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Doulberis M, Kountouras J, Stadler T, Meerwein C, Polyzos SA, Kulaksiz H, Chapman MH, Rogler G, Riva D, Linas I, Kavaliotis J, Kazakos E, Mouratidou M, Liatsos C, Papaefthymiou A. Association between Helicobacter pylori Infection and Nasal Polyps: A Systematic Review and Meta-Analysis. Microorganisms 2023; 11:1581. [PMID: 37375083 DOI: 10.3390/microorganisms11061581] [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: 04/28/2023] [Revised: 05/20/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Helicobacter pylori (H. pylori) has definite or possible associations with multiple local and distant manifestations. H. pylori has been isolated from multiple sites throughout the body, including the nose. Clinical non-randomized studies with H. pylori report discrepant data regarding the association between H. pylori infection and nasal polyps. The aim of this first systematic review and meta-analysis was the assessment of the strength of the association between H. pylori infection and incidence of nasal polyps. METHODS We performed an electronic search in the three major medical databases, namely PubMed, EMBASE and Cochrane, to extract and analyze data as per PRISMA guidelines. RESULTS Out of 57 articles, 12 studies were graded as good quality for analysis. Male-to-female ratio was 2:1, and age ranged between 17-78 years. The cumulative pooled rate of H. pylori infection in the nasal polyp group was 32.3% (controls 17.8%). The comparison between the two groups revealed a more significant incidence of H. pylori infection among the nasal polyp group (OR 4.12), though with high heterogeneity I2 = 66%. Subgroup analysis demonstrated that in European studies, the prevalence of H. pylori infection among the nasal polyp group was significantly higher than in controls, yielding null heterogeneity. Subgroup analysis based on immunohistochemistry resulted in null heterogeneity with preserving a statistically significant difference in H. pylori infection prevalence between the groups. CONCLUSION The present study revealed a positive association between H. pylori infection and nasal polyps.
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Affiliation(s)
- Michael Doulberis
- Gastroklinik, Private Gastroenterological Practice, 8810 Horgen, Switzerland
- Department of Gastroenterology, University Hospital Zurich, 8091 Zurich, Switzerland
- Division of Gastroenterology and Hepatology, Medical University Department, Kantonsspital Aarau, 5001 Aarau, Switzerland
- Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Macedonia, Greece
| | - Jannis Kountouras
- Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Macedonia, Greece
| | - Thomas Stadler
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, 8091 Zurich, Switzerland
| | - Christian Meerwein
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, 8091 Zurich, Switzerland
| | - Stergios A Polyzos
- First Laboratory of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Macedonia, Greece
| | - Hasan Kulaksiz
- Gastroklinik, Private Gastroenterological Practice, 8810 Horgen, Switzerland
| | - Michael H Chapman
- Pancreaticobiliary Medicine Unit, University College London Hospitals (UCLH), London NW1 2BU, UK
| | - Gerhard Rogler
- Department of Gastroenterology, University Hospital Zurich, 8091 Zurich, Switzerland
| | - Daniele Riva
- Gastrocentro Plus, Private Gastroenterological Practice, 6900 Lugano, Switzerland
| | - Ioannis Linas
- Gastroenterologische Gruppenpraxis, Private Gastroenterological Practice, 3011 Bern, Switzerland
| | - John Kavaliotis
- Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Macedonia, Greece
| | - Evangelos Kazakos
- Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Macedonia, Greece
- School of Healthcare Sciences, Midwifery Department, University of West Macedonia, 50100 Kozani, Macedonia, Greece
| | - Maria Mouratidou
- Department of Internal Medicine, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Macedonia, Greece
| | - Christos Liatsos
- Department of Gastroenterology, 401 General Military Hospital of Athens, 11525 Athens, Attica, Greece
| | - Apostolis Papaefthymiou
- Pancreaticobiliary Medicine Unit, University College London Hospitals (UCLH), London NW1 2BU, UK
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Watanabe J, Shimamoto J, Kotani K. The Effects of Antibiotics for Helicobacter pylori Eradication or Dapsone on Chronic Spontaneous Urticaria: A Systematic Review and Meta-Analysis. Antibiotics (Basel) 2021; 10:antibiotics10020156. [PMID: 33557074 PMCID: PMC7913800 DOI: 10.3390/antibiotics10020156] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/30/2021] [Accepted: 02/01/2021] [Indexed: 01/19/2023] Open
Abstract
Background: Chronic spontaneous urticaria (CSU) is a disease with wheals and/or angioedema. Some drugs, especially antibiotics for Helicobacter pylori (H. pylori) eradication and the sulfone antibiotic dapsone, may be candidates for treating CSU. The present study assessed the efficacy of these antibiotic therapies for CSU. Methods: Databases (MEDLINE, the Cochrane Central Register of Controlled Trials, EMBASE, the World Health Organization International Clinical Trials Platform Search Portal and ClinicalTrials.gov) were searched until October 2020. Study selection, data abstraction and quality assessments were independently performed using the Grading of Recommendations Assessment, Development and Evaluation approach. The outcomes were the remission of CSU-related symptoms, activities and adverse events due to antibiotics for H. pylori eradication or dapsone. Results: Nine randomized controlled trials (RCTs; 361 patients) were included. The antibiotics for H. pylori eradication increased the remission rate (risk ratio (RR) = 3.99, 95% confidence interval (CI) = 1.31 to 12.14; I2 = 0%), but dapsone did not (RR = 1.15, 95% CI = 0.74 to 1.78). Antibiotics for H. pylori eradication (standard mean difference (SMD) = 1.49, 95% CI = 0.80 to 2.18; I2 = 69%) and dapsone (SMD = 7.00, 95% CI = 6.92 to 7.08; I2 = 0%) improved symptoms. The evidence of certainty was moderate. Dapsone was associated with mild adverse events, whereas H. pylori eradication was not. Conclusion: Antibiotics, especially those for H. pylori eradication, improved the remission rate and symptoms of CSU with few adverse events. Further studies are needed.
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Affiliation(s)
| | | | - Kazuhiko Kotani
- Correspondence: author: ; Tel.: +81-285-58-7394; Fax: +81-285-44-0628
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The Etiological Evaluation of Patients with Chronic Urticaria. MEDICAL BULLETIN OF SISLI ETFAL HOSPITAL 2020; 54:424-427. [PMID: 33364881 PMCID: PMC7751234 DOI: 10.14744/semb.2018.98216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 12/12/2018] [Indexed: 11/20/2022]
Abstract
Objectives Chronic urticaria (CU) is a common skin disease characterised by skin lesions and angioedema lasting longer than six weeks. Although many factors, such as autoimmune diseases, infections, drugs and malignities, are blamed in the etiology, no reason can be found in a significant majority of the patients. The present study aims to investigate the factors which have a role in the etiology in patients diagnosed with CU. Methods Sixty-two patients who were followed-up with the diagnosis of CU in the Allergy Polyclinic of Dermatology Clinic were retrospectively evaluated in this study. The clinical and laboratory data of the patients were obtained from the patient files and the hospital automation system. The obtained data were given as a number and percentage for the categorical variables and as mean, standard deviation, minimum, and maximum for the numerical variables. Results The patient group consisted of 33 women (53.2%), and 29 men (46.8%), with 62 patients. The prevalence of angioedema was calculated as 51.6%, and the accompanying physical hives was calculated as 40.3%. Autoimmune disease was accompanying in 14 (22.6%) patients, and coexisting infection was detected in 15 (24.2%) patients. Thyroid autoantibodies were detected positive in 24.5% of the patients, and helicobacter pylori (H.pylori) antigen was found positive in 69% of the patients. Conclusion Autoimmune thyroid diseases and infections are frequently detected as the accompanying diseases in patients diagnosed with CU.
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Kim HJ, Kim YJ, Lee HJ, Hong JY, Park AY, Chung EH, Lee SY, Lee JS, Park YL, Lee SH, Kim JE. Systematic review and meta-analysis: Effect of Helicobacter pylori eradication on chronic spontaneous urticaria. Helicobacter 2019; 24:e12661. [PMID: 31523897 DOI: 10.1111/hel.12661] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 08/25/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Helicobacter pylori (HP) infection is considered to play a role in the pathogenesis of chronic spontaneous urticaria (CSU). However, the efficacy of HP eradication therapy on CSU symptom improvement has not been well established. This meta-analysis was conducted to estimate the association between HP infection and CSU and to evaluate whether HP eradication therapy benefits patients with CSU. MATERIAL AND METHODS In October 2018, we searched databases for studies investigating the efficacy of HP eradication therapy for patients with CSU. Risk ratios (RRs) and 95% confidence intervals (CIs) were pooled using random effects models. RESULTS The meta-analysis included 22 studies with a total of 1385 patients with CSU. When comparing the spontaneous remission of urticarial symptom in patients with HP-positive to HP-negative patients, HP-negative patients showed significantly higher spontaneous remission of urticarial symptoms. (risk ratio 0.39; 95% confidence interval: 0.19-0.81). Among HP-positive CSU patients, remission of CSU was more likely shown in HP eradication therapy group compared to untreated group, aside from achieving HP elimination (risk ratio 2.10; 95% confidence interval: 1.20-3.68). However, there was no significant difference in the remission of CSU whether antibiotic therapy was successful in eradication of HP or not (risk ratio 1.00; 95% confidence interval: 0.65-1.54). CONCLUSIONS The results of this meta-analysis show that HP might be associated with the occurrence and persistence of CSU. The effectiveness of HP eradication therapy in suppressing CSU symptoms was significant. Interestingly, we found that resolution of CSU was not associated with successful eradication of HP infection. CSU Patients who were undergone antibiotic therapy for HP eradication showed significant higher CSU remission with or without HP eradication. Further studies are recommended to evaluate the mechanisms associated with relation of HP with CSU.
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Affiliation(s)
- Hyun Jung Kim
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| | - Yeon-Ji Kim
- Department of Internal Medicine, St. Vincent's Hospital, The Catholic University College of Medicine, Suwon, Korea
| | - Ho Jung Lee
- Department of Dermatology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Jeong Yeon Hong
- Department of Dermatology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - A Young Park
- Department of Dermatology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Euy Hyun Chung
- Department of Dermatology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Sung Yul Lee
- Department of Dermatology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Jong Suk Lee
- Department of Dermatology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Young Lip Park
- Department of Dermatology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Sang Hoon Lee
- Department of Dermatology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Jung Eun Kim
- Department of Dermatology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
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