldwide and infection levels reach over 70% in developing countries. The infection has classically been associated with different gastro-intestinal diseases, but also with extra gastric diseases. Despite such associations, the bacterium frequently persists in the human host without inducing disease, and it has been suggested that H. pylori may also play a beneficial role in health. To understand how H. pylori can produce such diverse effects in the human host, several studies have focused on understanding the local and systemic effects triggered by this bacterium. One of the main mechanisms by which H. pylori is thought to damage the host is by inducing local and systemic inflammation. However, more recently, studies are beginning to focus on the effects of H. pylori and its metabolism on the gastric and intestinal microbiome. The objective of this review is to discuss how H. pylori has co-evolved with humans, how H. pylori presence is associated with positive and negative effects in human health and how inflammation and/or changes in the microbiome are associated with the observed outcomes.
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Affiliation(s)
- Denisse Bravo
- Oral Microbiology Laboratory, Pathology and Oral Medicine Department, Faculty of Dentistry, Universidad de Chile, Santiago 8380492, Chile
| | - Anilei Hoare
- Oral Microbiology Laboratory, Pathology and Oral Medicine Department, Faculty of Dentistry, Universidad de Chile, Santiago 8380492, Chile
| | - Cristopher Soto
- Oral Microbiology Laboratory, Pathology and Oral Medicine Department, Faculty of Dentistry, Universidad de Chile, Santiago 8380492, Chile
| | - Manuel A Valenzuela
- Advanced Center for Chronic Diseases, Institute for Health-Related Research and Innovation, Faculty of Health Sciences, Universidad Central de Chile, Santiago 8380447, Chile
| | - Andrew FG Quest
- Advanced Center for Chronic Diseases, Center for Studies on Exercise, Metabolism and Cancer, Biomedical Science Institute, Faculty of Medicine, Universidad de Chile, Santiago 8380447, Chile
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Zhou X, Du L, Shi R, Chen Z, Zhou Y, Li Z. Early-life food nutrition, microbiota maturation and immune development shape life-long health. Crit Rev Food Sci Nutr 2018; 59:S30-S38. [PMID: 29874476 DOI: 10.1080/10408398.2018.1485628] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The current knowledge about early-life nutrition and environmental factors that affect the interaction between the symbiotic microbiota and the host immune system has demonstrated novel regulatory target for treating allergic diseases, autoimmune disorders and metabolic syndrome. Various kinds of food nutrients (such as dietary fiber, starch, polyphenols and proteins) can provide energy resources for both intestinal microbiota and the host. The indigestible food components are fermented by the indigenous gut microbiota to produce diverse metabolites, including short-chain fatty acids, bile acids and trimethylamine-N-oxide, which can regulate the host metabolized physiology, immunity homeostasis and health state. Therefore it is commonly believed early-life perturbation of the microbial community structure and the dietary nutrition interference on the child mucosal immunity contribute to the whole life susceptibility to chronic diseases. In all, the combined interrelationship between food ingredients nutrition, intestinal microbiota configurations and host system immunity provides new therapeutic targets to treat various kinds of pathogenic inflammations and chronic diseases.
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Affiliation(s)
- Xiaoli Zhou
- a Shanghai Institute of Technology , Shanghai , China
| | - Lina Du
- a Shanghai Institute of Technology , Shanghai , China
| | - Ronghua Shi
- a Shanghai Institute of Technology , Shanghai , China
| | - Zhidong Chen
- a Shanghai Institute of Technology , Shanghai , China
| | - Yiming Zhou
- a Shanghai Institute of Technology , Shanghai , China
| | - Zongjie Li
- a Shanghai Institute of Technology , Shanghai , China
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Helicobacter pylori infection does not protect against eosinophilic esophagitis: results from a large multicenter case-control study. Am J Gastroenterol 2018; 113:972-979. [PMID: 29545632 DOI: 10.1038/s41395-018-0035-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 01/09/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Rising trends in eosinophilic esophagitis (EoE) have been repeatedly linked to declining Helicobacter pylori (H. pylori) infection, mostly in retrospective studies. We aimed to prospectively evaluate this inverse association. METHODS Prospective case-control study conducted in 23 centers. Children and adults naïve to eradication therapy for H. pylori were included. Cases were EoE patients, whereas controls were defined by esophageal symptoms and <5 eos/HPF on esophageal biopsies. H. pylori status was diagnosed by non-invasive (excluding serology) or invasive testing off proton pump inhibitor (PPI) therapy for 2 weeks. Atopy was defined by the presence of IgE-mediated conditions diagnosed by an allergist. RESULTS 808 individuals, including 404 cases and 404 controls (170 children) were enrolled. Overall H. pylori prevalence was 38% (45% children vs. 37% adults, p 0.009) and was not different between cases and controls (37% vs. 40%, p 0.3; odds ratio (OR) 0.97; 95% confidence interval (CI) 0.73-1.30), neither in children (42% vs. 46%, p 0.1) nor in adults (36% vs. 38%, p 0.4). Atopy (OR 0.85; 95%CI 0.75-0.98) and allergic rhinitis (OR 0.81; 95%CI 0.68-0.98) showed a borderline inverse association with H. pylori infection in EoE patients. This trend was not confirmed for asthma or food allergy. CONCLUSIONS H. pylori infection was not inversely associated with EoE, neither in children nor in adults. A borderline inverse association was confirmed for atopy and allergic rhinitis, but not asthma of food allergy. Our findings question a true protective role of H. pylori infection against allergic disorders, including EoE.
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Li J, Perez-Perez GI. Helicobacter pylori the Latent Human Pathogen or an Ancestral Commensal Organism. Front Microbiol 2018; 9:609. [PMID: 29666614 PMCID: PMC5891615 DOI: 10.3389/fmicb.2018.00609] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 03/15/2018] [Indexed: 12/15/2022] Open
Abstract
We dedicated this review to discuss Helicobacter pylori as one of the latest identified bacterial pathogens in humans and whether its role is mainly as a pathogen or a commensal. Diseases associated with this bacterium were highly prevalent during the 19th century and gradually have declined. Most diseases associated with H. pylori occurred in individuals older than 40 years of age. However, acquisition of H. pylori occurs mainly in young children inside the family setting. Prevalence and incidence of H. pylori has had a dramatic change in the last part of the 20th century and beginning of the 21th century. In developed countries there is a clear interruption of transmission and the lowest prevalence is observed in children younger than 10 years in these countries. A similar decline is observed but not at the same level in developing countries. Here we discuss the impact of the presence or absence of H. pylori in the health status of humans. We also discuss whether it is necessary or not to establish H. pylori eradication programs on light of the current decline in H. pylori prevalence.
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Affiliation(s)
- Jackie Li
- Department of Medicine, School of Medicine, New York University, New York, NY, United States
| | - Guillermo I Perez-Perez
- Department of Medicine, School of Medicine, New York University, New York, NY, United States.,Department of Medicine and Microbiology, School of Medicine, New York University, New York, NY, United States
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15
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Zabala Torrres B, Lucero Y, Lagomarcino AJ, Orellana-Manzano A, George S, Torres JP, O'Ryan M. Review: Prevalence and dynamics of Helicobacter pylori infection during childhood. Helicobacter 2017. [PMID: 28643393 DOI: 10.1111/hel.12399] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Long-term persistent Helicobacter pylori infection has been associated with ulceropeptic disease and gastric cancer. Although H. pylori is predominantly acquired early in life, a clear understanding of infection dynamics during childhood has been obfuscated by the diversity of populations evaluated, study designs, and methods used. AIM Update understanding of true prevalence of H. pylori infection during childhood, based on a critical analysis of the literature published in the past 5 years. METHODS Comprehensive review and meta-analysis of original studies published from 2011 to 2016. RESULTS A MEDLINE® /PubMed® search on May 1, 2016, using the terms pylori and children, and subsequent exclusion, based on abstract review using predefined criteria, resulted in 261 citations. An Embase® search with the same criteria added an additional 8 citations. In healthy children, meta-analysis estimated an overall seroprevalence rate of 33% (95% CI: 27%-38%). Seven healthy cohort studies using noninvasive direct detection methods showed infection prevalence estimates ranging from 20% to 50% in children ≤5 and 38% to 79% in children >5 years. The probability of infection persistence after a first positive sample ranged from 49% to 95%. Model estimates of cross-sectional direct detection studies in asymptomatic children indicated a prevalence of 37% (95% CI: 30%-44%). Seroprevalence, but not direct detection rates increased with age; both decreased with increasing income. The model estimate based on cross-sectional studies in symptomatic children was 39% (95% CI: 35%-43%). CONCLUSIONS The prevalence of H. pylori infection varied widely in the studies included here; nevertheless, model estimates by detection type were similar, suggesting that overall, one-third of children worldwide are or have been infected. The few cohort and longitudinal studies available show variability, but most studies, show infection rates over 30%. Rather surprisingly, overall infection prevalence in symptomatic children was only slightly higher, around 40%. Studies including only one positive stool sample should be interpreted with caution as spontaneous clearance can occur.
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Affiliation(s)
- Beatriz Zabala Torrres
- Microbiology and Mycology Program, Faculty of Medicine, Institute of Biomedical Sciences, Universidad de Chile, Santiago, Chile.,Universidad de Aysén, Campus Rio Simpson, Coyhaique, Chile
| | - Yalda Lucero
- Department of Pediatrics, Faculty of Medicine, Hospital Luis Calvo Mackenna, Universidad de Chile, Santiago, Chile
| | - Anne J Lagomarcino
- Microbiology and Mycology Program, Faculty of Medicine, Institute of Biomedical Sciences, Universidad de Chile, Santiago, Chile
| | - Andrea Orellana-Manzano
- Escuela Superior Politécnica del Litoral, ESPOL, Facultad de Ciencias de la Vida (FCV), Campus Gustavo Galindo Km. 30.5 Vía Perímetral, P. O. Box 09-01-5863, Guayaquil, Ecuador
| | - Sergio George
- Microbiology and Mycology Program, Faculty of Medicine, Institute of Biomedical Sciences, Universidad de Chile, Santiago, Chile
| | - Juan P Torres
- Department of Pediatrics, Faculty of Medicine, Hospital Luis Calvo Mackenna, Universidad de Chile, Santiago, Chile
| | - Miguel O'Ryan
- Microbiology and Mycology Program, Faculty of Medicine, Institute of Biomedical Sciences, Universidad de Chile, Santiago, Chile
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16
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Taye B, Enquselassie F, Tsegaye A, Amberbir A, Medhin G, Fogarty A, Robinson K, Davey G. Association between infection with Helicobacter pylori and atopy in young Ethiopian children: A longitudinal study. Clin Exp Allergy 2017; 47:1299-1308. [PMID: 28787771 DOI: 10.1111/cea.12995] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 06/07/2017] [Accepted: 07/26/2017] [Indexed: 01/01/2023]
Abstract
BACKGROUND Epidemiological evidence from developed countries indicates that Helicobacter pylori infection correlates with a reduced risk of atopy and allergic disorders; however, limited data are available from low-income countries. OBJECTIVE We examined associations between H. pylori infection in early childhood and atopy and reported allergic disorders at the age of 6.5 years in an Ethiopian birth cohort. METHODS A total of 856 children (85.1% of the 1006 original singletons in a population-based birth cohort) were followed up at age six and half years. An interviewer-led questionnaire administered to mothers provided information on demographic and lifestyle variables. Questions on allergic disease symptoms were based on the International Study of Asthma and Allergies in Children (ISAAC) core allergy and environmental questionnaire. Serum samples were analysed for total IgE levels and anti-H. pylori cytotoxin-associated gene A (CagA) IgG antibody using commercially available ELISA kits. Stool samples were analysed for H. pylori antigen using a rapid immunochromatographic test. The independent effects of H. pylori infection (measured at age of 3, 5 and 6.5 years) on prevalence and incidence of atopy and reported allergic disorders (measured at age of 6.5 years) were determined using multiple logistic regression. RESULTS In cross-sectional analysis, current H. pylori infection at age 6.5 years was inversely, though not significantly, related to prevalence of atopy and "any allergic condition" at age 6.5 years. However, detection of H. pylori infection at any point up to age 6.5 years was associated with a significantly reduced odds of both atopy and "any allergic condition" (adjusted OR AOR, 95% CI, 0.54; 0.32-0.92, P = .02, and .31; 0.10-0.94, P = .04, respectively). In longitudinal analyses, H. pylori infection at age 3 was inversely associated with incidence of atopy (AOR, 95% CI, 0.49; 0.27-0.89, P = .02). Furthermore, among H. pylori-infected children, those with a CagA+ strain had a more pronounced reduction in odds of atopy (AOR = 0.35 vs 0.63 for CagA+ vs CagA-), and this reduction reached borderline significance. CONCLUSION These data are consistent with the hypothesis that early exposure to H. pylori is inversely associated with atopy and allergic conditions. A possible modest protective association against atopy was observed in those infected with a more virulent CagA+ strain of H. pylori.
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Affiliation(s)
- B Taye
- Department of Biology, Colgate University, Hamilton, NY, USA
| | - F Enquselassie
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - A Tsegaye
- School of Allied Health Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - G Medhin
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - A Fogarty
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - K Robinson
- Nottingham Digestive Diseases Biomedical Research Centre, School of Medicine, University of Nottingham, Nottingham, UK
| | - G Davey
- Wellcome Trust Centre for Global Health Research, Brighton & Sussex Medical School, Brighton, UK
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17
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Accumulated evidence on Helicobacter pylori infection and the risk of asthma: A meta-analysis. Ann Allergy Asthma Immunol 2017. [PMID: 28634020 DOI: 10.1016/j.anai.2017.05.021] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Helicobacter pylori (H pylori) infection has been suggested to be related to a decreased risk of asthma, but findings in the literature are inconsistent. OBJECTIVE To quantitatively summarize the existing evidence on the association between H pylori infection and asthma risk. METHODS The PubMed database was searched for observational studies of H pylori infection in relation to the risk of asthma published in English through May 2017. Measurements of association were pooled using a meta-analytic approach and expressed as odds ratios (ORs) with 95% confidence intervals (95% CIs). RESULTS Twenty-four studies were identified in this meta-analysis, including 8 case-control studies composed of 1,247 cases and 2,410 controls, and 16 cross-sectional studies composed of 50,290 participants (4,185 cases and 46,105 noncases). The average H pylori infection rates were 40.01% and 48.74% in case-control and cross-sectional studies, respectively. Five studies subcategorized H pylori infection according to CagA status, in which 59.37% of H pylori-infected participants were identified as having CagA positivity. Helicobacter pylori infection was significantly inversely associated with the risk of asthma in case-control studies (OR 0.83, 95% CI 0.71-0.98) but was borderline significant in cross-sectional studies (OR 0.88, 95% CI 0.76-1.02). The observed inverse association persisted for CagA-positive H pylori infection (OR 0.77, 95% CI 0.63-0.93, P for interaction = .03) but not for CagA-negative strains (OR 1.08, 95% CI 0.66-1.78). No significant difference was observed across age or region subgroups. CONCLUSION The accumulated evidence supports that H pylori infection, especially CagA-positive H pylori infection, is inversely associated with the risk of asthma.
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18
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Miftahussurur M, Nusi IA, Graham DY, Yamaoka Y. Helicobacter, Hygiene, Atopy, and Asthma. Front Microbiol 2017; 8:1034. [PMID: 28642748 PMCID: PMC5462935 DOI: 10.3389/fmicb.2017.01034] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Accepted: 05/23/2017] [Indexed: 12/13/2022] Open
Abstract
The hygiene hypothesis links environmental and microbial exposures in early life to the prevalence of atopy, allergy, and asthma. Helicobacter pylori infection is typically acquired in childhood and acquisition of the infection is associated with poor household hygiene. Some population surveys have shown an inverse association between H. pylori infection and atopy, allergy, and asthma leading to the suggestion that H. pylori infection may be protective against disease; others consider it simply a biomarker for poor household hygiene. We review the relevant surveys, cohort studies, meta-analyses, and studies testing the protective hypothesis. Overall, the results of surveys and cohort studies are inconsistent, whereas meta-analyses show a significant but weak inverse correlation. In contrast, studies directly testing the protection hypothesis in relation to asthma in populations with poor hygiene and low H. pylori prevalence failed to confirm a protective effect. H. pylori is a major cause of human disease including chronic gastritis, peptic ulcer, and gastric malignancies. H. pylori infections most likely serve as a biomarker for poor hygienic conditions in childhood. We conclude that while synergistic interactions between environmental factors in childhood are important determinants of the pathogenesis of atopy, allergy, and asthma; H. pylori is inversely related to good hygiene and thus it's presence serves as a biomarker rather than for a specific prevention role for H. pylori or H. pylori antigens.
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Affiliation(s)
- Muhammad Miftahussurur
- Gastroenterology and Hepatology Section, Department of Medicine, Baylor College of MedicineHouston, TX, United States
- Department of Environmental and Preventive Medicine, Oita University Faculty of MedicineYufu, Japan
- Gastroentero-Hepatology Division, Department of Internal Medicine, Faculty of Medicine-Institute of Tropical Disease, Universitas AirlanggaSurabaya, Indonesia
| | - Iswan A. Nusi
- Gastroentero-Hepatology Division, Department of Internal Medicine, Faculty of Medicine-Institute of Tropical Disease, Universitas AirlanggaSurabaya, Indonesia
| | - David Y. Graham
- Gastroenterology and Hepatology Section, Department of Medicine, Baylor College of MedicineHouston, TX, United States
| | - Yoshio Yamaoka
- Gastroenterology and Hepatology Section, Department of Medicine, Baylor College of MedicineHouston, TX, United States
- Department of Environmental and Preventive Medicine, Oita University Faculty of MedicineYufu, Japan
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19
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Lankarani KB, Honarvar B, Athari SS. The Mechanisms Underlying Helicobacter Pylori-Mediated Protection against Allergic Asthma. TANAFFOS 2017; 16:251-259. [PMID: 29849681 PMCID: PMC5971755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Helicobacter pylori, a gram negative pathogen, infects the stomach and gastrointestinal tract and causes pathological damage to these organs. H. pylori infection is more prevalent among people living in developing countries. Allergic asthma is a chronic inflammatory disease of the airways. Hyperinflation, hyperresponsiveness, and abnormal immunological and inflammatory processes in respiratory airways typically occur during an asthma attack. The results of recent studies have suggested an association between H. pylori and asthma risk. However, the role of H. pylori infection in the pathophysiology of asthma is still a matter of debate. The results of some studies indicate an association between H. pylori infection and protection against allergic asthma. Exposure to infectious agents might educate the immune system and provide protection against allergic diseases. H. pylori inflammation also changes gastric hormonal levels and could influence the autonomic nervous system. T-regs could be influenced by the immunological response to H. pylori and then inhibit the Th-2-mediated allergic response. Therefore, H. pylori might play a protective role against asthma. H. pylori can also reduce gastro-esophageal reflux, which is an asthma stimulator. High loads of H. pylori are not always present during infection. It is not definitely clear whether H. pylori is a pathogen or simply an opportunist. It has been suggested that early exposure to H. pylori prevents development of pediatric asthma. Therefore, it is possible that therapeutic products made from H. pylori can be used for the treatment or prevention of asthma.
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Affiliation(s)
- Kamran Bagheri Lankarani
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Behnam Honarvar
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyyed Shamsadin Athari
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Immunology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
- Research Center for Food Hygiene and Safety, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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20
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Helicobacter pylori infection increases the risk of adult-onset asthma: a nationwide cohort study. Eur J Clin Microbiol Infect Dis 2017; 36:1587-1594. [DOI: 10.1007/s10096-017-2972-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 03/22/2017] [Indexed: 12/29/2022]
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21
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Ribaldone DG, Fagoonee S, Colombini J, Saracco G, Astegiano M, Pellicano R. Helicobacter pylori infection and asthma: Is there a direct or an inverse association? A meta-analysis. World J Meta-Anal 2016; 4:63-68. [DOI: 10.13105/wjma.v4.i3.63] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Revised: 05/18/2016] [Accepted: 06/03/2016] [Indexed: 02/05/2023] Open
Abstract
AIM: To analyze the consistency of a potential involvement of the bacterium infection in the asthma disease.
METHODS: A systematic literature search of the terms “Helicobacter pylori” (H. pylori) associated to “asthma” using PubMed, Scopus and the Cochrane Library Central was performed. Reference lists from published articles were also employed. Titles of these publications and their abstracts were scanned in order to eliminate duplicates and irrelevant articles. The criteria of inclusion of the studies were: Original studies; the H. pylori diagnostic method has been declared; all ranges of age have been included in our study; a definitive diagnosis of asthma has been reported.
RESULTS: We selected 14 articles in which the association between the two conditions was addressed. In 7 studies the prevalence of H. pylori infection in the asthma population and in the control population was made explicit. There was heterogeneity between the studies (Cohran’s Q = 0.02). The H. pylori infection in the asthma population resulted 33.6% (518 of 1542), while in the control population resulted 37.6% (2746 of 7310) (relative risk of H. pylori infection in the asthma population = 0.87, 95%CI: 0.72-1.05, P = 0.015, random effects model). Instead, considering the more virulent strains, the majority of studies showed an inverse relationship between the prevalence of H. pylori infection and asthma.
CONCLUSION: In our meta-analysis the prevalence of H. pylori infection in the asthma population resulted not statistically significant lower than in control population (P = 0.15). Instead, considering the more virulent strains, the majority of studies showed an inverse relationship between the prevalence of H. pylori infection and asthma.
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22
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den Hollander WJ, Sonnenschein-van der Voort AMM, Holster IL, de Jongste JC, Jaddoe VW, Hofman A, Perez-Perez GI, Moll HA, Blaser MJ, Duijts L, Kuipers EJ. Helicobacter pylori in children with asthmatic conditions at school age, and their mothers. Aliment Pharmacol Ther 2016; 43:933-943. [PMID: 26932510 PMCID: PMC5009009 DOI: 10.1111/apt.13572] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 06/17/2015] [Accepted: 02/05/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Helicobacter pylori prevalence in Western countries has been declining simultaneously with increases in childhood asthma and allergic diseases; prior studies have linked these phenomena. AIMS To examine the association between H. pylori colonisation in children and risk of asthma and related conditions at school age. We secondly examined additional effects of maternal H. pylori status by pairing with children's status. METHODS This study was embedded in a multi-ethnic population-based cohort in Rotterdam, The Netherlands. We measured anti-H. pylori and anti-CagA antibodies in serum of children obtained at age 6 years, and of their mothers obtained during midpregnancy. Asthma or related conditions were reported for children at age 6 years. We used multivariate logistic regression analyses among 3797 subjects. RESULTS In children, the H. pylori positivity rate was 8.7%, and 29.2% of these were CagA-positive. A child's colonisation with a CagA-negative-H. pylori strain was associated with an increased risk of asthma (Odds ratio 2.11; 95% CI 1.23-3.60), but this differed for European (3.64; 1.97-6.73) and non-European (0.52; 0.14-1.89) children. When taking into account maternal H. pylori status, only H. pylori-positive children with an H. pylori-negative mother had increased risk of asthma (2.42; 1.11-5.27), accounting for 3.4% of the asthma risk. CONCLUSIONS Colonisation of a European child with a CagA-negative-H. pylori strain at age 6 was associated with an increased prevalence of asthma, but there was no association for non-European children. The underlying mechanisms for the observed risk differences require further research.
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Affiliation(s)
- Wouter J. den Hollander
- Department of Gastroenterology and Hepatology, Erasmus University Medical Centre, Rotterdam, The Netherlands,The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Agnes M. M. Sonnenschein-van der Voort
- The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands,Department of Paediatrics, division of Respiratory Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands,Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - I. Lisanne Holster
- Department of Gastroenterology and Hepatology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Johan C. de Jongste
- Department of Paediatrics, division of Respiratory Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Vincent W. Jaddoe
- The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands,Department of Paediatrics, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Guillermo I. Perez-Perez
- Departments of Medicine and Microbiology, New York University Langone Medical Centre, New York, USA
| | - Henriëtte A. Moll
- Department of Paediatrics, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Martin J. Blaser
- Departments of Medicine and Microbiology, New York University Langone Medical Centre, New York, USA
| | - Liesbeth Duijts
- Department of Paediatrics, division of Respiratory Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands,Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, The Netherlands,Department of Paediatrics, division of Neonatology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Ernst J. Kuipers
- Department of Gastroenterology and Hepatology, Erasmus University Medical Centre, Rotterdam, The Netherlands,Department of Internal Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
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23
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Hussain K, Letley DP, Greenaway AB, Kenefeck R, Winter JA, Tomlinson W, Rhead J, Staples E, Kaneko K, Atherton JC, Robinson K. Helicobacter pylori-Mediated Protection from Allergy Is Associated with IL-10-Secreting Peripheral Blood Regulatory T Cells. Front Immunol 2016; 7:71. [PMID: 27014260 PMCID: PMC4779884 DOI: 10.3389/fimmu.2016.00071] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 02/15/2016] [Indexed: 12/18/2022] Open
Abstract
Helicobacter pylori infections are usually established in early childhood and continuously stimulate immunity, including T-helper 1 (Th1), Th17, and regulatory T-cell (Treg) responses, throughout life. Although known to be the major cause of peptic ulcer disease and gastric cancer, disease occurs in a minority of those who are infected. Recently, there has been much interest in beneficial effects arising from infection with this pathogen. Published data robustly show that the infection is protective against asthma in mouse models. Epidemiological studies show that H. pylori is inversely associated with human allergy and asthma, but there is a paucity of mechanistic data to explain this. Since Th1 and Treg responses are reported to protect against allergic responses, we investigated if there were links between the human systemic Th1 and Treg response to H. pylori and allergen-specific IgE levels. The human cytokine and T-cell responses were examined using peripheral blood mononuclear cells (PBMCs) from 49 infected and 58 uninfected adult patients. Concentrations of total and allergen-specific plasma IgE were determined by ELISA and ImmunoCAP assays. These responses were analyzed according to major virulence factor genotypes of the patients' colonizing H. pylori strains. An in vitro assay was employed, using PBMCs from infected and uninfected donors, to determine the role of Treg cytokines in the suppression of IgE. Significantly higher frequencies of IL-10-secreting CD4(+)CD25(hi) Tregs, but not H. pylori-specific Th1 cells, were present in the peripheral blood of infected patients. Total and allergen-specific IgE concentrations were lower when there was a strong Treg response, and blocking IL-10 in vitro dramatically restored IgE responses. IgE concentrations were also significantly lower when patients were infected with CagA(+) strains or those expressing the more active i1 form of VacA. The systemic IL-10(+) Treg response is therefore likely to play a role in H. pylori-mediated protection against allergy in humans.
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Affiliation(s)
- Khiyam Hussain
- Nottingham Digestive Diseases Biomedical Research Unit, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, UK; Centre for Biomolecular Sciences, University of Nottingham, Nottingham, UK
| | - Darren P Letley
- Nottingham Digestive Diseases Biomedical Research Unit, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, UK; Centre for Biomolecular Sciences, University of Nottingham, Nottingham, UK
| | - A Borgel Greenaway
- Nottingham Digestive Diseases Biomedical Research Unit, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, UK; Centre for Biomolecular Sciences, University of Nottingham, Nottingham, UK
| | - Rupert Kenefeck
- Nottingham Digestive Diseases Biomedical Research Unit, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, UK; Centre for Biomolecular Sciences, University of Nottingham, Nottingham, UK
| | - Jody A Winter
- Nottingham Digestive Diseases Biomedical Research Unit, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, UK; Centre for Biomolecular Sciences, University of Nottingham, Nottingham, UK
| | - William Tomlinson
- Nottingham Digestive Diseases Biomedical Research Unit, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, UK; Centre for Biomolecular Sciences, University of Nottingham, Nottingham, UK
| | - Joanne Rhead
- Nottingham Digestive Diseases Biomedical Research Unit, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, UK; Centre for Biomolecular Sciences, University of Nottingham, Nottingham, UK
| | - Emily Staples
- Nottingham Digestive Diseases Biomedical Research Unit, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, UK; Centre for Biomolecular Sciences, University of Nottingham, Nottingham, UK
| | - Kazuyo Kaneko
- Nottingham Digestive Diseases Biomedical Research Unit, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, UK; Centre for Biomolecular Sciences, University of Nottingham, Nottingham, UK
| | - John C Atherton
- Nottingham Digestive Diseases Biomedical Research Unit, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, UK; Centre for Biomolecular Sciences, University of Nottingham, Nottingham, UK
| | - Karen Robinson
- Nottingham Digestive Diseases Biomedical Research Unit, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, UK; Centre for Biomolecular Sciences, University of Nottingham, Nottingham, UK
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25
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Daugule I, Zavoronkova J, Santare D. Helicobacter pylori and allergy: Update of research. World J Methodol 2015; 5:203-211. [PMID: 26713280 PMCID: PMC4686417 DOI: 10.5662/wjm.v5.i4.203] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 07/16/2015] [Accepted: 10/19/2015] [Indexed: 02/06/2023] Open
Abstract
Recently a lot of literature has been published about the possible preventive action of Helicobacter pylori (H. pylori) against allergy. The present review summarizes research data about the association between H. pylori and allergic diseases, as well as discusses possible hypotheses about the preventive action of H. pylori against atopy. There is evidence from observational studies to support a weak inverse association between prevalence of H. pylori infection and allergy. However, confounders like some unidentified socioeconomic factors, antibiotic use and others could bias the association. Although data from cohort studies point to a possible association of H. pylori with some of the allergic diseases, no definite proof for causal relationship has been clearly demonstrated yet. A biological mechanism proposed to explain the preventive action of H. pylori to allergy is reduced exposure to a major stimulus for the generation of Treg cells in individuals without H. pylori infection. In addition, H. pylori could be an indicator for changes in gut microbiome, reflecting the complex interaction between microbes and immune system.
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26
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Kalali B, Formichella L, Gerhard M. Diagnosis of Helicobacter pylori: Changes towards the Future. Diseases 2015; 3:122-135. [PMID: 28943614 PMCID: PMC5548244 DOI: 10.3390/diseases3030122] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 06/18/2015] [Accepted: 06/19/2015] [Indexed: 12/19/2022] Open
Abstract
Since the first evidence demonstrating the dramatically high incidence of H. pylori infection and the subsequent medical challenges it incurs, health management of H. pylori infection has been a high priority for health authorities worldwide. Despite a decreasing rate of infection in western countries, prevalence of H. pylori infection in developing and in some industrial countries is still very high. Whereas treatment and vaccination against H. pylori is a contemporary issue in medical communities, selective treatment and prior high-throughput screening of the subject population is a major concern of health organizations. So far, diagnostic tests are either elaborative and require relatively advanced medical care infrastructure or they do not fulfill the criteria recommended by the Maastricht IV/Florence consensus report. In this review, in light of recent scientific studies, we highlight current and possible future approaches for the diagnosis of H. pylori. We point out that novel non-invasive tests may not only cover the requirements of gold standard methods in H. pylori detection but also offer the potential for risk stratification of infection in a high throughput manner.
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Affiliation(s)
- Behnam Kalali
- Institute of Medical Microbiology, Immunology and Hygiene, TU-Munich, Troger Str.30, 81675 Munich, Germany.
- ImevaX GmbH, Grillparzer Str.18, 81675 Munich, Germany.
| | - Luca Formichella
- Institute of Medical Microbiology, Immunology and Hygiene, TU-Munich, Troger Str.30, 81675 Munich, Germany.
| | - Markus Gerhard
- Institute of Medical Microbiology, Immunology and Hygiene, TU-Munich, Troger Str.30, 81675 Munich, Germany.
- ImevaX GmbH, Grillparzer Str.18, 81675 Munich, Germany.
- German Center for Infection Research (DZIF), Partner site Munich, Troger Str.30, 81675 Munich, Germany.
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27
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Fahey JW, Stephenson KK, Wallace AJ. Dietary amelioration of Helicobacter infection. Nutr Res 2015; 35:461-73. [PMID: 25799054 PMCID: PMC4465045 DOI: 10.1016/j.nutres.2015.03.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 03/01/2015] [Accepted: 03/02/2015] [Indexed: 12/18/2022]
Abstract
We review herein the basis for using dietary components to treat and/or prevent Helicobacter pylori infection, with emphasis on (a) work reported in the last decade, (b) dietary components for which there is mechanism-based plausibility, and (c) components for which clinical results on H pylori amelioration are available. There is evidence that a diet-based treatment may reduce the levels and/or the virulence of H pylori colonization without completely eradicating the organism in treated individuals. This concept was endorsed a decade ago by the participants in a small international consensus conference held in Honolulu, Hawaii, USA, and interest in such a diet-based approach has increased dramatically since then. This approach is attractive in terms of cost, treatment, tolerability, and cultural acceptability. This review, therefore, highlights specific foods, food components, and food products, grouped as follows: bee products (eg, honey and propolis); probiotics; dairy products; vegetables; fruits; oils; essential oils; and herbs, spices, and other plants. A discussion of the small number of clinical studies that are available is supplemented by supportive in vitro and animal studies. This very large body of in vitro and preclinical evidence must now be followed up with rationally designed, unambiguous human trials.
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Affiliation(s)
- Jed W Fahey
- Lewis B. and Dorothy Cullman Chemoprotection Center, Department of Pharmacology & Molecular Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD, USA; Center for Human Nutrition, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Katherine K Stephenson
- Lewis B. and Dorothy Cullman Chemoprotection Center, Department of Pharmacology & Molecular Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Alison J Wallace
- New Zealand Institute for Plant and Food Research Limited, Lincoln, New Zealand
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Robinson K. Helicobacter pylori-Mediated Protection against Extra-Gastric Immune and Inflammatory Disorders: The Evidence and Controversies. Diseases 2015; 3:34-55. [PMID: 28943607 PMCID: PMC5548235 DOI: 10.3390/diseases3020034] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 03/03/2015] [Accepted: 03/05/2015] [Indexed: 12/11/2022] Open
Abstract
A large number of studies link H. pylori infection with a reduced risk of developing extra-gastric conditions such as allergy, asthma, inflammatory bowel disease, coeliac disease and multiple sclerosis. The strength of the evidence for these protective associations is quite variable, and published studies often do not agree. This review article discusses some of the reasons for these discrepancies, and the difficulties faced when designing studies. Examples of some protective disease associations are described in detail, where the evidence is most abundant and thought to be more reliable. The most convincing of these are supported by published mechanistic data, for example with animal models, or incidence of disease exacerbation in humans following H. pylori eradication. Although controversial, this field is very important as the prevalence of H. pylori is decreasing throughout the world whilst many chronic diseases are becoming more common. These trends are likely to continue in the future, therefore it is important that we fully understand if and how H. pylori confers protection.
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Affiliation(s)
- Karen Robinson
- Nottingham Digestive Diseases Biomedical Research Unit, School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK.
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Lionetti E, Leonardi S, Lanzafame A, Garozzo MT, Filippelli M, Tomarchio S, Ferrara V, Salpietro C, Pulvirenti A, Francavilla R, Catassi C. Helicobacter pylori infection and atopic diseases: Is there a relationship? A systematic review and meta-analysis. World J Gastroenterol 2014; 20:17635-17647. [PMID: 25516679 PMCID: PMC4265626 DOI: 10.3748/wjg.v20.i46.17635] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 07/19/2014] [Accepted: 09/05/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To review and conduct a meta-analysis of the existing literature on the relationship between Helicobacter pylori (H. pylori), atopy and allergic diseases.
METHODS: Studies published in English assessing the prevalence of atopy and/or allergic diseases in patients with H. pylori infection and the prevalence of H. pylori infection in patients with atopy and/or allergic diseases were identified through a MEDLINE search (1950-2014). Random-effect model was used for the meta-analysis.
RESULTS: Pooled results of case-control studies showed a significant inverse association of H. pylori infection with atopy/allergic disease or with exclusively atopy, but not with allergic disease, whereas pooled results of cross-sectional studies showed only a significant association between allergic disease and H. pylori infection.
CONCLUSION: There is some evidence of an inverse association between atopy/allergic diseases and H. pylori infection, although further studied are needed.
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30
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Nevin DT, Morgan CJ, Graham DY, Genta RM. Helicobacter pylori gastritis in HIV-infected patients: a review. Helicobacter 2014; 19:323-9. [PMID: 24773336 DOI: 10.1111/hel.12131] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND The risk factors for acquiring Helicobacter pylori and Human Immunodeficiency Virus (HIV) infections are different: H. pylori is transmitted by gastro- or fecal-oral routes and is associated with low socioeconomic conditions, while HIV is transmitted through sexual intercourse, infected body fluids, and transplacentally. If the host responses to these infections were independent, the prevalence of H. pylori should be similar in HIV-infected and non-infected patients. Yet, several studies have detected a lower prevalence of H. pylori in patients with HIV infection, whereas other studies found either no differences or greater rates of H. pylori infection in HIV-positive subjects. OBJECTIVE To review studies that addressed the issue of these two simultaneous infections and attempt to determine whether reliable conclusions can be drawn from this corpus of often contrasting evidence. METHODS Electronic literature search for relevant publications, followed by manual search of additional citations from extracted articles. RESULTS The initial search yielded 44 publications; after excluding case reports, reviews, narrowly focused articles, and duplicate reports, there remained 29 articles, which are the corpus of this review. With one exception, all studies reported higher rates of H. pylori infection in HIV-negative subjects. Five studies also examined the CD4 lymphocyte counts and found an inverse correlation between the degree of immunosuppression and the prevalence of active H. pylori infection. CONCLUSIONS Current evidence suggests that it is likely that H. pylori needs a functional immune system to successfully and persistently colonize the human gastric mucosa.
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Affiliation(s)
- Daniel T Nevin
- Miraca Life Sciences Research Institute, Irving, TX, USA
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31
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Wong F, Rayner-Hartley E, Byrne MF. Extraintestinal manifestations of Helicobacter pylori: A concise review. World J Gastroenterol 2014; 20:11950-11961. [PMID: 25232230 PMCID: PMC4161781 DOI: 10.3748/wjg.v20.i34.11950] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 01/28/2014] [Accepted: 05/05/2014] [Indexed: 02/06/2023] Open
Abstract
Helicobacter pylori (H. pylori) infection has been clearly linked to peptic ulcer disease and some gastrointestinal malignancies. Increasing evidence demonstrates possible associations to disease states in other organ systems, known as the extraintestinal manifestations of H. pylori. Different conditions associated with H. pylori infection include those from hematologic, cardiopulmonary, metabolic, neurologic, and dermatologic systems. The aim of this article is to provide a concise review of the evidence that supports or refutes the associations of H. pylori and its proposed extraintestinal manifestations. Based on data from the literature, PUD, mucosal associated lymphoid tumors lymphoma, and gastric adenocarcinoma has well-established links. Current evidence most supports extraintestinal manifestations with H. pylori in immune thrombocytopenic purpura, iron deficiency anemia, urticaria, Parkinson’s, migraines and rosacea; however, there is still plausible link with other diseases that requires further research.
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32
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Yucel O. Prevention of Helicobacter pylori infection in childhood. World J Gastroenterol 2014; 20:10348-10354. [PMID: 25132751 PMCID: PMC4130842 DOI: 10.3748/wjg.v20.i30.10348] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 12/04/2013] [Accepted: 04/16/2014] [Indexed: 02/07/2023] Open
Abstract
Helicobacter pylori (H. pylori) infection is one of the most common infections worldwide. Although infection rates are falling in the developed and developing countries, H. pylori is still widespread in the world. This article has reviewed the important publications on H. pylori in childhood with a focus on its evolving transmission route and the source of infection and preventive strategies in childhood, PubMed was searched up to identify eligible studies. Relevant publications were searched using the following.
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The Association of Childhood Asthma and Helicobacter pylori Infection in Sardinia. ARCHIVES OF PEDIATRIC INFECTIOUS DISEASES 2013. [DOI: 10.5812/pedinfect.14202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abstract
This review concerned the important pediatric studies published between April 2012 and March 2013. Symptomatology in Helicobacter pylori-positive children is nonspecific, except for those suffering from peptic ulcer diseases. Investigation of H. pylori status in children and adolescents with sideropenic anemia is recommended, and it is the aim of several studies worldwide. Associations of H. pylori with plasma ghrelin levels as well as the negative association of H. pylori with atopic disease were interesting objectives for several studies this year. Success rates of sequential therapy tended to be lower in recent studies than in previous trials, which probably reflects the increase in macrolide resistance. A beneficial effect of probiotics was reported although not all trials supported this result in children. Intrafamilial transmission and young age could be major risk factors associated with reinfection in children.
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Affiliation(s)
- Teresa Alarcón
- Department of Microbiology, Hospital Universitario de La Princesa, Madrid, Spain
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IRAK-M expression limits dendritic cell activation and proinflammatory cytokine production in response to Helicobacter pylori. PLoS One 2013; 8:e66914. [PMID: 23776703 PMCID: PMC3679069 DOI: 10.1371/journal.pone.0066914] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 05/10/2013] [Indexed: 12/12/2022] Open
Abstract
Helicobacter pylori (H. pylori) infects the gastric mucosa and persists for the life of the host. Bacterial persistence may be due to the induction of regulatory T cells (Tregs) whichmay have protective effects against other diseases such as asthma. It has been shown that H. pylori modulates the T cell response through dendritic cell reprogramming but the molecular pathways involved are relatively unknown. The goal of this study was to identify critical elements of dendritic cell (DC) activation and evaluate potential influence on immune activation. Microarray analysis was used to demonstrate limited gene expression changes in H. pylori stimulated bone marrow derived DCs (BMDCs) compared to the BMDCs stimulated with E. coli. IRAK-M, a negative regulator of TLR signaling, was upregulated and we selectedit for investigation of its role in modulating the DC and T cell responses. IRAK-M−/− and wild type BMDC were compared for their response to H. pylori. Cells lacking IRAK-M produced significantly greater amounts of proinflammatory MIP-2 and reduced amounts of immunomodulatory IL-10 than wild type BMDC. IRAK-M−/− cells also demonstrated increased MHC II expression upon activation. However, IRAK-M−/− BMDCs were comparable to wild type BMDCs in inducing T-helper 17 (TH17) and Treg responses as demonstrated in vitro using BMDC CD4+ T cells co-culture assays,and in vivo though the adoptive transfer of CD4+ FoxP3-GFP T cells into H. pylori infected IRAK-M−/− mice. These results suggest that H. pylori infection leads to the upregulation of anti-inflammatory molecules like IRAK-M and that IRAK-M has a direct impact on innate functions in DCs such as cytokine and costimulation molecule upregulation but may not affect T cell skewing.
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Abstract
OBJECTIVE Helicobacter pylori infection is recognized as a worldwide public health threat. Some studies have suggested that individuals with asthma have a lower rate of H. pylori infection, but the relation remains controversial. This meta-analysis was carried out to quantify the association between H. pylori infection and asthma. METHODS Published information on the prevalence of H. pylori in individuals with asthma was collected to assess the potential associations between H. pylori infection and the risk of asthma. Fourteen eligible studies were selected for analysis. Data on the study populations, detection method of H. pylori, and publication year were summarized. Meta-regression models and subgroup analyses were established to screen the factors resulting in heterogeneity. RESULTS Of the 106 articles retrieved, 14 fulfilled the inclusion criteria. The 14 studies involved 28 283 patients, with a total H. pylori infection rate of 40.53%. This meta-analysis found a significantly lower rate of H. pylori infection in the asthmatics than in the controls (odds ratio=0.84, 95% confidence interval: 0.73-0.96, P=0.013). Subgroup analysis indicated a similar infection rate of CagA-positive H. pylori infection in the asthmatic group and the control group (odds ratio=0.73, 95% confidence interval: 0.41-1.28, P=0.03). CONCLUSION The pooled data suggest that asthmatics have a significantly lower rate of H. pylori infection. Large-scale and multicenter studies should be carried out to further determine the relation between this bacterium and allergic disorders.
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Abstract
OBJECTIVE The severity and incidence of asthma have increased drastically in the developed nations of the world over the last decades. Currently, some evidences indicate an inverse association between Helicobacter pylori and asthma, but some studies did not get the same conclusion. To make this question clear, we systematically reviewed the published evidence for an association between H. pylori infection and asthma. METHODS Medline and SCI databases up to April 2012 were searched to identify studies that evaluated the association between H. pylori and asthma. Relevant publications were searched using the following keywords or synonyms: asthma or Helicobacter pylori. Methodologic quality was scored by using a standardized list of criteria, and meta-analysis was conducted to calculate crude odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS Nineteen studies met our inclusion criteria: nine cross-sectional studies, seven case-control studies, and three prospective cohort studies. The overall methodologic quality score was high. Pooled ORs for the association between asthma and H. pylori infection were 0.84 (95% CI: 0.74-0.96) in nine cross-sectional studies, 0.94 (95% CI: 0.79-1.12) in seven case-control studies, and 0.82 (95% CI: 0.53-1.27) in three cohort studies. The pooled OR for all included studies was 0.81 (95% CI: 0.72-0.91) in children and 0.88 (95% CI: 0.71-1.08) in adults. CONCLUSIONS We found a weak evidence for an inverse association between asthma and H. pylori infection both in children and in adults.
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Affiliation(s)
- Qiang Wang
- The Second Clinical Department, Tongji Hospital, Tongji Medical College, HuazhongUniversity of Science & Technology, Xue zi yuan 508-520, Hangkong Road 13#, Wuhan 430030, Hubei, China.
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Abstract
This review summarizes important pediatric studies published from April 2011 up to March 2012. Proteomics profile of ulcerogenic Helicobacter pylori strains was defined in the most interesting study of the last year. The antigen stool test is becoming the "gold standard" in prevalence studies, and according to the last epidemiologic studies, the prevalence of H. pylori infection in childhood is not decreasing any more in the developed world. The resistance rate of H. pylori strains is high in children. Therefore, among other important issues concerning H. pylori in pediatrics, guidelines published by ESPGHAN and NASPGHAN last year also recommended culture and susceptibility testing before first-line treatment in areas with high or unknown antibiotic resistance rates.
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Affiliation(s)
- Matjaž Homan
- University Children's Hospital, Ljubljana, Slovenia.
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Banić M, Franceschi F, Babić Z, Gasbarrini A. Extragastric manifestations of Helicobacter pylori infection. Helicobacter 2012; 17 Suppl 1:49-55. [PMID: 22958156 DOI: 10.1111/j.1523-5378.2012.00983.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In the last year, different diseases possibly linked to Helicobacter pylori infection but localized outside of the stomach have been investigated. There are, in fact, several studies concerning cardiovascular diseases, hematologic disorders, neurologic diseases, metabolic, hepatobiliary diseases, and other conditions. Some of those studies, such as those on sideropenic anemia and idiopathic thrombocytopenic purpura, are quite large and well conducted, while in other cases there are just small or isolated studies or even case reports. Nonetheless, there is much interest among researchers all over the world for such a topic as demonstrated by the large number of studies published in the last year.
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Affiliation(s)
- Marko Banić
- Division of Gastroenterology, University Hospital Dubrava, Zagreb, Croatia
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Bureš J, Kopáčová M, Koupil I, Seifert B, Škodová Fendrichová M, Špirková J, Voříšek V, Rejchrt S, Douda T, Král N, Tachecí I. Significant decrease in prevalence of Helicobacter pylori in the Czech Republic. World J Gastroenterol 2012; 18:4412-8. [PMID: 22969207 PMCID: PMC3436059 DOI: 10.3748/wjg.v18.i32.4412] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Revised: 08/13/2012] [Accepted: 08/16/2012] [Indexed: 02/06/2023] Open
Abstract
AIM: To study possible decrease in prevalence of Helicobacter pylori (H. pylori) infection in the Czech Republic within a 10-year period.
METHODS: A total of 22 centres entered the study. The catchment areas of these centres covered cities and towns with more than 20 000 inhabitants, smaller towns (≤ 20 000 inhabitants) with surrounding villages and rural areas, and were spread over the whole country, corresponding well to the geographical distribution of the Czech population. A total of 1 837 subjects (aged 5-98 years) took part in the study, randomly selected out of 38 147 people from the general population. H. pylori infection was investigated by means of a 13C-urea breath test. Breath samples in duplicates were analysed using isotope ratio mass spectrometry. The cut-off point was 3.5. Social and demographic characteristics were based on data from self-completed questionnaires.
RESULTS: The overall prevalence of H. pylori infection was 23.5% (430/1826), and 4.8% (20/420) in children aged 15 or less. There was no statistically significant difference in prevalence between males (24.3%; 208/857) and females (22.9%, 222/969, P = 0.494). H. pylori infection was strongly associated with higher age, among subjects aged 55+ years, prevalence of H. pylori infection was 39.8% (252/633, P < 0.001). The highest prevalence of H. pylori infection was found among persons aged 55-64 years (43.9%, 97/221) and 75+ years (37.9%, 58/153). Among study subjects aged 15+ years, prevalence of H. pylori infection was significantly increased in those with lowest education (odds risk 3.19, 95% CI 1.87-5.47). Compared to never married (14.1%), the prevalence of H. pylori infection was statistically significantly higher among married (35.4%, 246/694, P < 0.001), divorced (36.8%, 49/133, P < 0.001) and widowed study subjects (40.2%, 45/112, P < 0.001), both in minimally and fully adjusted analysis. There was no significant difference in the prevalence of H. pylori infection between married and widowed subjects (35.4%, 246/694 vs 40.2%, 45/112, P = 0.389). There was little variation in smoking prevalence across categories of smoking and there was no evidence of an increased risk of H. pylori infection among current or past smokers in our data (odds risk 1.04 with 95% CI 0.78-1.40 for current smokers; odds ratio 0.83 with 95% CI 0.60-1.16 for former smokers). The current prevalence of H. pylori in 2011 was significantly lower compared to the prevalence reported from identical geographical areas in 2001 (23.5% vs 41.7%, P < 0.001).
CONCLUSION: The overall prevalence of H. pylori infection in the general population has fallen substantially in the Czech Republic over the past 10 years.
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Wang Y, Bi Y, Zhang L, Wang C. Is Helicobacter pylori infection associated with asthma risk? A meta-analysis based on 770 cases and 785 controls. Int J Med Sci 2012; 9:603-10. [PMID: 23028243 PMCID: PMC3461765 DOI: 10.7150/ijms.4970] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Accepted: 09/06/2012] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Helicobacter pylori (H. pylori) infection has been thought to play a critical role in disorders such as gastric and lung cancer. A number of studies have been devoted to the relationship between H. pylori infection and asthma risk, which have generated inconclusive results. In this study we aimed to derive a more precise estimation of the relationship. METHODS Meta-analyses evaluating the association of H. pylori infection and asthma risk were conducted and subgroup analyses on ethnicity and source of controls as well as CagA status were further conducted. Eligible studies were identified for the period up to Jul 2012. RESULTS A total of five case-control studies comprising 770 cases and 785 controls were lastly selected for analysis. The overall data failed to indicate a significant association of H. pylori infection and asthma risk (OR=1.01; 95%CI=0.82-1.24). Likewise, in the subgroup analysis regarding ethnicity, source of controls and CagA status, no associations could be observed. CONCLUSIONS The pooled data failed to suggest a marked association between H. pylori infection and asthma risk. Future studies are needed to confirm this conclusion.
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Affiliation(s)
- Yan Wang
- Institute of Respiratory Diseases, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
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