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Aniekwe O, Jolaiya T, Ajayi A, Adeleye IA, Gerhard M, Smith SI. Co-infection of Helicobacter pylori and intestinal parasites in children of selected low-income communities in Lagos State, Nigeria. Parasitol Int 2024; 101:102896. [PMID: 38648879 DOI: 10.1016/j.parint.2024.102896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 04/15/2024] [Accepted: 04/15/2024] [Indexed: 04/25/2024]
Abstract
Helicobacter pylori and intestinal parasites cause gastrointestinal diseases with a high prevalence in children in resource limited developing countries. There is paucity of information in Nigeria on co-infection of H. pylori and intestinal parasites. The study was conducted to determine the prevalence of H. pylori and parasite co-infection in children from selected low-income communities in Lagos, Nigeria. Fecal samples were collected from 151 healthy children aged ≤11 years across six low-income communities in Lagos. H. pylori was detected using stool antigen test and conventional PCR assay, intestinal parasites were detected using formol-ether concentration and nested PCR assay. Structured questionnaires were administered to parents and legal guardians of the children by an interviewer to collect relevant data on demographic and lifestyle factors. The prevalence of H. pylori was 31.79% (48), with a higher prevalence in children aged 2-3 years. The prevalence of intestinal parasites was 21.19% (32) with the lowest frequency found in children aged 8-9 years. The parasites detected include: A. lumbricoides (10.6%), G. intestinalis (7.3%), hookworm (1.99%), E. histolytica (0.66%), S. mansoni (0.66%). There was co-infection prevalence of 10.6% (16) which was associated with the parasites: G. intestinalis (7.3%) and A. lumbricoides (3.97%). Polyparasitism with G. intestinalis and A. lumbricoides was reported in 2 children infected with H. pylori. This study which is the first reported in Lagos established a low prevalence of H. pylori and intestinal parasite co-infection in children and provides better understanding of the epidemiology of H. pylori infection associated with intestinal parasites in Nigeria.
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Affiliation(s)
- O Aniekwe
- Department of Microbiology and Botany, University of Lagos, Nigeria
| | - T Jolaiya
- Department of Medical Laboratory Services, Lagos State Primary Health Care Board, Nigeria
| | - A Ajayi
- Department of Molecular Biology and Biotechnology, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - I A Adeleye
- Department of Microbiology, Anchor University, Ayobo, Nigeria
| | - M Gerhard
- Institute for Medical Microbiology, Immunology and Hygiene (MIH), Technische Universität München, Germany
| | - S I Smith
- Department of Molecular Biology and Biotechnology, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria.
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Li J, Sun Y, Wang R, Ma S, Shi L, Wang K, Zhang H, Wang T, Liu L. Seasonal differences in intestinal flora are related to rats' intestinal water metabolism. Front Microbiol 2023; 14:1109696. [PMID: 36910220 PMCID: PMC9999011 DOI: 10.3389/fmicb.2023.1109696] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 02/07/2023] [Indexed: 03/14/2023] Open
Abstract
Many studies have reported obvious seasonal differences in the intestinal flora of rats, and this stable distribution of the seasonal flora helps in maintaining the normal physiological function of the host. However, the mechanism underlying these seasonal differences in intestinal flora remains unclear. To explore the correlation among seasonal factors and intestinal water metabolism and intestinal flora, 20 Sprague Dawley (SD) rats were divided into spring, summer, autumn, and winter groups. The environment for the four seasons was simulated using the Balanced Temperature and Humidity Control system. The intestinal water metabolism was evaluated by determining the intestinal transmission function, fecal water content, water content of colonic tissue, and the colonic expression levels of AQP3, AQP4, and AQP8. The composition and relative abundance of intestinal microflora in rats in each season were assessed through 16S rDNA amplifier sequencing, and the relationship between the dominant flora and intestinal water metabolism in each season was analyzed using Spearman correlation analysis. The high temperature and humidity season could lead to an increase in intestinal water metabolism and intestinal water content in rats, whereas the low temperature and humidity season could lead to a decrease, which was closely related to the change in microflora. To explore the molecular mechanism of seasonal changes in intestinal water metabolism, the concentration of colonic 5-HT, VIP, cAMP, and PKA associated with intestinal water metabolism in rats were also examined. Seasonal changes could affect the concentration of colonic 5-HT and VIP in rats, and then regulate AQPs through cAMP/PKA pathway to affect the intestinal water metabolism. These results suggest that seasonal factors affect the level of intestinal water metabolism in rats and result in seasonal differences in intestinal flora.
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Affiliation(s)
- Jing Li
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yike Sun
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Ruochong Wang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Shuran Ma
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Lei Shi
- Department of Gastroenterology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Kai Wang
- Department of Emergency, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Hairong Zhang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Tong Wang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Leilei Liu
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
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Effects of Helicobacter pylori Infection on Ghrelin and Insulin-like Growth Factor 1 Secretion in Children with Idiopathic Short Stature. J Clin Med 2022; 11:jcm11195868. [PMID: 36233735 PMCID: PMC9572010 DOI: 10.3390/jcm11195868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 09/23/2022] [Accepted: 09/28/2022] [Indexed: 11/17/2022] Open
Abstract
Background: A diagnosis of "idiopathic short stature" (ISS) in a child means that the cause of the disease has not been established, although there are certainly some unknown factors that contributed to its occurrence. Ghrelin and leptin are important in controlling food intake; ghrelin is also a growth hormone (GH) stimulator. Both enterohormones are produced in the stomach and their secretion may be affected by a Helicobacter pylori (H. pylori) infection. Methods: Our study included a group of 61 children (53 prepubertal and 8 peripubertal) with ISS, without any gastrointestinal tract symptoms but in whom the histopathological evaluation of stomach tissue was made during gastroscopy to diagnose H. pylori infection. In each child, fasting ghrelin, leptin and IGF-1 concentrations, and GH levels in two stimulation tests were assessed. Results: H. pylori infection was confirmed in 24.6% of the children. Ghrelin and IGF-1 concentrations were significantly lower in H. pylori-positive than H. pylori-negative children (this was more noticeable in prepubertal subgroups), however there was not a discrepancy in regards to GH concentrations in stimulation tests, leptin levels or the nutritional state between groups. Conclusions: Short children, infected by H. pylori seem to have lower ghrelin and IGF-1 concentrations than children without infection, this may be the reason for a worse growth rate in this subgroup.
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Diagnostic Challenges of Helicobacter pylori Infection in Ethiopia: A Community-Based Cross-Sectional Study. Can J Gastroenterol Hepatol 2022; 2022:4013020. [PMID: 36247045 PMCID: PMC9553705 DOI: 10.1155/2022/4013020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/23/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND In resource-constrained countries, accurate diagnosis of Helicobacter pylori infection remains a challenge. This study aimed to assess the clinical utility of locally available serological and stool antigen test kits in the management of people with suspected H. pylori infection in Ethiopia. METHODS A community-based cross-sectional study was conducted with apparently healthy adults and children living in southwest Ethiopia. Participants were interviewed for dyspepsia symptoms and related clinical conditions. H. pylori infection was examined using commercially available serological and stool antigen tests. The association between H. pylori tests and dyspepsia symptoms was analyzed using logistic regression models. RESULTS Out of 1392 participants included in the final analysis, 49.1% and 6.5% tested positive for H. pylori infection with serology and stool antigen test kits, respectively. Participants reporting epigastric symptoms in the past three months (AOR = 1.93, 95% CI = 1.28-2.91) and those with recent dyspepsia treatment (AOR = 1.51, 95% CI = 1.05-2.18) were likely to have positive serology test. However, no association between dyspepsia symptoms and H. pylori stool antigen positivity was observed in our study. CONCLUSION ccurate detection of H. pylori infections using commercially accessible diagnostics remains difficult in Ethiopia. With these methods, it will be hard to ensure adequate diagnosis and early treatment of H. pylori infection, as well as rational antibiotic use.
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Tanous O, Levin C, Suchdev PS, Luo H, Rinawi F. Resolution of iron deficiency following successful eradication of Helicobacter pylori in children. Acta Paediatr 2022; 111:1075-1082. [PMID: 35028968 DOI: 10.1111/apa.16255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 01/12/2022] [Accepted: 01/12/2022] [Indexed: 12/26/2022]
Abstract
AIM To assess correlation between successful Helicobacter pylori (HP) eradication and resolution of iron deficiency in children, without iron supplementation. METHODS Medical records of children diagnosed with HP infection based on endoscopy were retrospectively reviewed. Among those with non-anaemic iron deficiency (NAID) or iron deficiency anaemia (IDA), haemoglobin, ferritin and CRP levels were compared prior and 6-9 months' post-successful HP eradication. Predictors of resolution of iron deficiency following HP eradication were assessed. RESULTS Among 60 included children (median age 14.8, IQR12.3-16 years; 62% males), 35% had IDA while the remaining 65% had NAID. Following successful HP eradication, iron normalised in 60% of patients with iron deficiency (ID), without iron supplementation. There were significant improvements in haemoglobin and ferritin concentrations following HP eradication with haemoglobin increasing from 12.3 g/dL to 13.0 g/dL and ferritin increasing from 6.3 μg/L to 15.1 μg/L (p < 0.001). In multiple logistic regression, older age was the only factor associated with resolution of anaemia following HP eradication (OR 1.65, 95% CI 1.16-2.35, p = 0.005). CONCLUSION Successful HP eradication could be helpful in improving iron status among children with refractory NAID or IDA. Older age may predict this outcome. Screening for HP might be considered in the workup of refractory IDA or ID.
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Affiliation(s)
- Osama Tanous
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Carina Levin
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
- Pediatric Hematology Unit, Emek Medical Centre, Afula, Israel
| | - Parminder S Suchdev
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
- Department of Pediatrics, Emory Global Health Institute, Atlanta, Georgia, USA
| | - Hanqi Luo
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Firas Rinawi
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
- Pediatric Gastroenterology Unit, Emek Medical Center, Afula, Israel
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Yuan C, Adeloye D, Luk TT, Huang L, He Y, Xu Y, Ye X, Yi Q, Song P, Rudan I. The global prevalence of and factors associated with Helicobacter pylori infection in children: a systematic review and meta-analysis. THE LANCET. CHILD & ADOLESCENT HEALTH 2022; 6:185-194. [PMID: 35085494 DOI: 10.1016/s2352-4642(21)00400-4] [Citation(s) in RCA: 75] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/09/2021] [Accepted: 12/13/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Synthesised data on the prevalence of, and factors associated with, paediatric Helicobacter pylori infection at the global level remain scarce. We aimed to estimate the global prevalence of H pylori infection and its associated factors in children and adolescents. METHODS In this systematic review and meta-analysis, we searched PubMed, Embase, MEDLINE, and Scopus for observational population-based studies published between database inception and Oct 25, 2021, without language or geographical restrictions. We included studies that reported the prevalence of H pylori infection in children aged 18 years or younger. Records were screened and data were extracted using a standardised extraction form. We estimated the worldwide prevalence of H pylori infection in children (our main outcome) using multilevel mixed-effects meta-regression and then stratified prevalence by diagnostic method (serology vs urea breath tests or stool antigen tests). We analysed the significance of associated factors using a random-effects meta-analysis. This study is registered in PROSPERO, CRD42020209717. FINDINGS We identified 3181 records, of which 198 articles with 632 data points from 152 650 children were included. The overall global prevalence of H pylori infection in children was 32·3% (95% CI 27·3-37·8), which varied by diagnostic test (28·6% [23·0-35·0] for serology vs 35·9% [29·2-43·2] for urea breath tests or stool antigen tests). Regardless of diagnostic test, the prevalence of H pylori infection was significantly higher in low-income and middle-income countries than in high-income countries (43·2% [36·5-50·2] vs 21·7% [16·9-27·4]; p<0·0001) and in older children than in younger children (41·6% [35·6-47·8] in 13-18-year-olds vs 33·9% [28·6-39·7] in 7-12-year-olds vs 26·0% [21·4-31·0] in 0-6-year-olds; p<0·0001). Paediatric H pylori infection was significantly associated with lower economic status (odds ratio [OR] 1·63 [95% CI 1·46-1·82]), more siblings or children (1·84 [1·44-2·36]), room sharing (1·89 [1·49-2·40]), no access to a sewage system (1·60 [1·22-2·10]), having a mother infected with H pylori (3·31 [2·21-4·98]), having a sibling or siblings infected with H pylori (3·33 [1·53-7·26]), drinking unboiled or non-treated water (1·52 [1·32-1·76]), and older age (OR per year 1·27 [1·15-1·40]). INTERPRETATION H pylori infection is still highly prevalent in children and adolescents globally. Our findings can help to guide further research and the development and implementation of preventive and therapeutic measures to reduce H pylori infection in children. FUNDING None.
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Affiliation(s)
- Changzheng Yuan
- School of Public Health, the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China; National Clinical Research Centre for Child Health, Zhejiang University School of Medicine, Hangzhou, China; Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Davies Adeloye
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Tzu Tsun Luk
- School of Nursing, University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Liyan Huang
- School of Public Health, the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China; National Clinical Research Centre for Child Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Yusa He
- School of Public Health, the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China; National Clinical Research Centre for Child Health, Zhejiang University School of Medicine, Hangzhou, China
| | - Yunhan Xu
- Department of Maternal and Child health, School of Public Health, Peking University, Beijing, China
| | - Xinxin Ye
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qian Yi
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Peige Song
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Igor Rudan
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
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Taskin DG, Sursal A, Dogan AE, Ozdener F. Evaluation of parameters associated with growth retardation in children with coeliac disease. J Paediatr Child Health 2021; 57:1454-1459. [PMID: 33908087 DOI: 10.1111/jpc.15525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/08/2021] [Accepted: 04/10/2021] [Indexed: 11/29/2022]
Abstract
AIMS Coeliac disease (CD) is an autoimmune disorder with a prevalence ≤2% that causes an immune reaction to gluten. Growth retardation (GR) generally accompanies CD due to gastrointestinal complications and should be treated as early as possible along with initiation of a gluten-free diet. The aim of this study was to determine the indicators of GR in patients with CD. METHODS This single-centre retrospective study included paediatric outpatients with CD. All patients were diagnosed with CD via serological analysis and upper gastrointestinal endoscopy if necessary. Patient records were obtained from Adana City Training and Research Hospital. Patients that were diagnosed with GR accompanying CD were given oral nutritional supplements and followed-up every 3-6 months. Statistical relationships between demographics, and anthropometric measurements, duration of breastfeeding, gluten contact time, diet duration, presenting complaints and serological findings were evaluated. RESULTS This study included 169 paediatric outpatients between ages 1 and 18. Longer symptom duration and shorter breastfeeding duration were significantly correlated with GR accompanying CD (P = 0.007 and P = 0.029, respectively). Vomiting was the only symptom that was correlated with the presence of GR (P = 0.010). Helicobacter pylori infection was not correlated with the presence of GR (P = 0.277). CONCLUSIONS GR should be treated as early as possible to reduce the severity of CD and a 6 months sole breastfeeding followed by solid foods accompanied by breastfeeding for 2 years is crucial for preventing GR. Moreover, vomiting as a presenting complaint in patients with CD might be indicative of the presence of GR.
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Affiliation(s)
- Didem G Taskin
- Department of Pediatric Gastroenterology, Adana City Training and Research Hospital, Adana, Turkey
| | - Alihan Sursal
- Department of Neuroscience, Bahcesehir University, School of Medicine, Istanbul, Turkey
| | - Ali E Dogan
- Medical Department, Nutricia, Advanced Medical Nutrition, Istanbul, Turkey
| | - Fatih Ozdener
- Department of Pharmacology, Bahcesehir University, School of Medicine, Istanbul, Turkey
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Baltierra-Uribe SL, Montañez-Barragán A, Romero-Ramírez H, Klimov-Kravtchenko K, Martínez-Pedro KI, Sánchez-Salguero E, Camorlinga-Ponce M, Torres J, Santos-Argumedo L. Colostrum IgA1 antibodies recognize antigens from Helicobacter pylori and prevent cytoskeletal changes in human epithelial cells. Eur J Immunol 2021; 51:2641-2650. [PMID: 34398472 DOI: 10.1002/eji.202049117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 06/11/2021] [Accepted: 08/13/2021] [Indexed: 11/06/2022]
Abstract
Helicobacter pylori is a gram-negative bacterium found on the luminal surface of the gastric mucosa in at least 50% of the world's human population. The protective effect of breastfeeding against H. pylori infection has been extensively reported; however, the mechanisms behind this protection remain poorly understood. Human IgA from colostrum has reactivity against H. pylori antigens. Despite that IgA1 and IgA2 display structural and functional differences, their reactivity against H. pylori had not been previously determined. We attested titers and reactivity of human colostrum-IgA subclasses by ELISA, immunoblot, and flow cytometry. Colostrum samples from healthy mothers had higher titers of IgA; and IgA1 mostly recognized H. pylori antigens. Moreover, we found a correlation between IgA1 reactivity and their neutralizing effect determined by inhibition of cytoskeletal changes in AGS cells infected with H. pylori. In conclusion, colostrum-IgA reduces H. pylori infection of epithelial gastric cells, suggesting an important role in preventing the bacteria establishment during the first months of life. As a whole, these results suggest that IgA1 from human colostrum provides protection that may help in the development of the mucosal immune system of newborn children. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Shantal Lizbeth Baltierra-Uribe
- Department of Molecular Biomedicine, Center for Research and Advanced Studies of the National Polytechnic Institute (CINVESTAV-IPN), Mexico City, Mexico
| | - Alejandra Montañez-Barragán
- Department of Molecular Biomedicine, Center for Research and Advanced Studies of the National Polytechnic Institute (CINVESTAV-IPN), Mexico City, Mexico
| | - Héctor Romero-Ramírez
- Department of Molecular Biomedicine, Center for Research and Advanced Studies of the National Polytechnic Institute (CINVESTAV-IPN), Mexico City, Mexico
| | - Ksenia Klimov-Kravtchenko
- Department of Molecular Biomedicine, Center for Research and Advanced Studies of the National Polytechnic Institute (CINVESTAV-IPN), Mexico City, Mexico.,University Center of Biological and Agricultural Sciences (CUCBA), University of Guadalajara, Zapopan, Jalisco, Mexico
| | - Karla Ivette Martínez-Pedro
- Department of Molecular Biomedicine, Center for Research and Advanced Studies of the National Polytechnic Institute (CINVESTAV-IPN), Mexico City, Mexico.,"La Cañada" University (UNCA), Oaxaca, Mexico
| | - Erick Sánchez-Salguero
- Department of Molecular Biomedicine, Center for Research and Advanced Studies of the National Polytechnic Institute (CINVESTAV-IPN), Mexico City, Mexico
| | - Margarita Camorlinga-Ponce
- Infectious and Parasitic Disease Medical Research Unit (UIMEIP) at Pediatric Hospital in National Medical Center (CMN- SIGLO XXI) Mexican Institute of Social Security (IMSS), Mexico City, Mexico
| | - Javier Torres
- Infectious and Parasitic Disease Medical Research Unit (UIMEIP) at Pediatric Hospital in National Medical Center (CMN- SIGLO XXI) Mexican Institute of Social Security (IMSS), Mexico City, Mexico
| | - Leopoldo Santos-Argumedo
- Department of Molecular Biomedicine, Center for Research and Advanced Studies of the National Polytechnic Institute (CINVESTAV-IPN), Mexico City, Mexico
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Concurrent infection of intestinal parasites and Helicobacter pylori among school-age children in Central Ethiopia. Parasite Epidemiol Control 2020; 11:e00177. [PMID: 32944660 PMCID: PMC7481810 DOI: 10.1016/j.parepi.2020.e00177] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 07/03/2020] [Accepted: 08/16/2020] [Indexed: 12/13/2022] Open
Abstract
Background Coinfection of multiple intestinal microbial pathogens plays an important role in individuals harboring these organisms. However, data on magnitude and risk factors are scarce from resource limited settings. Objective We examined the prevalence and associated risk factors of intestinal parasites and Helicobacter pylori co-infection among young Ethiopian school children. Method Data from a total of 434 Ethiopian school children from the Ziway region were analyzed in the study. Stool antigen and blood serum antibody tests were used to detect H. pylori, while the presence of any intestinal parasites was detected using direct wet mount microscopy and formol-ether concentration techniques. A structured questionnaire was delivered to mothers and legal guardians of the children by an interviewer to collect data relevant demographic and lifestyle factors. Multivariate logistic regression analysis was performed to assess the association of these sociodemographic characteristics with the coinfection of H. pylori and intestinal parasites. Results The prevalence of coinfection with any intestinal parasites and Helicobacter pylori was 23.0% (n = 92/400). Univariate analysis showed an increased risk for co-infection among children whose mothers had non-formal education (COR: 1.917, p < 0.01) and those who had no history of child vaccination (COR: 3.455, p = 0.084). Children aged 10–14 and those who lived in a house that had a flush or ventilated latrine were found at lower odds of coinfection between intestinal parasites and Helicobacter pylori (COR: 0.670, p = 0.382; COR: 0.189, p = 0.108). Multivariate regression analysis showed increased odds of co-infection among children whose mothers had non-formal education (AOR: 1.978, p < 0.01). Maternal education was also associated with a two-fold increase in odds for H. pylori and any protozoa co-infection (AOR: 2.047, p < 0.01). Conclusion Our study shows a moderate prevalence of H. pylori and intestinal parasite co-infection and identified maternal education as a significant risk factor among school children.
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Khdair Ahmad F, Aladily TN, Altamimi M, Ajour M, Alsaber N, Rawashdeh M. Helicobacter pylori Prevalence and Impact: A Histology-Based Report About Children from an Endemic Country. Int J Gen Med 2020; 13:207-214. [PMID: 32547162 PMCID: PMC7250302 DOI: 10.2147/ijgm.s240205] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 05/07/2020] [Indexed: 12/25/2022] Open
Abstract
Background Helicobacter pylori is spreading worldwide with a high prevalence rate in the developing countries. Our primary goal was to measure the histology-based prevalence of Helicobacter pylori infection in children and to quantify its impact on the gastric inflammation and anemia. Our secondary goal was to study possible predictors for the presence of Helicobacter pylori in this cohort. Methods A retrospective chart review was performed for children who underwent Esophago-gastro-duodenoscopy at Jordan university hospital in Jordan from 2008 to 2016. Data collected included epidemiological data, indication for endoscopy, endoscopic findings, and laboratory data. The gastric biopsies were re-examined by a pathologist to check for the presence of Helicobacter pylori, the presence of gastritis, and to grade gastritis according to the updated Sydney criteria. Results A total of 98 children (53 girls-54%) underwent Esophago-gastro-duodenoscopy. The average age was 11.7 years ± 4.7 years. Of them, 53 patients (29 boys-55%) had Helicobacter pylori identified in the gastric biopsy. The histology-based prevalence rate of Helicobacter pylori was 54%. The most common indication for endoscopy was abdominal pain (53%) followed by vomiting (18%). Nodular gastric mucosa was present in 43% of the Helicobacter pylori-positive group, and in only 11% of the Helicobacter pylori-negative group (P-value <0.0.5). Moderate to severe chronic gastritis was seen in 59% of the biopsies of Helicobacter pylori-positive group, compared to 31% in the Helicobacter pylori-negative group (p value <0.05). Presence of anemia was not different between the two groups (p value > 0.05). Presence of endoscopic nodularity, active gastritis by histology, and moderate to severe gastritis by histology were positive predicators for the presence of Helicobacter pylori. (p value <0.05). Conclusion Helicobacter pylori infection in this study cohort of Jordanian children is common, with a histology-based prevalence rate of 54%. Nodularity of the stomach is the most common positive endoscopic feature, and its presence predicts the presence of Helicobacter pylori. Moderate to severe active gastritis is associated with Helicobacter pylori. The presence of Helicobacter pylori does not affect anemia status in this cohort of Jordanian children.
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Affiliation(s)
- Fareed Khdair Ahmad
- Section of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, School of Medicine, The University of Jordan, Amman, Jordan
| | - Tariq N Aladily
- Department of Pathology, School of Medicine, The University of Jordan, Amman, Jordan
| | - Motaz Altamimi
- Department of Pediatrics, School of Medicine, The University of Jordan, Amman, Jordan
| | - Maher Ajour
- Department of Pediatrics, School of Medicine, The University of Jordan, Amman, Jordan
| | - Nisreen Alsaber
- Department of Pediatrics, School of Medicine, The University of Jordan, Amman, Jordan
| | - Mohamed Rawashdeh
- Section of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, School of Medicine, The University of Jordan, Amman, Jordan
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Wei S, Dang Y, Peng L, Li X, Tang L, Zhang G. Association between Helicobacter pylori infection and delayed growth in children: A meta-analysis. Exp Ther Med 2020; 19:3814-3828. [PMID: 32346446 PMCID: PMC7185169 DOI: 10.3892/etm.2020.8654] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 03/17/2020] [Indexed: 12/11/2022] Open
Abstract
Helicobacter pylori (H. pylori) infection is associated with extra-gastrointestinal diseases in children. The present study aimed to investigate the potential association between H. pylori infection and growth in children. The PubMed, Exerpta Medica dataBASE, Cochrane Library and Chinese Biomedical Literature Database databases were comprehensively searched for relevant publications dated between January 1st 1994 and January 1st 2019. Delayed childhood growth was defined according to the age-appropriate criteria in the World Health Organization Child Growth Charts (2006 edition). The odds ratios (ORs) and 95% CIs were pooled using the fixed-effects model and subgroup and sensitivity analyses were performed using Review Manager (version 5.3; Cochrane) and STATA (version 12.0; StataCorp LP) software. A total of 15 observational studies comprising 4,199 subjects were included in the present study. A higher frequency of delayed growth was observed in H. pylori-positive children compared with that in H. pylori-negative children (OR, 1.51; 95% CI, 1.28-1.78), particularly for linear growth (OR, 1.63; 95% CI, 1.32-2.00). The aforementioned association was only observed when H. pylori infection was detected using 13C-urea breath tests (OR, 1.72; 95% CI, 1.22-2.40) or serum IgG antibodies targeted against H. pylori (OR, 1.81; 95% CI, 1.35-2.44). H. pylori infection was also associated with delayed childhood growth in studies with a H. pylori prevalence of ≤30% (OR, 1.71; 95% CI, 1.31-2.23) or >30% but not >50% (OR, 1.43; 95% CI, 1.10-1.86). The association between infection and growth was only statistically significant in the cross-sectional (OR, 1.43; 95% CI, 1.18-1.73) and case-control (OR, 1.81; 95% CI, 1.23-2.67) studies. No significant heterogeneity among studies was identified in the present analysis. According to Begg's and Egger's linear regression methods for funnel plots and quantification assessments, no publication bias was identified. The trim and fill method further suggested that H. pylori-positive children were prone to delayed linear growth. Therefore, the present study suggested that preventing and detecting H. pylori infection in children may be critical to ensure normal growth and development during childhood.
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Affiliation(s)
- Shuchun Wei
- Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Yini Dang
- Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Lei Peng
- Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Xuan Li
- Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Liming Tang
- Department of General Surgery, Changzhou No. 2 People's Hospital, Changzhou, Jiangsu 213000, P.R. China
| | - Guoxin Zhang
- Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
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Rahman YA, Ahmed LAW, Hafez RMM, Ahmed RMM. Helicobacter pylori and its hematological effect. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2019. [DOI: 10.4103/ejim.ejim_103_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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Exploring the impact of Helicobacter pylori on gut microbiome composition. PLoS One 2019; 14:e0218274. [PMID: 31211818 PMCID: PMC6581275 DOI: 10.1371/journal.pone.0218274] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 05/29/2019] [Indexed: 02/07/2023] Open
Abstract
Helicobacter pylori (H. pylori) is known to colonize gastric mucosa, induce inflammation, and alter gastric microbiota resulting in a spectrum of gastric diseases. Likewise, changes in gut microbiota have recently been linked with various metabolic and inflammatory diseases. While extensive number of studies were published examining the relationship between H. pylori and gastric microbiota, little is known about the impact of H. pylori on downstream gut microbiota. In this study, we performed 16 S rRNA and ITS2-based microbial profiling analysis of 60 stool samples from adult individuals. Remarkably, the gut microbiota of H. pylori infected individuals was shown to be increased of members belonging to Succinivibrio, Coriobacteriaceae, Enterococcaceae, and Rikenellaceae. Moreover, gut microbiota of H. pylori infected individuals was shown to have increased abundance of Candida glabrata and other unclassified Fungi. These results links possible role for H. pylori-associated changes in the gut microbiota in intestinal mucosal barrier disruption and early stage colorectal carcinoma deployment. Altogether, the identified differences in bacterial and fungal composition provides important information that may eventually lead to the development of novel biomarkers and more effective management strategies.
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Galal YS, Ghobrial CM, Labib JR, Abou-Zekri ME. Helicobacter pylori among symptomatic Egyptian children: prevalence, risk factors, and effect on growth. J Egypt Public Health Assoc 2019; 94:17. [PMID: 32813082 PMCID: PMC7364677 DOI: 10.1186/s42506-019-0017-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 04/17/2019] [Indexed: 12/27/2022]
Abstract
AIM This study was carried out to determine the prevalence and predictors of Helicobacter pylori (H. pylori) infection among symptomatic children and the effect on growth. METHODS A cross-sectional study was conducted in the Outpatient Clinics of the Gastroenterology Unit of the Pediatric Hospital, Cairo University. A total of 630 children complaining of any symptoms or signs suspicious of H. pylori infection were enrolled. Weight and height were measured for each child, and the standard deviation scores (Z-scores) for weight-for-age (WAZ), weight-for-height (WHZ), and height-for-age (HAZ) were calculated. H. pylori was diagnosed using a stool antigen test. RESULTS The overall prevalence of infection was 64.6%. Socio-demographic variables significantly associated with H. pylori were residence in Upper Egypt (P = 0.013) and rural areas (P = 0.004), illiteracy of mothers (P = 0.017), household crowding index ≥ 3 (P = 0.011), absence of pure water supply (P = 0.005), and eating from street vendors (P < 0.001). Values of WAZ [median, interquartile range (IQR) in infected = - 1.3(- 2.7 to - 0.4) and non-infected = - 0.7(- 2.1 to - 0.1), P < 0.001], HAZ (P = 0.036), and WHZ (P = 0.005) were significantly lower in children infected with H. pylori. After performing a backward logistic regression analysis, eating from street vendors (OR = 1.879, 95% CI 1.346-2.625, P < 0.001), absence of pure water supply (OR = 1.725, 95% CI 1.162-2.561, P = 0.007), and overcrowding (OR = 1.547, 95% CI 1.100-2.177, P = 0.012) remained the significant predictors of H. pylori infection. CONCLUSION A high prevalence of H. pylori infection among symptomatic children was detected. The extra-digestive effects of H. pylori were revealed in the form of affection of growth parameters and reduced levels of serum hemoglobin, iron, and ferritin.
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Affiliation(s)
- Yasmine Samir Galal
- Departments of Public Health and Community Medicine, Faculty of Medicine, Cairo University, 31 Mohamed Hassan El-Gamal Street, Nasr City, Cairo, 11759, Egypt.
| | | | - John Rene Labib
- Pediatrics, Faculty of Medicine, , Cairo University, 7 Riyad Abdel Kader, Nasr City, Cairo, 11759, Egypt
| | - Maha Elsayed Abou-Zekri
- Pediatrics, Faculty of Medicine, , Cairo University, 47 El-Sudan Street, Dokki, Giza, 13211, Egypt
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Groome MJ, Parashar UD. Understanding the full clinical spectrum of childhood diarrhoea in low-income and middle-income countries. Lancet Glob Health 2019; 7:e534-e535. [PMID: 31000117 PMCID: PMC11262419 DOI: 10.1016/s2214-109x(19)30056-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 02/20/2019] [Indexed: 11/19/2022]
Affiliation(s)
- Michelle J Groome
- South African Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, 2013 Johannesburg, South Africa.
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Baxendell K, Walelign S, Tesfaye M, Wordofa M, Abera D, Mesfin A, Wolde M, Desta K, Tsegaye A, Taye B. Association between infection with Helicobacter pylori and platelet indices among school-aged children in central Ethiopia: a cross-sectional study. BMJ Open 2019; 9:e027748. [PMID: 30962240 PMCID: PMC6500313 DOI: 10.1136/bmjopen-2018-027748] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Previous clinical studies in adults from developed countries have implicated Helicobacter pylori infections in the development of thrombocytopenia. However, studies in children, particularly those from low-income countries, are unusually scarce. We examined the association between H. pylori infection and platelet indices in young Ethiopian school children. DESIGN Cross-sectional study SETTING: This study was conducted in five elementary schools located in central Ethiopia. PARTICIPANTS Blood and stool samples were collected from 971 children across five elementary schools in Ethiopia. H. pylori infection was diagnosed using stool antigen and serum antibody tests, and haematological parameters were measured using an automated haematological analyser. An interviewer-led questionnaire administered to mothers provided information on demographic and lifestyle variables. The independent effects of H. pylori infection on platelet indices were determined using multivariate linear and logistic regressions. STUDY OUTCOMES H. pylori-infected children had a lower average platelet count and mean platelet volume than uninfected after adjusting the potential confounders (adjusted mean difference: -20.80×109/L; 95% CI -33.51 to -8.09×109, p=0.001 and adjusted mean difference: -0.236 fL; 95% CI -0.408 to -0.065, p=0.007, respectively). Additionally, H. pylori-infected children had lower red blood cell counts (adjusted mean difference: -0.118×1012/L; 95% CI -0.200 to -0.036, p=0.005) compared with non-infected. CONCLUSION Our study from a developing country provides further support for an association between H. pylori infections and reduced platelet indices in young Ethiopian school children, after controlling for potential confounders. Further research is needed, particularly longitudinal studies, to establish causality.
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Affiliation(s)
- Kellyann Baxendell
- Department of Biology, Colgate University Division of Natural Sciences and Mathematics, Hamilton, New York, USA
| | - Sosina Walelign
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mehret Tesfaye
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Moges Wordofa
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Dessie Abera
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abiyot Mesfin
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mistire Wolde
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Kassu Desta
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Aster Tsegaye
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Bineyam Taye
- Department of Biology, Colgate University Division of Natural Sciences and Mathematics, Hamilton, New York, USA
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Abstract
Helicobacter pylori (H. pylori) is known to colonize gastric mucosa, induce inflammation, and alter gastric microbiota resulting in a spectrum of gastric diseases. Likewise, changes in gut microbiota have recently been linked with various metabolic and inflammatory diseases. While extensive number of studies were published examining the relationship between H. pylori and gastric microbiota, little is known about the impact of H. pylori on downstream gut microbiota. In this study, we performed 16 S rRNA and ITS2-based microbial profiling analysis of 60 stool samples from adult individuals. Remarkably, the gut microbiota of H. pylori infected individuals was shown to be increased of members belonging to Succinivibrio, Coriobacteriaceae, Enterococcaceae, and Rikenellaceae. Moreover, gut microbiota of H. pylori infected individuals was shown to have increased abundance of Candida glabrata and other unclassified Fungi. These results links possible role for H. pylori-associated changes in the gut microbiota in intestinal mucosal barrier disruption and early stage colorectal carcinoma deployment. Altogether, the identified differences in bacterial and fungal composition provides important information that may eventually lead to the development of novel biomarkers and more effective management strategies.
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18
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Abstract
Helicobacter pylori infection is acquired mainly in childhood and remains an essential cause of peptic ulcer disease and gastric cancer. This article provides commentary on the last ESPGHAN/NASPGHAN guidelines and on publications made after the consensus conference of 2015. The majority of infected children are asymptomatic and pediatric studies do not support a role for H. pylori in functional disorders such as recurrent abdominal pain. The role of H. pylori infection in failure to thrive, children's growth, type I diabetes mellitus (T1DM), and celiac disease remains controversial. The diagnosis of infection should be based on upper-digestive endoscopy with biopsy-based methods. Eradication control after treatment should be based on validated non-invasive tests. Nodular gastritis is the main endoscopic finding of childhood H. pylori infection, but gastroduodenal erosions/ulcers are seen in some children, especially after 10 years of age. When indicated, eradication treatment should be given when good compliance is expected and based on the antimicrobial susceptibility profile.
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Romo-González C, Mendoza E, Mera RM, Coria-Jiménez R, Chico-Aldama P, Gomez-Diaz R, Duque X. Helicobacter pylori infection and serum leptin, obestatin, and ghrelin levels in Mexican schoolchildren. Pediatr Res 2017; 82:607-613. [PMID: 28422951 DOI: 10.1038/pr.2017.69] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 02/19/2017] [Indexed: 12/14/2022]
Abstract
BackgroundThere is little information about the possible role of Helicobacter pylori infection on appetite-regulating peptides in children. This study evaluated the association between H. pylori infection and serum levels of ghrelin, leptin, and obestatin in schoolchildren.MethodsOne hundred seventy-eight schoolchildren, students at boarding schools in Mexico City, participated. H. pylori infection status was determined every 6 months for 1 year by a breath test using 13C-urea; schoolchildren with consistently positive or negative results were selected to participate. Age, sex, and body mass index (BMI) were recorded. Serum concentrations of total ghrelin, leptin, and obestatin via specific enzyme-linked immunosorbent assays were determined.ResultsSchoolchildren with H. pylori infection had lower concentration of leptin, -0.54 pg/ml (95% CI: -0.98 to -0.09), compared to the schoolchildren without infection, after adjustment by age, gender, and BMI. And the children with the infection had a median of obestatin lower in 0.99 ng/ml (95% CI: -1.93 to -0.06) compared with the uninfected children after adjustment by BMI.ConclusionAssociation was found between H. pylori infection and decreased serum concentrations of leptin and obestatin. These results suggest that in schoolchildren, H. pylori infection affects the levels of hormones implicated in regulating appetite and energy homeostasis.
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Affiliation(s)
- Carolina Romo-González
- Experimental Laboratory of Bacteriology, Department of Health, National Institute of Pediatrics, Mexico City, Mexico
| | - Eugenia Mendoza
- Research Unit in Infectious and Parasitic Diseases, Pediatric Hospital, 21st Century National Medical Center, IMSS, Mexico City, Mexico
| | - Robertino M Mera
- Division of Gastroenterology, Hepatology and Nutrition, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Rafael Coria-Jiménez
- Experimental Laboratory of Bacteriology, Department of Health, National Institute of Pediatrics, Mexico City, Mexico
| | - Patricia Chico-Aldama
- Experimental Laboratory of Bacteriology, Department of Health, National Institute of Pediatrics, Mexico City, Mexico
| | - Rita Gomez-Diaz
- Unit of Research in Clinical Epidemiology, Specialty Hospital, 21st Century National Medical Center, IMSS, Mexico City, Mexico
| | - Ximena Duque
- Research Unit in Infectious and Parasitic Diseases, Pediatric Hospital, 21st Century National Medical Center, IMSS, Mexico City, Mexico
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Benson J, Rahim RA, Agrawal R. Newly arrived refugee children with Helicobacter pylori are thinner than their non-infected counterparts. Aust J Prim Health 2017; 23:92-96. [DOI: 10.1071/py15187] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 04/05/2016] [Indexed: 12/17/2022]
Abstract
The hypothesis of this study was that those refugee children with Helicobacter pylori are thinner than their non-infected counterparts. This cross-sectional study investigated the height and weight of newly arrived refugee children up to age 19 years, who were screened for H. pylori using a stool antigen test at the Migrant Health Service in Adelaide between August 2010 and October 2013. Of 460 children, 21% were infected with H. pylori. After adjusting for vitamin B12 and iron levels, ethnicity, age and sex, the odds of being thin in the 10- to 19-year-old age group was 4.28-fold higher (95% CI 1.48–12.4) if they were H. pylori positive compared with those who were H. pylori negative. The difference between the two groups is statistically significant (P=0.01). Screening and treatment for H. pylori in the general population in developed countries is not recommended unless there are symptoms such as dyspepsia or risk of peptic ulcer, duodenal ulcer or gastric cancer. Given the findings of this study, a recommendation could be made that newly arrived refugee children who are thin should be tested for H. pylori. Thinness in children may influence their cognitive ability, school performance, physical endurance and hence their ability to successfully settle into their new country.
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Dietary Composition Influences Incidence of Helicobacter pylori-Induced Iron Deficiency Anemia and Gastric Ulceration. Infect Immun 2016; 84:3338-3349. [PMID: 27620719 DOI: 10.1128/iai.00479-16] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 09/02/2016] [Indexed: 12/17/2022] Open
Abstract
Epidemiologic studies have provided conflicting data regarding an association between Helicobacter pylori infection and iron deficiency anemia (IDA) in humans. Here, a Mongolian gerbil model was used to investigate a potential role of H. pylori infection, as well as a possible role of diet, in H. pylori-associated IDA. Mongolian gerbils (either H. pylori infected or uninfected) received a normal diet or one of three diets associated with increased H. pylori virulence: high-salt, low-iron, or a combination of a high-salt and low-iron diet. In an analysis of all infected animals compared to uninfected animals (independent of diet), H. pylori-infected gerbils had significantly lower hemoglobin values than their uninfected counterparts at 16 weeks postinfection (P < 0.0001). The mean corpuscular volume (MCV) and serum ferritin values were significantly lower in H. pylori-infected gerbils than in uninfected gerbils, consistent with IDA. Leukocytosis and thrombocytosis were also detected in infected gerbils, indicating the presence of a systemic inflammatory response. In comparison to uninfected gerbils, H. pylori-infected gerbils had a higher gastric pH, a higher incidence of gastric ulcers, and a higher incidence of fecal occult blood loss. Anemia was associated with the presence of gastric ulceration but not gastric cancer. Infected gerbils consuming diets with a high salt content developed gastric ulcers significantly more frequently than gerbils consuming a normal-salt diet, and the lowest hemoglobin levels were in infected gerbils consuming a high-salt/low-iron diet. These data indicate that H. pylori infection can cause IDA and that the composition of the diet influences the incidence and severity of H. pylori-induced IDA.
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Effect of Helicobacter pylori infection on growth trajectories in young Ethiopian children: a longitudinal study. Int J Infect Dis 2016; 50:57-66. [PMID: 27531186 DOI: 10.1016/j.ijid.2016.08.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 06/15/2016] [Accepted: 08/08/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Helicobacter pylori infection has been associated with early childhood growth impairment in high- and middle-income countries; however, few studies have examined this relationship within low-income countries or have used a longitudinal design. The possible effects of H. pylori infection on growth trajectories were examined in a cohort of young Ethiopian children. METHODS In 2011/12, 856 children (85.1% of the 1006 original singletons in a population-based birth cohort) were followed up at age 6.5 years. An interviewer-led questionnaire administered to mothers provided information on demographic and lifestyle variables. Height and weight were measured twice, and the average of the two measurements was used. Exposure to H. pylori infection was assessed using a rapid H. pylori stool antigen test. The independent associations of positive H. pylori infection status (measured at ages 3 and 6.5 years) with baseline height and weight (age 3 years) and height and weight growth trajectory (from age 3 to 6.5 years) were modelled using hierarchical linear models. RESULTS At baseline (age 3 years), the children's mean height was 85.7cm and their mean weight was 11.9kg. They gained height at a mean rate of 8.7cm/year, and weight at a mean rate of 1.76kg/year. H. pylori infection was associated with lower baseline measurements and linear height trajectory (β=-0.74cm and -0.79cm/year, respectively), after controlling for demographics and markers of socio-economic status. However, the positive coefficient was associated with quadratic growth in height among H. pylori-infected children (β=0.28, 95% confidence interval 0.07 to 0.49, p<0.01), and indicated an increase in height trajectory as the child increased in age. A non-significant difference in baseline and trajectory of weight was observed between H. pylori-infected and non-infected children. CONCLUSIONS These findings add to the growing body of evidence supporting that H. pylori infection is inversely associated with childhood growth trajectory, after controlling for a range of factors associated with reduced growth and H. pylori status. Further follow-up will be important to confirm possible catch-up in height trajectory among H. pylori-infected children as they grow older.
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Liu C, Zhang Z, Zhu M. Immune Responses Mediated by Th17 Cells in Helicobacter pylori Infection. ACTA ACUST UNITED AC 2016. [DOI: 10.1159/000446317] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Abstract
OBJECTIVES Helicobacter pylori infection is acquired in early childhood, yet its role in children's health is still not fully clear. In this narrative review, we focused on the association between H pylori infection and children's growth. METHODS A literature search of the Ovid MEDLINE (till June 2015) and EMBASE (till August 2015) databases was performed using the terms "Helicobacter pylori, growth, body height, growth disorders and child development." Original studies that addressed the association between H pylori infection or eradication and children's growth were reviewed and the risk of bias of each study was assessed. RESULTS The existing evidence is based on observational studies (N = 48) and suggests that H pylori infection may adversely influence children's growth; findings were more consistent across studies with low risk of bias. Regarding linear growth, observational studies have repeatedly linked between H pylori infection and slower or diminished linear growth; yet, it is not known whether this association is causal. The association between H pylori infection and ponderal growth has been less consistent. Scarce evidence exists on the effect of H pylori eradication on children's skeletal growth and weight gain, but there is an indication that H pylori eradication may benefit nutritional status. CONCLUSIONS H pylori infection may impair children's growth. Additional studies, especially clinical trials, are needed to elucidate the role of H pylori eradication in children's growth, and the mechanisms that may be involved in such.
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Serrano CA, Villagrán A, Toledo H, Crabtree JE, Harris PR. Iron Deficiency and IL1β Polymorphisms in Helicobacter pylori-infected Children. Helicobacter 2016. [PMID: 26211930 DOI: 10.1111/hel.12247] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Helicobacter pylori infection has been associated with an imbalance of iron homeostasis. IL-1β has been related with iron absorption disturbances through a variety of mechanisms. The aim of this study was to evaluate the presence of polymorphic variants for IL-1β cluster and gastric IL1β mRNA expression in H. pylori-infected children and their relationship with hypochlorhydria and iron deficiency (ID). PATIENTS AND METHODS Prospective study of 123 symptomatic children. At endoscopy, antral biopsies were taken for urease test, pathology and culture and blood for analysis of ferritin, transferrin, serum iron, and total iron-binding capacity. Polymorphisms in the IL-1β cluster (positions -511, -31, +3954, ILRN) were determined by PCR-RFLP. Gastric mucosal expression of IL-1β mRNA was determined by RT-PCR. RESULTS After exclusions, of 105 patients, 33 (31.4%) were H. pylori positive. Nine (8.6%) children were classified as iron deficient (ID). Helicobacter pylori positivity was associated with ID (OR: 5.1; 95% CI: 1.2-21.9) (p = .04). No significant differences were found in allele frequency for IL1β gene cluster polymorphisms between infected and uninfected children. Helicobacter pylori-infected children with ID had significantly increased gastric IL1β mRNA in comparison with infected children without ID. In addition, a significant positive correlation was observed between mucosal IL-1β mRNA and fasting gastric juice pH. Gastric pH values were significantly increased in H. pylori-infected patients with ID compared to uninfected children. CONCLUSIONS The established association between H. pylori infection and ID in children may be mediated by increased gastric mucosal IL-1β.
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Affiliation(s)
- Carolina A Serrano
- Department of Pediatric Gastroenterology and Nutrition, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Andrea Villagrán
- Department of Pediatric Gastroenterology and Nutrition, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Héctor Toledo
- Laboratory of Molecular Microbiology, Celular and Molecular Biology Program, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Jean E Crabtree
- Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, Leeds, UK
| | - Paul R Harris
- Department of Pediatric Gastroenterology and Nutrition, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
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Amieva M, Peek RM. Pathobiology of Helicobacter pylori-Induced Gastric Cancer. Gastroenterology 2016; 150:64-78. [PMID: 26385073 PMCID: PMC4691563 DOI: 10.1053/j.gastro.2015.09.004] [Citation(s) in RCA: 555] [Impact Index Per Article: 69.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 09/01/2015] [Accepted: 09/03/2015] [Indexed: 02/07/2023]
Abstract
Colonization of the human stomach by Helicobacter pylori and its role in causing gastric cancer is one of the richest examples of a complex relationship among human cells, microbes, and their environment. It is also a puzzle of enormous medical importance given the incidence and lethality of gastric cancer worldwide. We review recent findings that have changed how we view these relationships and affected the direction of gastric cancer research. For example, recent data have indicated that subtle mismatches between host and microbe genetic traits greatly affect the risk of gastric cancer. The ability of H pylori and its oncoprotein CagA to reprogram epithelial cells and activate properties of stemness show the sophisticated relationship between H pylori and progenitor cells in the gastric mucosa. The observation that cell-associated H pylori can colonize the gastric glands and directly affect precursor and stem cells supports these observations. The ability to mimic these interactions in human gastric organoid cultures as well as animal models will allow investigators to more fully unravel the extent of H pylori control on the renewing gastric epithelium. Finally, our realization that external environmental factors, such as dietary components and essential micronutrients, as well as the gastrointestinal microbiota, can change the balance between H pylori's activity as a commensal or a pathogen has provided direction to studies aimed at defining the full carcinogenic potential of this organism.
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Affiliation(s)
- Manuel Amieva
- Department of Microbiology and Immunology, Stanford University, Palo Alto, CA,Department of Pediatrics, Stanford University, Palo Alto, CA
| | - Richard M. Peek
- Division of Gastroenterology, Hepatology, and Nutrition, Department of Medicine, Vanderbilt University, Nashville, TN,Department of Cancer Biology, Vanderbilt University, Nashville, TN
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Gheibi S, Noroozi M, Hejazi S, Karamyyar M, Farrokh-Eslamlou H. Severe Anemia and Helicobacter Pylori Infection in school age Children; A case reports. IRANIAN JOURNAL OF PEDIATRIC HEMATOLOGY AND ONCOLOGY 2016; 6:64-9. [PMID: 27222704 PMCID: PMC4867173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Accepted: 08/05/2015] [Indexed: 11/05/2022]
Abstract
BACKGROUND Iron-deficiency anemia is a widespread public health problem with major consequences for human health especially, children. However, in a fraction of patients an underlying cause is never found during routine investigation. Recent studies have suggested an association between Helicobacter pylori (H. Pylori) infection and iron-deficiency anemia. CASE PRESENTATION Here is reported four school aged children (two male, two female) with refractory severe iron-deficiency anemia associated H. Pylori gastritis. Mean age of the patients was 13.62 years old and they were admitted with chief complaints of abdominal, chest pain weakness, headache and respiratory distress. Mean hemoglobin level in patients was 6.2 g/dl with persistence to iron therapy. After the diagnosis and therapy of H. pylori infection, clinical complaints, hemoglobin level and iron profiles were being normal and they gained weight. CONCLUSION This study suggests screening of H. pylori infection and appropriate treatment in any case of refractory moderate to severe iron-deficiency anemia, especially with clinical manifestations of gastrointestinal tract in children.
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Affiliation(s)
- Sh Gheibi
- Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran.
| | - M Noroozi
- Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran.,Corresponding Author Mehran Noroozi MD, Assistant Professor of Pediatric Hematology and Oncology, Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Shahid Motahari Hospital, Urmia, I.R. Iran. .
| | - S Hejazi
- Department of Pediatric. Urmia University of Medical Sciences, Urmia, Iran.
| | - M Karamyyar
- Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran.
| | - H Farrokh-Eslamlou
- UrmiaReproductive Health Research Center, School of Public Health, Urmia University of Medical Sciences, Kashani Street, Urmia, Iran.
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Burns M, Muthupalani S, Ge Z, Wang TC, Bakthavatchalu V, Cunningham C, Ennis K, Georgieff M, Fox JG. Helicobacter pylori Infection Induces Anemia, Depletes Serum Iron Storage, and Alters Local Iron-Related and Adult Brain Gene Expression in Male INS-GAS Mice. PLoS One 2015; 10:e0142630. [PMID: 26575645 PMCID: PMC4648568 DOI: 10.1371/journal.pone.0142630] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 10/23/2015] [Indexed: 01/25/2023] Open
Abstract
Iron deficiency anemia (IDA) affects > 500 million people worldwide, and is linked to impaired cognitive development and function in children. Helicobacter pylori, a class 1 carcinogen, infects about half of the world’s population, thus creating a high likelihood of overlapping risk. This study determined the effect of H. pylori infection on iron homeostasis in INS-GAS mice. Two replicates of INS-GAS/FVB male mice (n = 9-12/group) were dosed with H. pylori (Hp) strain SS1 or sham dosed at 6–9 weeks of age, and were necropsied at 27–29 weeks of age. Hematologic and serum iron parameters were evaluated, as was gene expression in gastric and brain tissues. Serum ferritin was lower in Hp SS1-infected mice than uninfected mice (p < 0.0001). Infected mice had a lower red blood cell count (p<0.0001), hematocrit (p < 0.001), and hemoglobin concentration (p <0.0001) than uninfected mice. Relative expression of gastric hepcidin antimicrobial peptide (Hamp) was downregulated in mice infected with Hp SS1 compared to sham-dosed controls (p<0.001). Expression of bone morphogenic protein 4 (Bmp4), a growth factor upstream of hepcidin, was downregulated in gastric tissue of Hp SS1-infected mice (p<0.001). Hp SS1-infected mice had downregulated brain expression of tyrosine hydroxylase (Th) (p = 0.02). Expression of iron-responsive genes involved in myelination (myelin basic protein (Mbp) and proteolipid protein 2 (Plp2)) was downregulated in infected mice (p = 0.001 and p = 0.02). Expression of synaptic plasticity markers (brain derived neurotrophic factor 3 (Bdnf3), Psd95 (a membrane associated guanylate kinase), and insulin-like growth factor 1 (Igf1)) was also downregulated in Hp SS1-infected mice (p = 0.09, p = 0.04, p = 0.02 respectively). Infection of male INS-GAS mice with Hp SS1, without concurrent dietary iron deficiency, depleted serum ferritin, deregulated gastric and hepatic expression of iron regulatory genes, and altered iron-dependent neural processes. The use of Hp SS1-infected INS-GAS mice will be an appropriate animal model for further study of the effects of concurrent H. pylori infection and anemia on iron homeostasis and adult iron-dependent brain gene expression.
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Affiliation(s)
- Monika Burns
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
| | - Sureshkumar Muthupalani
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
| | - Zhongming Ge
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
| | - Timothy C. Wang
- Department of Medicine, Columbia University, New York, New York, United States of America
| | - Vasudevan Bakthavatchalu
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
| | - Catriona Cunningham
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
- School of Medicine and Dentistry, University of Aberdeen, Aberdeen, Scotland, United Kingdom
| | - Kathleen Ennis
- Division of Neonatology, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota, United States of America
| | - Michael Georgieff
- Division of Neonatology, Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota, United States of America
| | - James G. Fox
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
- * E-mail:
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Xu Y, Wang Q, Liu Y, Cui R, Zhao Y. Is Helicobacter pylori infection a critical risk factor for vascular dementia? Int J Neurosci 2015; 126:899-903. [PMID: 26269142 DOI: 10.3109/00207454.2015.1081387] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Yuzhen Xu
- 1Department of Neurology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Qian Wang
- 2Department of Central Laboratory, The Central Hospital of Tai'an, Taishan Medical College, Tai'an, China
| | - Yunlin Liu
- 3Department of Neurology, The Central Hospital of Tai'an, Taishan Medical College, Tai'an, China
| | - Ruiting Cui
- 3Department of Neurology, The Central Hospital of Tai'an, Taishan Medical College, Tai'an, China
| | - Yuwu Zhao
- 1Department of Neurology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
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Eberhardt KA, Sarfo FS, Dompreh A, Kuffour EO, Geldmacher C, Soltau M, Schachscheider M, Drexler JF, Eis-Hübinger AM, Häussinger D, Bedu-Addo G, Phillips RO, Norman B, Burchard GD, Feldt T. Helicobacter pylori Coinfection Is Associated With Decreased Markers of Immune Activation in ART-Naive HIV-Positive and in HIV-Negative Individuals in Ghana. Clin Infect Dis 2015. [PMID: 26195015 DOI: 10.1093/cid/civ577] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Helicobacter pylori coinfection in human immunodeficiency virus (HIV) patients has been associated with higher CD4+ cell counts and lower HIV-1 viral loads, with the underlying mechanisms being unknown. The objective of this study was to investigate the impact of H. pylori infection on markers of T-cell activation in HIV-positive and HIV-negative individuals. METHODS In a cross-sectional, observational study, HIV patients (n = 457) and HIV-negative blood donors (n = 79) presenting to an HIV clinic in Ghana were enrolled. Data on clinical and sociodemographic parameters, CD4+/CD8+ T-cell counts, and HIV-1 viral load were recorded. Helicobacter pylori status was tested using a stool antigen test. Cell surface and intracellular markers related to T-cell immune activation and turnover were quantified by flow cytometry and compared according to HIV and H. pylori status. RESULTS Helicobacter pylori infection was associated with decreased markers of CD4+ T-cell activation (HLA-DR+CD38+CD4+; 22.55% vs 32.70%; P = .002), cell proliferation (Ki67; 15.10% vs 26.80%; P = .016), and immune exhaustion (PD-1; 32.45% vs 40.00%; P = .005) in 243 antiretroviral therapy (ART)-naive patients, but not in 214 patients on ART. In HIV-negative individuals, H. pylori infection was associated with decreased frequencies of activated CD4+ and CD8+ T cells (6.31% vs 10.40%; P = .014 and 18.70% vs 34.85%, P = .006, respectively). CONCLUSIONS Our findings suggest that H. pylori coinfection effectuates a systemic immune modulatory effect with decreased T-cell activation in HIV-positive, ART-naive patients but also in HIV-negative individuals. This finding might, in part, explain the observed association of H. pylori infection with favorable parameters of HIV disease progression. CLINICAL TRIALS REGISTRATION Clinicaltrials.gov NCT01897909.
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Affiliation(s)
| | - Fred Stephen Sarfo
- Kwame Nkrumah University of Science and Technology Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | | | - Edmund Osei Kuffour
- Clinic of Gastroenterology, Hepatology and Infectious Diseases, Heinrich Heine University Düsseldorf
| | - Christof Geldmacher
- Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (Ludwig Maximilian University [LMU]) German Centre for Infection Research (partner site), Munich
| | - Mareike Soltau
- Clinical Research Unit, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Marei Schachscheider
- Clinical Research Unit, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | | | | | - Dieter Häussinger
- Clinic of Gastroenterology, Hepatology and Infectious Diseases, Heinrich Heine University Düsseldorf
| | - George Bedu-Addo
- Kwame Nkrumah University of Science and Technology Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Richard Odame Phillips
- Kwame Nkrumah University of Science and Technology Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Betty Norman
- Kwame Nkrumah University of Science and Technology Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Gerd Dieter Burchard
- Clinical Research Unit, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany Institute for Interdisciplinary Medicine, Asklepios Klinik St Georg, Hamburg, Germany
| | - Torsten Feldt
- Clinical Research Unit, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany Clinic of Gastroenterology, Hepatology and Infectious Diseases, Heinrich Heine University Düsseldorf
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Dietary and anthropometric indicators of nutritional status in relation to Helicobacter pylori infection in a paediatric population. Br J Nutr 2015; 113:1113-9. [PMID: 25761510 DOI: 10.1017/s0007114515000483] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
It has been postulated that Helicobacter pylori infection could affect growth and appetite, consequently influencing body weight. Therefore, the association between H. pylori infection and the dietary and anthropometric indicators of nutritional status of a paediatric population were investigated. A total of 525 children (aged 4-16 years) who were referred to the gastroenterology unit of the Sor Maria Ludovica Children's Hospital from Buenos Aires, Argentina, were enrolled and completed an epidemiological questionnaire. H. pylori infection was diagnosed using the ¹³C-urea breath test (¹³C-UBT). Height and weight were assessed for calculation of anthropometric indicators. Energy and macronutrient intakes were estimated by 24 h dietary recall. Data analysis was performed using a χ² test, a Student's t test, a Mann-Whitney U test and linear and logistic regressions. The prevalence of H. pylori infection was 25·1 % (with a mean age of 10·1 (SD 3·1) years). A tendency towards lower energy, carbohydrate, protein and fat intakes was observed in infected patients; however, it was not associated with H. pylori infection in any of the evaluated age groups (4-8, 9-13 and 14-16 years). Underweight, stunting, overweight and obesity were also not associated with the infection. Although height-for-age and BMI-for-age Z scores tended to be lower in infected patients, the differences between H. pylori-positive and H. pylori-negative children were not statistically significant. In conclusion, H. pylori infection was not associated with dietary intake or with anthropometric indicators in the present population of children with gastrointestinal symptoms; however, an increased sample size would be needed to confirm the observed tendency towards lower dietary intake and lower anthropometric indicators of nutritional status in H. pylori-infected children.
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Olefson S, Moss SF. Obesity and related risk factors in gastric cardia adenocarcinoma. Gastric Cancer 2015; 18:23-32. [PMID: 25209115 DOI: 10.1007/s10120-014-0425-4] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 08/23/2014] [Indexed: 02/07/2023]
Abstract
Over recent decades, the incidence of cancers of the gastroesophageal junction, including gastric cardia tumors, has increased markedly. This is a trend that has been well documented, especially in studies from the USA and northern Europe that have also demonstrated a concomitant rise in the ratio of cardia to distal gastric cancers. The rise in the prevalence of gastric cardia adenocarcinoma has been paralleled by the worldwide obesity epidemic, with almost all epidemiological studies reporting increased body mass index and obesity increase the risk of cardia cancer development. However, the strength of this association is less marked than the link between obesity and esophageal adenocarcinoma, and the mechanisms remain poorly understood. Other possible confounders of the relationship between obesity and cardia cancer include the decline in Helicobacter pylori infection and the widespread use of proton pump inhibitors, although these have rarely been controlled for in case-control and cohort studies investigating associations between obesity and cardia cancer. We review these epidemiological trends and discuss proposed mechanisms for the association, drawing attention to controversies over the difficulty of defining cardia cancer. The relative paucity of high-quality epidemiological studies from other regions of the world should prompt further investigation of this issue, especially in populations undergoing rapid socioeconomic change.
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Affiliation(s)
- Sidney Olefson
- Department of Medicine, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, RI, 02903, USA
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Pacifico L, Osborn JF, Tromba V, Romaggioli S, Bascetta S, Chiesa C. Helicobacter pylori infection and extragastric disorders in children: a critical update. World J Gastroenterol 2014; 20:1379-401. [PMID: 24587617 PMCID: PMC3925850 DOI: 10.3748/wjg.v20.i6.1379] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 11/10/2013] [Accepted: 01/06/2014] [Indexed: 02/06/2023] Open
Abstract
Helicobacter pylori (H. pylori) is a highly prevalent, serious and chronic infection that has been associated causally with a diverse spectrum of extragastric disorders including iron deficiency anemia, chronic idiopathic thrombocytopenic purpura, growth retardation, and diabetes mellitus. The inverse relation of H. pylori prevalence and the increase in allergies, as reported from epidemiological studies, has stimulated research for elucidating potential underlying pathophysiological mechanisms. Although H. pylori is most frequently acquired during childhood in both developed and developing countries, clinicians are less familiar with the pediatric literature in the field. A better understanding of the H. pylori disease spectrum in childhood should lead to clearer recommendations about testing for and treating H. pylori infection in children who are more likely to develop clinical sequelae. A further clinical challenge is whether the progressive decrease of H. pylori in the last decades, abetted by modern clinical practices, may have other health consequences.
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