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Manfredi M, Gismondi P, Iuliano S. Is Helicobacter pylori Anyway Pathogen in Children? INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231154650. [PMID: 36803205 PMCID: PMC9940224 DOI: 10.1177/00469580231154650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Helicobacter pylori (H. pylori) infection is a continuous challenge for both gastroenterologists and pediatricians. The international guidelines regarding diagnostic and treatment pathways differ between adults and children. The pediatric guidelines are more restrictive because children are rarely affected by serious consequences, particularly in Western countries. Therefore, infected children should be treated only after a careful case-by-case evaluation by a pediatric gastroenterologist. In any case, recent studies are confirming an increasingly all-around pathological role of H. pylori even in asymptomatic children. For these reasons, following the current evidence, we feel that H. pylori-infected children could be treated starting in pre-adolescence, particularly in Eastern countries, because their stomachs have already begun to develop the biomarkers of gastric damage. Therefore, we believe that H. pylori is anyway pathogen in children. Nevertheless, the possible beneficial role of H. pylori in humans has not yet been conclusively disproved.
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Affiliation(s)
- Marco Manfredi
- Azienda USL-IRCCS di Reggio Emilia, Maternal and Child Department, Pediatric Unit, Sant’Anna Hospital, Castelnovo ne Monti, Reggio Emilia, Italy,Marco Manfredi, Azienda USL-IRCCS di Reggio Emilia, Maternal and Child Department, Pediatric Unit, Sant’Anna Hospital, via Roma, 2 - Castelnovo ne Monti, Reggio Emilia 42122, Italy.
| | - Pierpacifico Gismondi
- Week Hospital, Pietro Barilla Children’s Hospital, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Silvia Iuliano
- Pediatric Gastroenterology, Pietro Barilla Children’s Hospital, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
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Muacevic A, Adler JR, Doğan AE, Özdener F. Factors Affecting Prognosis in the Course of Pediatric Celiac Disease. Cureus 2022; 14:e32208. [PMID: 36620822 PMCID: PMC9812003 DOI: 10.7759/cureus.32208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2022] [Indexed: 12/09/2022] Open
Abstract
Introduction Celiac disease (CD) is a rather frequent chronic autoimmune disease that causes impaired growth in children. The present study aims to evaluate patients' condition after diagnosis cross-sectionally and determine the factors affecting prognosis. Methods Control visits were performed at the end of the 13-month intervention period. The study was designed as a single-center retrospective study and included patients diagnosed with CD. The study cohort consisted of 211 patients aged 1 to 18 years. Statistical parameters include Helicobacter positivity, Marsh classification; economic status; and body mass index (BMI) z-score, weight z-score, and height z-score to observe the difference between admission and follow-up. Results Treatment adherence is one of the most critical factors influencing improvement in developmental parameters during control visits (p<0.033). It was observed that the weight z-scores at the control visit deteriorated significantly with a longer duration of complaints (p=0.033). Better improvement of control visit BMI z-scores among patients with complaints compared to asymptomatic patients (p=0.036) indicate the importance of early diagnosis in asymptomatic cases. Developmental parameters of patients with CD without growth retardation (GR) show faster improvement compared to patients with GR (p<0.001). Families with good socioeconomic status can easily adapt to the diet by reaching a greater variety of gluten-free products, so anthropometric measurements are observed to be significantly higher at the control visit (p<0.002). Conclusions Treatment adherence is the most critical factor for improvement in CD treatment, as in all treatments. In addition, the investigation of suspected, additional disease symptoms during the follow-up of a CD patient is also of great importance for early diagnosis. The importance of early diagnosis has been emphasized in terms of anthropometric improvement in asymptomatic CD cases.
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Shah SC, Tarassishin L, Eisele C, Rendon A, Debebe A, Hawkins K, Hillenbrand C, Agrawal M, Torres J, Peek RM, Stone J, Dubinsky M, Colombel JF, Peter I, Hu J. Breastfeeding Is Associated with Lower Likelihood of Helicobacter Pylori Colonization in Babies, Based on a Prospective USA Maternal-Infant Cohort. Dig Dis Sci 2022; 67:5149-5157. [PMID: 35119598 PMCID: PMC9349469 DOI: 10.1007/s10620-021-07371-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 12/20/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND Mother-to-child transmission of Helicobacter pylori (H. pylori) is the primary source of intrafamilial spread in early childhood in regions of high H. pylori prevalence. However, early-in-life H. pylori colonization and associated protective or risk factors have not been fully evaluated in lower prevalence regions, such as the USA. AIMS Therefore, from a well-characterized prospective US cohort, we selected women who provided fecal samples during pregnancy and had paired fecal samples from their babies up to 24 months postpartum. We evaluated maternal and baby factors associated with likelihood of H. pylori colonization in the babies. Fecal antigen testing was used to determine H. pylori status. We also evaluated the association between maternal breastmilk cytokines and H. pylori colonization in breastfed babies. RESULTS Among included mother-baby pairs (n = 66), H. pylori prevalence was 31.8% in mothers and 19.7% in their babies. Dominant breastfeeding (adjusted odds ratio [aOR] 0.17, 95% CI 0.03-0.98) and maternal IBD (aOR 0.05, 95% CI 0.01-0.27) were associated with significantly lower likelihood of H. pylori colonization among babies; no other clinical factors were associated with H. pylori colonization in the babies. Matrix metalloproteinase-10 (MMP-10) and tumor necrosis factor-related activation-induced cytokine expression were significantly higher in breastmilk of mothers with H. pylori positive vs negative babies. CONCLUSIONS Consistent with data from high H. pylori prevalence regions, our findings suggest dominant breastfeeding may protect against early H. pylori colonization. Downregulation of pro-inflammatory cytokines such as MMP-10 may be relevant in mediating this protection among breastfed babies, but more data are needed.
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Affiliation(s)
- Shailja C Shah
- Section of Gastroenterology, Veterans Affairs San Diego Health System, 3350 La Jolla Villa Drive, San Diego VA, GI Section 3, rdFl, San Diego, CA, 92161, USA
- Division of Gastroenterology, University of California, San Diego, CA, USA
- Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Leonid Tarassishin
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, 1425 Madison Ave., 1402F, New York, NY, 10029, USA
| | - Caroline Eisele
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, 1425 Madison Ave., 1402F, New York, NY, 10029, USA
| | - Alexa Rendon
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, 1425 Madison Ave., 1402F, New York, NY, 10029, USA
| | - Anketse Debebe
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, 1425 Madison Ave., 1402F, New York, NY, 10029, USA
| | - Kelly Hawkins
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, 1425 Madison Ave., 1402F, New York, NY, 10029, USA
| | - Christen Hillenbrand
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, 1425 Madison Ave., 1402F, New York, NY, 10029, USA
| | - Manasi Agrawal
- The Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joana Torres
- The Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Gastroenterology, Surgical Department, Hospital Beatriz Ângelo, Loures, Portugal
| | - Richard M Peek
- Section of Gastroenterology, Veterans Affairs San Diego Health System, 3350 La Jolla Villa Drive, San Diego VA, GI Section 3, rdFl, San Diego, CA, 92161, USA
| | - Joanne Stone
- Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Science,, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Marla Dubinsky
- Department of Pediatric Gastroenterology and Nutrition, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jean-Frederic Colombel
- The Henry D. Janowitz Division of Gastroenterology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Inga Peter
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, 1425 Madison Ave., 1402F, New York, NY, 10029, USA
| | - Jianzhong Hu
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, 1425 Madison Ave., 1402F, New York, NY, 10029, USA.
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Xu C, Wu Y, Xu S. Association between Helicobacter pylori infection and growth outcomes in children: A meta-analysis. Helicobacter 2022; 27:e12861. [PMID: 34997950 DOI: 10.1111/hel.12861] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 11/13/2020] [Accepted: 11/15/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Multiple studies have reported the association between Helicobacter pylori (H. pylori) infection and children's growth. The results of these studies are controversial. Our meta-analysis aimed to evaluate the association between H. pylori infection and growth outcomes in children. METHODS We searched PubMed, Embase, Web of Science, and Cochrane Library, as well as two Chinese databases, Wanfang, and CNKI from inception to September 2019. Odds ratios (ORs) and standardized mean differences (SMDs) with their 95% confidence interval (95% CI) were selected as the effect size. We assessed pooled data using a random-effects model. Subgroup and sensitivity analyses were conducted. RESULTS In total, 29 studies provided data from 9384 subjects. The meta-analysis results indicated a significant association of H. pylori infection with ponderal growth disorders (OR: 2.47; 95% CI: 1.13, 5.37; p = 0.02) and linear growth disorders (OR =1.76; 95% CI: 1.15, 2.69, p = 0.01). H. pylori infection has an adverse impact on children's height-for-age Z (HAZ) scores (SMD = -0.41; 95% CI: -0.69, -0.13; p < 0.01). Pooling SMDs by other outcomes (height, weight, BMI, weight-for-age and BMI-for-age Z scores, weight-for-age percentile scores, and linear and ponderal growth velocity with/without infection and eradication/non-eradication) all indicated no significant association. CONCLUSION The current evidence supports the hypothesis that H. pylori infection is associated with growth outcomes in children, mainly HAZ scores. Clinicians might consider H. pylori infection in investigating linear growth disorders in children.
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Affiliation(s)
- Chenjing Xu
- Department of Gastroenterology, Jiangsu Province Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yao Wu
- Department of Gastroenterology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Shunfu Xu
- Department of Gastroenterology, Jiangsu Province Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.,Department of Gastroenterology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
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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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Fang LJ, Lin XC, Huang D, Pan TT, Yan XM, Hu WG, Zhu H, Xu Z, Zhu XZ, Lu HJ, Chen GP, Huang KY. 1H NMR-based metabolomics analyses in children with Helicobacter pylori infection and the alteration of serum metabolites after treatment. Microb Pathog 2020; 147:104292. [PMID: 32505653 DOI: 10.1016/j.micpath.2020.104292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 03/28/2020] [Accepted: 05/26/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIMS Helicobacter pylori (H. pylori) infection can occur in early childhood, without eradication therapies such infection can persist throughout life and cause many different diseases. This study investigated the metabolic characteristics and explored the underlying mechanism of children with H. pylori infection, and identified potential biomarkers for evaluating the efficacy of H. pylori eradication therapies. METHODS We performed 1H NMR-based metabonomics coupled with multivariate analysis to investigate the metabolic profiling of serum samples between Children with and without H. pylori infection. In the same manner, we compared the alternations of metabolites in H. pylori-infected children before and after H. pylori eradication therapies. RESULTS 21 metabolites from serum in H. pylori-infected and H. pylori-uninfected children were identified, which were mainly involved in energy, amino acid, lipid and microbial metabolism. We found that the serum levels of trimethylamine N-oxide and alanine were significantly higher in H. pylori-infected children compared to uninfected sera, whereas lactate was significantly lower. We also found that the levels of trimethylamine N-oxide and creatine in H. pylori-infected children was significantly decreased after H. pylori eradication therapies, whereas lactate and low-density lipoprotein/very low-density lipoprotein was significantly increased. CONCLUSIONS This is the first study using 1H NMR-based metabolomics approach to explore the effects of H. pylori infection in children. Our results demonstrated that the disturbances of metabolism in energy, amino acids, lipids and microbiota could play an important role in the pathogenesis of gastrointestinal and extragastric diseases caused by H. pylori infection. Trimethylamine N-oxide and lactate might serve as potential serum biomarkers for evaluating the efficacy of H. pylori eradication therapies.
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Affiliation(s)
- Ling-Juan Fang
- Department of Pediatric Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Xiao-Chun Lin
- Department of Pediatric Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Dian Huang
- The Second School of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Tong-Tong Pan
- Department of Pediatric Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Xiu-Mei Yan
- Department of Pediatric Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Wei-Guo Hu
- Department of Pediatric Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Huan Zhu
- Department of Pediatric Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Zhang Xu
- Department of Pediatric Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Xiao-Zhou Zhu
- Department of Pediatric Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Hua-Jun Lu
- Department of Pediatric Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Gui-Ping Chen
- Department of Pediatric Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Kai-Yu Huang
- Department of Pediatric Gastroenterology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.
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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: 1.0] [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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de Sena-Reis JS, Bezerra DD, Figueiredo CA, Barreto ML, Alcântara-Neves NM, da Silva TM. Relationship between African Biogeographical Ancestry and Helicobacter pylori infection in children of a large Latin American urban center. Helicobacter 2019; 24:e12662. [PMID: 31571359 DOI: 10.1111/hel.12662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 08/05/2019] [Accepted: 08/25/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND AND AIM The relationship between race/ethnicity and H pylori infection has been extensively reported, with a higher prevalence of infection observed in black individuals. Whether such differences are due to genetic factors underlying African ancestry remains to be clarified. In the present study, we evaluated the association between the proportion of individual African ancestry and H pylori infection in a sample of 1046 children living in a large Latin American urban center. MATERIALS AND METHODS Estimation of individual biogeographical ancestry was based on 370,539 SNPs and performed using the ADMIXTURE software. Multivariate logistic regression models and mediation analysis considering the influence of previously recognized socioenvironmental risk factors to H pylori infection were performed. All analyses were conducted using the statistical package STATA v.14.0. RESULTS Each 10% increase in the proportion of individual African ancestry was positively and independently associated with H pylori infection in our population (adjusted OR = 1.22, 95% CI = 1.10-1.36, P < .001). Mediation analysis demonstrated that only 9.23% of the effect of the individual African ancestry on H pylori infection was explained by factors such as household income, the absence of street paving and crowding. CONCLUSIONS The results suggest that genetic variants that covariate with African ancestry may explain an important part of the racial differences observed for the prevalence of H pylori infection.
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Affiliation(s)
- Jucineide Silva de Sena-Reis
- Postgraduate Program in Genetics, Biodiversity and Conservation - PPGGBC, State University of Southwest of Bahia - UESB, Jequié, Bahia, Brazil
| | - Débora Diniz Bezerra
- Postgraduate Program in Genetics, Biodiversity and Conservation - PPGGBC, State University of Southwest of Bahia - UESB, Jequié, Bahia, Brazil
| | - Camila A Figueiredo
- Institute of Health Sciences, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Maurício Lima Barreto
- Center for Integration of Data and Knowledge for Health (CIDACS) / FIOCRUZ, Salvador, Bahia, Brazil
| | | | - Thiago Magalhães da Silva
- Laboratory of Biology and Human Genetics, Department of Biological Sciences - DCB, UESB, Jequié, Bahia, Brazil
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Abstract
BACKGROUND In adults, Helicobacter pylori is aetiologically associated with peptic ulcer disease and gastric cancer. However, the relationship between this bacteria and gastro-intestinal symptoms in children is less clear. AIMS To review the recent literature on H. pylori in children and to outline the approach to diagnosis and management. METHODS The English language literature was searched for articles on H. pylori in children. Special attention was paid to prevalence, diagnosis and management pertinent to low- and middle-income countries (LMIC). RESULTS Although the prevalence of H. pylori is 60-80% in LMIC, only 5% of infected children develop peptic ulcer disease. The virulence of the organism determines the outcome. There is a suggestion that H. pylori causes iron deficiency anaemia, growth retardation and idiopathic thrombocytopenic purpura, but the evidence is not sufficiently strong to justify screening. There is no evidence to suggest a link between H. pylori infection and recurrent abdominal pain. Endoscopy (with invasive tests) is the preferred method of investigation as the primary goal is to determine the underlying cause of the symptoms. Children with H. pylori-related diseases should be treated with a standard triple-drug regimen consisting of a protein pump inhibitor and two antibiotics for 10-14 days. All treated patients should be monitored for eradication with non-invasive tests such as the urea (13-C) breath test or stool antigen tests. CONCLUSIONS Although H. pylori infection is common in LMIC, most children are asymptomatic. There is no association between H. pylori and recurrent abdominal pain. Invasive tests are preferred for diagnosis and a triple-drug regimen is the treatment of choice.
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Affiliation(s)
- Ujjal Poddar
- a Department of Paediatric Gastroenterology , Sanjay Gandhi Postgraduate Institute of Medical Sciences , Lucknow , India
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Impact of Helicobacter pylori Immunoglobulin G Levels and Atrophic Gastritis Status on Risk of Metabolic Syndrome. PLoS One 2016; 11:e0166588. [PMID: 27851820 PMCID: PMC5113018 DOI: 10.1371/journal.pone.0166588] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Accepted: 10/31/2016] [Indexed: 12/16/2022] Open
Abstract
Background Helicobacter pylori (HP) infection is implicated in gastric and extra-gastric diseases. While gastritis-related chronic inflammation represents a known trigger of metabolic disturbances, whether metabolic syndrome (MetS) is affected by gastritis status remains unclear. We aimed to clarify the effect of HP-related gastritis on the risk of MetS. Materials and Methods We retrospectively enrolled patients undergoing screening for MetS between 2014 and 2015. Investigations included HP-specific immunoglobulin G (IgG) antibody assays to detect HP infection, and serum pepsinogen assays to evaluate atrophic gastritis status. The risk of MetS was evaluated via multiple logistic regression analyses with two covariates: serum HP infection status (IgG levels) and atrophic gastritis status (two criteria were applied; pepsinogen I/II ratio < 3 or both pepsinogen I levels ≤ 70 μg/L and pepsinogen I/II ratio < 3). Results Of 1,044 participants, 247 (23.7%) were HP seropositive, and 62 (6.0%) had MetS. HP seronegative and seropositive patients had similar risks of MetS. On the other hand, AG (defined in terms of serum PG I/II <3) was significant risk of MetS (OR of 2.52 [95% CI 1.05–7.52]). After stratification according to HP IgG concentration, patients with low HP infection status had the lowest MetS risk (defined as an odds ratio [OR] adjusted for age, sex, smoking, drinking and physical activity status). Taking this result as a reference, patients with negative, moderate, and high HP infection status had ORs (with 95% confidence intervals [CI]) of 2.15 (1.06–4.16), 3.69 (1.12–16.7), and 4.05 (1.05–26.8). Conclusions HP-associated gastritis represents a risk factor for MetS. Research should determine why low and not negative HP infection status is associated with the lowest MetS risk.
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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: 15] [Impact Index Per Article: 1.7] [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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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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Effect of long-term Helicobacter pylori infection on growth of children: a cohort study. World J Pediatr 2016; 12:196-201. [PMID: 25846067 DOI: 10.1007/s12519-015-0021-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 11/10/2014] [Indexed: 01/22/2023]
Abstract
BACKGROUND The effects of Helicobacter pylori (H. pylori) infection on growth are a controversial issue. We investigated the effects of long-term H. pylori infection on height and weight in children. METHODS A total of 200 children of 7-18 years old suffering from dyspeptic complaints were classified into two groups: H. pylori positive and negative groups, respectively. Whether the infection was impoved was followed up while performing urea breath test, and according to exposure time to the infection, the children were further divided into group 1 (≤1.5 months), group 2 (>1.5-≤6 months) and group 3 (>6 months). Antropometric measurements were obtained and repeated every six months. RESULTS Mean growth velocity scores in the H. pylori positive and negative groups were 0.49±3.85 [95% confidence interval (CI): -0.21-1.18] and 1.98±4.42 (95% CI: 1-2.96), respectively. The difference between both groups was statistically significant (P=0.012). Mean growth velocity scores in groups 1, 2 and 3 were 0.96±3.84, 0.16±4.51 and -0.85±3.09, respectively. Mean growth velocity scores of group 3 were significantly lower than those of groups 0 and 1 (P=0.005 and P=0.041). The mean weight scores in group 3 were similar to those in group 2, but the scores in group 3 were significantly lower than those in group 1 (-1.75±1.05, -1.21±1.37 and -0.88±1.49, respectively). CONCLUSION As the duration of exposure is prolonged in children with H. pylori infection, the negative effect of the infection on both height and weight is evident.
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Characteristics and Risk Factors of Helicobacter pylori Associated Gastritis: A Prospective Cross-Sectional Study in Northeast Thailand. Gastroenterol Res Pract 2016; 2016:9130602. [PMID: 27042174 PMCID: PMC4793146 DOI: 10.1155/2016/9130602] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 01/14/2016] [Accepted: 01/31/2016] [Indexed: 12/22/2022] Open
Abstract
Background and Aim. Risk factors for Helicobacter pylori infection are genetic susceptibility and poor living conditions. This study aimed to investigate the Mdm2 gene, clarithromycin resistance, and possible risk factors for Helicobacter pylori infection. Methods. Risk factors and clinical characteristics were analyzed, including patient demographic data, patient income, personal history, possible source of transmission, patient symptoms, endoscopic findings, patterns of clarithromycin resistance, and patterns of Mdm2 SNIP309. Results. Ingestion of pickled fish (OR = 11.27, 95% CI = 4.31-29.45, p < 0.0001), salt crab (OR = 8.83, 95% CI = 1.99-39.14, p < 0.001), and Papaya salad (OR = 8.73, 95% CI = 4.54-16.79, p < 0.01). The prevalence of clarithromycin resistance was 56% (wild type, A2143/2142A, is 23.8%; mutation, A2143/2142CG, is 35.7%; wild type + mutation is 40.5%). The genetic polymorphisms of Mdm2 SNIP309 were SNIP309 T/T homozygous in 78%, SNIP309 G/T heterozygous in 19%, and SNIP309 G/G homozygous in 3%. Conclusion. Pickled fish, salt crab, and Papaya salad are positive risk factors. There was high prevalence of clarithromycin resistance. The Mdm2 SNIP309 G/G homozygous genotype might be a risk factor for gastric cancer and the fact that it is infrequent in Thailand.
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Hasosah M, Satti M, Shehzad A, Alsahafi A, Sukkar G, Alzaben A, Sunaid A, Ahmed A, AlThubiti S, Mufti A, Jacobson K. Prevalence and risk factors of Helicobacter pylori infection in Saudi children: a three-year prospective controlled study. Helicobacter 2015; 20:56-63. [PMID: 25495104 DOI: 10.1111/hel.12172] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Helicobacter pylori (H. pylori) infection is the most common chronic infections. The risk factors for H. pylori infection in both developing and developed countries are closely related to poor living conditions in childhood. This study aimed to establish the prevalence of H. pylori infection and its associated risk factors among children in the western and central regions of Saudi Arabia. METHODS A prospective cross-sectional study was performed among symptomatic children in National Guard hospitals who underwent esophagogastroduodenoscopy from 2010 to 2013. The gold standard diagnosis of H. pylori infection was histologic presence of the bacteria in the gastric biopsy. The variables analyzed as possible risk factors included demographic and living characteristics, socioeconomic status, potential mode of transmission, and clinical indications of H. pylori infection. RESULTS A total of 303 children were included in the study. The overall prevalence of H. pylori infection was 49.8%. Among the studied variables, the following were positively associated with the presence of H. pylori in multivariable analyses: age above 10 years(OR = 11.84, 95% CI = 3.90-35.94, p < .0001), an income of <5000 SR (OR = 2.06, 95% CI = 1.07-3.95), more than eight persons in the household (OR = 3.46, 95% CI = 1.67-7.20), bed sharing (OR = 2.26, 95% CI = 1.32-3.86), and two affected parents (OR = 11.19, 95% CI = 1.29-97.27). Abdominal pain and anorexia were significant predictors of H. pylori infection (p = .005 and .009, respectively). CONCLUSION Helicobacter pylori infection had a high prevalence among Saudi children in the cities of Jeddah and Riyadh. It was a relatively common cause of abdominal pain and anorexia. In this cohort of children, H. pylori infection was associated with variables indicative of a crowded environment and poor living conditions, further supporting the conclusion that improving socioeconomic conditions and designing a preventive health strategy in Saudi Arabia will likely protect children against this infection.
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Affiliation(s)
- Mohammed Hasosah
- Pediatric Gastroenterology Department, King Saud Bin Abdulaziz University for Health Sciences, National Guard Hospital, Jeddah, Saudi Arabia
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Kopp EB, Medzhitov R. Infection and inflammation in somatic maintenance, growth and longevity. Evol Appl 2015; 2:132-41. [PMID: 25567853 PMCID: PMC3352410 DOI: 10.1111/j.1752-4571.2008.00062.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2008] [Accepted: 12/04/2008] [Indexed: 01/06/2023] Open
Abstract
All organisms must display a certain degree of environmental adaptability to survive and reproduce. Growth and reproduction are metabolically expensive and carry other costs that contribute to aging. Therefore, animals have developed physiologic strategies to assess the harshness of the environment before devoting resources to reproduction. Presumably, these strategies maximize the possibility for offspring survival. Current views of aging reflect a trade-off between reproductive fitness and somatic maintenance whereby environmental stress induces an adaptive metabolic response aimed at preserving cellular integrity while inhibiting growth, whereas favorable environmental conditions (abundance of food and water, and optimal temperature, etc.) promote growth and reproductive maturity but simultaneously increase cellular damage and aging. Here we propose that the prevalence of infectious pathogens in a given niche represents an additional environmental factor that, via innate immune pathways, actively shifts this balance in favor of somatic maintenance at the expense of reproduction and growth. We additionally propose the construction of a genetic model system with which to test this hypothesis.
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Affiliation(s)
- Elizabeth B Kopp
- HHMI and Department of Immunobiology, Yale University School of Medicine New Haven, CT, USA
| | - Ruslan Medzhitov
- HHMI and Department of Immunobiology, Yale University School of Medicine New Haven, CT, USA
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Kopacova M, Koupil I, Seifert B, Fendrichova MS, Spirkova J, Vorisek V, Rejchrt S, Douda T, Tacheci I, Bures J. Blood pressure and stature in Helicobacter pylori positive and negative persons. World J Gastroenterol 2014; 20:5625-5631. [PMID: 24914321 PMCID: PMC4024770 DOI: 10.3748/wjg.v20.i19.5625] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Revised: 12/13/2013] [Accepted: 01/08/2014] [Indexed: 02/06/2023] Open
Abstract
To evaluate vital signs and body indices in Helicobacter pylori (H. pylori) positive and negative persons. A total of 22 centres entered the study. They were spread over the whole country, corresponding well to the geographical distribution of the Czech population. A total of 1818 subjects (aged 5-98 years) took part in the study, randomly selected out of 38147 subjects. H. pylori infection was investigated by means of a 13C-urea breath test. Data on height, weight, systolic and diastolic blood pressure and heart rate were collected at the clinics of general practitioners. The overall prevalence of H. pylori infection was 30.4% (402/1321) in adults (≥ 18 year-old) and 5.2% (26/497) in children and adolescents (≤ 17 year-old). Once adjusted for age and gender, only a difference in body mass index remained statistically significant with H. pylori positive adults showing an increase of 0.6 kg/m2 in body mass index. Once adjusted for age and gender, we found a difference in height between H. pylori positive and H. pylori negative children and adolescents. On further adjustment for place of residence, this difference became statistically significant, with H. pylori positive children and adolescents being on average 3.5 cm shorter. H. pylori positive adults were significantly older compared to H. pylori negative subjects. Once adjusted for age and gender, H. pylori infection had no impact on body weight, body mass index and vital signs either in adults or children and adolescents. Chronic H. pylori infection appeared to be associated with short stature in children. H. pylori infection did not influence blood pressure, body weight and body mass index either in adults or children and adolescents.
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Buzás GM. Metabolic consequences of Helicobacter pylori infection and eradication. World J Gastroenterol 2014; 20:5226-5234. [PMID: 24833852 PMCID: PMC4017037 DOI: 10.3748/wjg.v20.i18.5226] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Accepted: 01/15/2014] [Indexed: 02/06/2023] Open
Abstract
Helicobacter pylori (H. pylori) is still the most prevalent infection of the world. Colonization of the stomach by this agent will invariably induce chronic gastritis which is a low-grade inflammatory state leading to local complications (peptic ulcer, gastric cancer, lymphoma) and remote manifestations. While H. pylori does not enter circulation, these extragastric manifestations are probably mediated by the cytokines and acute phase proteins produced by the inflammed mucosa. The epidemiologic link between the H. pylori infection and metabolic changes is inconstant and controversial. Growth delay was described mainly in low-income regions with high prevalence of the infection, where probably other nutritional and social factors contribute to it. The timely eradication of the infection will lead to a more healthy development of the young population, along with preventing peptic ulcers and gastric cancer An increase of total, low density lipoprotein and high density liporotein cholesterol levels in some infected people creates an atherogenic lipid profile which could promote atherosclerosis with its complications, myocardial infarction, stroke and peripheral vascular disease. Well designed and adequately powered long-term studies are required to see whether eradication of the infection will prevent these conditions. In case of glucose metabolism, the most consistent association was found between H. pylori and insulin resistance: again, proof that eradication prevents this common metabolic disturbance is expected. The results of eradication with standard regimens in diabetics are significantly worse than in non-diabetic patients, thus, more active regimens must be found to obtain better results. Successful eradication itself led to an increase of body mass index and cholesterol levels in some populations, while in others no such changes were encountered. Uncertainities of the metabolic consequences of H. pylori infection must be clarified in the future.
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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: 43] [Impact Index Per Article: 3.9] [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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Queiroz DMM, Rocha AMC, Crabtree JE. Unintended consequences of Helicobacter pylori infection in children in developing countries: iron deficiency, diarrhea, and growth retardation. Gut Microbes 2013; 4:494-504. [PMID: 23988829 PMCID: PMC3928161 DOI: 10.4161/gmic.26277] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Helicobacter pylori infection is predominantly acquired early in life. The prevalence of the infection in childhood is low in developed countries, whereas in developing countries most children are infected by 10 y of age. In poor resource settings, where malnutrition, parasitic/enteropathogen and H. pylori infection co-exist in young children, H. pylori might have potentially more diverse clinical outcomes. This paper reviews the impact of childhood H. pylori infection in developing countries that should now be the urgent focus of future research. The extra-gastric manifestations in early H. pylori infection in infants in poor resource settings might be a consequence of the infection associated initial hypochlorhydria. The potential role of H. pylori infection on iron deficiency, growth impairment, diarrheal disease, malabsorption and cognitive function is discussed in this review.
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Affiliation(s)
- Dulciene MM Queiroz
- Laboratory of Research in Bacteriology; Faculdade de Medicina; Universidade Federal de Minas Gerais; Belo Horizonte, Brazil
| | - Andreia MC Rocha
- Laboratory of Research in Bacteriology; Faculdade de Medicina; Universidade Federal de Minas Gerais; Belo Horizonte, Brazil
| | - Jean E Crabtree
- Leeds Institute Molecular Medicine; St. James’s University Hospital; University of Leeds; Leeds, UK,Correspondence to: Jean E Crabtree,
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Ozkasap S, Yarali N, Isik P, Bay A, Kara A, Tunc B. The role of prohepcidin in anemia due to Helicobacter pylori infection. Pediatr Hematol Oncol 2013; 30:425-31. [PMID: 23560993 DOI: 10.3109/08880018.2013.783144] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Hepcidin, a key regulator of iron homeostasis, increases when inflammation and some infections occur. It plays a critical role in macrophage iron retention, which underlies inflammation/infection caused anemia. It is known that Helicobacter pylori (HP) may lead to iron deficiency (ID) due to occult blood loss or reduced iron absorption. This study investigates the role of prohepcidin, hepcidin's precursor, in ID and ID anemia (IDA) with a concurrent HP infection. METHODS In this prospectively designed study, 15 patients with IDA and a concurrent HP infection (group 1), 11 patients with an ID and a concurrent HP infection (group 2), and 18 patients with HP infection (group 3) were observed. All groups received only HP eradication therapy. Twenty-five age- and sex-matched children without ID/IDA and HP infection were included in the study as the control group. In all groups and control group, measurements were taken for pre- and posttreatment hemoglobin, serum prohepcidin, serum ferritin, serum iron (SI), transferrin saturation, erythrocyte sedimentation rate, fibrinogen, and C-reactive protein levels. RESULTS The pretreatment prohepcidin levels were significantly higher only in group 1 compared to the control group (P < .05). In group 1, a significant increase in hemoglobin and SI levels and a significant reduction in prohepcidin levels were additionally observed following HP eradication treatment (P < .05). However, in groups 2 and 3, significant differences in hemoglobin, iron, and prohepcidin levels between pre- and posttreatment were not observed. CONCLUSION Elevated serum prohepcidin might indicate the role of inflammation in the etiology of anemia concurrent with HP.
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Affiliation(s)
- Serdar Ozkasap
- Division of Pediatric Hematology and Oncology, Rize University Education and Research Hospital, Rize, Turkey.
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Dehghani SM, Karamifar H, Raeesi T, Haghighat M. Growth parameters in children with dyspepsia symptoms and Helicobacter pylori infection. Indian Pediatr 2013; 50:324-326. [PMID: 23024103 DOI: 10.1007/s13312-013-0090-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2012] [Accepted: 06/06/2012] [Indexed: 02/05/2023]
Abstract
Controversy exists about relationship of H. pylori infection and somatic growth retardation of children. The aim of this study was to evaluate the relationship between H. pylori infection and growth parameters in children. 113 children with dyspepsia (4-18 years) were enrolled. C13 urea breath test was performed for determination of H.pylori infection. Height, weight, body mass index (BMI) and standard deviation score (SDS) was calculated and growth parameters were compared between two groups of H.pylori positive and those with negative results. The prevalence of H.pylori infection was 52.2%. There was no meaningful relation between calculated SDS (for height and BMI) and H.pylori infection.
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Affiliation(s)
- Seyed Mohsen Dehghani
- Department of Pediatric Gastroenterology, and Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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Deng ZH, Chu B, Xu YZ, Zhang B, Jiang LR. Influence of Helicobacter pylori infection on ghrelin levels in children. World J Gastroenterol 2012; 18:5096-100. [PMID: 23049220 PMCID: PMC3460338 DOI: 10.3748/wjg.v18.i36.5096] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Revised: 05/14/2012] [Accepted: 05/26/2012] [Indexed: 02/06/2023] Open
Abstract
AIM: To compare ghrelin levels in plasma and gastric mucosa before and after Helicobacter pylori (H. pylori) treatment in children with H. pylori-associated functional dyspepsia.
METHODS: Children with H. pylori-associated functional dyspepsia were enrolled in this study. H. pylori infection was confirmed by positive bacterial culture results. All of the children received triple H. pylori eradication therapy (a 2 wk course of omeprazole, amoxicillin, and clarithromycin). The children were divided into two groups based on the success of the H. pylori treatment: group 1 (eradicated) - patients who had a negative 13C-urea breath test 2 mo after the end of therapy; and group 2 (non-eradicated) - patients who had a positive 13C-urea breath test. Plasma ghrelin, gastric ghrelin mRNA, and the body mass index were evaluated in both groups before and after the H. pylori treatment. The plasma ghrelin levels were measured by a radioimmunoassay. The expression of gastric ghrelin mRNA was determined by real-time reverse transcription polymerase chain reaction.
RESULTS: A total of 50 children with H. pylori-associated functional dyspepsia were treated with triple H. pylori eradication therapy. The mean age of the children was 5.52 ± 0.83 years, and there were 28 males and 22 females. Among the 50 H. pylori-positive children, 30 successfully achieved eradication, and 20 did not. The mean plasma ghrelin levels of group 1 were 22.17 ± 1.73 ng/L and 26.59 ± 2.05 ng/L before and after the treatment, respectively, which was a significant increase (P = 0.001). However, the mean plasma ghrelin level of group 2 before and after the H. pylori treatment was 21.34 ± 2.40 ng/L and 22.24 ± 2.10 ng/L (P = 0.785). The plasma ghrelin levels increased substantially after treatment in group 1 but showed only minor changes in group 2. Similarly, the gastric ghrelin mRNA expression in group 1 before treatment was 2.84 ± 0.08. After treatment, the level was 3.11 ± 0.65, which was significantly different (P = 0.023). The gastric ghrelin mRNA expression in group 2 did not change significantly during the treatment (2.82 ± 0.44 vs 2.79 ± 0.31, P = 0.875). The plasma ghrelin and gastric ghrelin mRNA levels in group 1 increased substantially after the treatment but did not do so in group 2. In addition, the body mass index the two groups did not differ significantly 2 mo before and after the H. pylori treatment.
CONCLUSION: H. pylori eradication increases the plasma and tissue ghrelin levels in children with H. pylori-associated functional dyspepsia.
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Yang YJ, Sheu BS, Yang HB, Lu CC, Chuang CC. Eradication of Helicobacter pylori increases childhood growth and serum acylated ghrelin levels. World J Gastroenterol 2012; 18:2674-81. [PMID: 22690077 PMCID: PMC3370005 DOI: 10.3748/wjg.v18.i21.2674] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2011] [Revised: 12/08/2011] [Accepted: 04/28/2012] [Indexed: 02/06/2023] Open
Abstract
AIM: To determine whether Helicobacter pylori (H. pylori)-infected children have reduced body weight (BW) and height (BH) growth, and if H. pylori eradication may restore growth while improving serum acylated ghrelin.
METHODS: This longitudinal cohort study with one-year follow-up enrolled 1222 children aged 4 to 12 years old into an observation cohort (18 with and 318 without H. pylori) and intervention cohort (75 with and 811 without). The 7-d triple therapy was used for eradication in the intervention cohort. The net increases of BW and BH as well serum acylated ghrelin after one-year follow-up were compared between successful eradicated H. pylori-infected children and controls.
RESULTS: In the observation cohort, the H. pylori-infected children had lower z score of BW (-1.11 ± 0.47 vs 0.35 ± 0.69, P = 0.01) and body mass index (BMI) (0.06 ± 0.45 vs 0.44 ± 0.73, P = 0.02) at enrollment and lower net BW gain after one-year follow-up (3.3 ± 2.1 kg vs 4.5 ± 2.4 kg, P = 0.04) than the non-infected controls. In the intervention cohort, the H. pylori-infected children had lower z score of BMI (0.25 ± 1.09 vs 0.68 ± 0.87, P = 0.009) and serum acylated ghrelin levels (41.8 ± 35.6 pg/mL vs 83.6 ± 24.2 pg/mL, P < 0.001) than the non-infected controls. In addition to restoring decreased serum ghrelin levels (87.7 ± 38.0 pg/mL vs 44.2 ± 39.0 pg/mL, P < 0.001), the H. pylori-infected children with successful eradication had higher net gains (P < 0.05) and increase of z scores (P < 0.05) of both BW and BH as compared with non-infected controls after one-year follow-up.
CONCLUSION: H. pylori-infected children are associated with low serum acylated ghrelin and growth retardation. Successful eradication of H. pylori restores ghrelin levels and increases growth in children.
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Abstract
BACKGROUND Helicobacter pylori infection affects about half of the world's population and is usually acquired in childhood. The infection has been associated with chronic gastritis, peptic ulcer, and stomach cancer in adulthood. Little is known, however, about its consequences on child health. We examined the effect of H. pylori infection on growth among school-age children in the Colombian Andes by comparing growth velocity in the presence and absence of H. pylori infection. METHODS Children who were 4-8 years old in 2004 were followed up in a community where infected children received anti-H. pylori treatment (n = 165) and a comparison community (n = 161) for a mean of 2.5 years. Anthropometry measurements were made every 3 months and H. pylori status ascertained by urea breath test every 6 months. Growth velocities (cm/month) were compared across person-time with and without infection, using mixed models for repeated measures. RESULTS In the untreated community, 83% were H. pylori-positive at baseline and 89% were -positive at study end. The corresponding prevalences were 74% and 46%, respectively, in the treated community. Growth velocity in the pretreatment interval was 0.44 (standard deviation [SD] = 0.13) cm/month. Models that adjusted for age, sex, and height estimated that H. pylori-positive children grew on average 0.022 cm/month (95% confidence interval = 0.008 to 0.035) slower than H. pylori-negative children, a result that was not appreciably altered by adjustment for socioenvironmental covariates. CONCLUSIONS This study suggests that chronic H. pylori infection is accompanied by slowed growth in school-age Andean children.
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Effect of Helicobacter pylori infection on growth velocity of school-age Andean children. EPIDEMIOLOGY (CAMBRIDGE, MASS.) 2011. [PMID: 21068668 DOI: 10.1097/ede] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Helicobacter pylori infection affects about half of the world's population and is usually acquired in childhood. The infection has been associated with chronic gastritis, peptic ulcer, and stomach cancer in adulthood. Little is known, however, about its consequences on child health. We examined the effect of H. pylori infection on growth among school-age children in the Colombian Andes by comparing growth velocity in the presence and absence of H. pylori infection. METHODS Children who were 4-8 years old in 2004 were followed up in a community where infected children received anti-H. pylori treatment (n = 165) and a comparison community (n = 161) for a mean of 2.5 years. Anthropometry measurements were made every 3 months and H. pylori status ascertained by urea breath test every 6 months. Growth velocities (cm/month) were compared across person-time with and without infection, using mixed models for repeated measures. RESULTS In the untreated community, 83% were H. pylori-positive at baseline and 89% were -positive at study end. The corresponding prevalences were 74% and 46%, respectively, in the treated community. Growth velocity in the pretreatment interval was 0.44 (standard deviation [SD] = 0.13) cm/month. Models that adjusted for age, sex, and height estimated that H. pylori-positive children grew on average 0.022 cm/month (95% confidence interval = 0.008 to 0.035) slower than H. pylori-negative children, a result that was not appreciably altered by adjustment for socioenvironmental covariates. CONCLUSIONS This study suggests that chronic H. pylori infection is accompanied by slowed growth in school-age Andean children.
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Ozen A, Furman A, Berber M, Karatepe HO, Mutlu N, Sarıçoban HE, Büyükgebiz B. The effect of Helicobacter pylori and economic status on growth parameters and leptin, ghrelin, and insulin-like growth factor (IGF)-I concentrations in children. Helicobacter 2011; 16:55-65. [PMID: 21241414 DOI: 10.1111/j.1523-5378.2010.00814.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND It was suggested that gastric colonization with Helicobacter pylori (H. pylori) was associated with suboptimal nutrition and growth in childhood. Furthermore, several studies indicated a relationship between H. pylori colonization and alterations in the circulating levels of growth-related molecules (GRM). Accordingly, in this study, we investigate the effect of H. pylori infection on GRMs and on the growth of healthy school children, taking into consideration the effect of their economic status (ES) and anthropometric indices of their parents. METHODS To acquire sociodemographic and anthropometric nutritional parameters and to detect H. pylori-specific serum IgG antibodies and growth-related molecules, we evaluated a total of 473 children attending four different primary and secondary schools in Istanbul. Subsequently, we assessed the effect of H. pylori on growth-related parameters (weight for age SDS, height for age SDS, BMI SDS, TSF, and waist-to-hip ratio) and on GRMs (leptin, ghrelin, and insulin-like growth factor-1 (IGF-1)), controlling for age, gender, family income, household crowding (HC), breastfeeding, maternal and paternal BMI SDS, and midparental height SDS with complex statistical models. RESULTS Of the 473 children (275 F/198 M, age 6-15 years; mean: 10.3 ± 0.1 years), 161 (34%) were H. pylori-positive. The prevalence of H. pylori was significantly higher in lower economic status (ES) groups, in children living in crowded houses, and in older age groups. Using simple statistical models, we did not find any significant associations between H. pylori infection and the growth parameters. However, in complex models for height for age SDS and for weight for age SDS, there was a significant interaction between H. pylori infection status and ES. Whereas in H. pylori-positive subjects, mid-income family children were both taller and heavier than the low-income group, there was no such an association in H. pylori-negative subjects. Among biochemical parameters, only ghrelin levels were associated with H. pylori infection in all models. Leptin levels were associated with HC in girls, whereas none of the parameters was significantly associated with leptin levels in boys. For IGF-1 levels, for boys, age and maternal BMI, and for girls, age and HC were significantly associated with IGF-1 levels. CONCLUSION We suggest that H. pylori may impair growth significantly only in susceptible children where unfavorable socioeconomic conditions facilitate its action, probably through mechanisms, at least in part, involving growth-related molecules.
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Affiliation(s)
- Ahmet Ozen
- Department of Pediatrics, Medical Faculty, Yeditepe University
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Pacifico L, Anania C, Osborn JF, Ferraro F, Chiesa C. Consequences of Helicobacter pylori infection in children. World J Gastroenterol 2010; 16:5181-94. [PMID: 21049552 PMCID: PMC2975089 DOI: 10.3748/wjg.v16.i41.5181] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2010] [Revised: 06/21/2010] [Accepted: 06/28/2010] [Indexed: 02/06/2023] Open
Abstract
Although evidence is emerging that the prevalence of Helicobacter pylori (H. pylori) is declining in all age groups, the understanding of its disease spectrum continues to evolve. If untreated, H. pylori infection is lifelong. Although H. pylori typically colonizes the human stomach for many decades without adverse consequences, children infected with H. pylori can manifest gastrointestinal diseases. Controversy persists regarding testing (and treating) for H. pylori infection in children with recurrent abdominal pain, chronic idiopathic thrombocytopenia, and poor growth. There is evidence of the role of H. pylori in childhood iron deficiency anemia, but the results are not conclusive. The possibility of an inverse relationship between H. pylori and gastroesophageal reflux disease, as well as childhood asthma, remains a controversial question. 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.
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Gulcan M, Ozen A, Karatepe HO, Gulcu D, Vitrinel A. Impact of H. pylori on growth: is the infection or mucosal disease related to growth impairment? Dig Dis Sci 2010; 55:2878-86. [PMID: 20112067 DOI: 10.1007/s10620-009-1091-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2009] [Accepted: 12/03/2009] [Indexed: 12/17/2022]
Abstract
BACKGROUND Helicobacter pylori (H. pylori) has been recognized as one of the most common chronic bacterial infections in the world. Most children are colonized in early childhood, and the infection will last a lifetime unless the child is treated with appropriate antibiotics. AIM To evaluate whether H. pylori infection has an influence on growth and whether the severity of endoscopic findings relates to the growth impairment. METHODS We formed four groups based on the presence or absence of H. pylori infection and gastrointestinal complaints as follows: group I: RAP +/H. pylori+; group II: RAP +/H. pylori-; group III: RAP -/H. pylori+; group IV: RAP -/H. pylori-. The relationship between endoscopic appearances, histological severity of gastritis, and antral H. pylori density with growth parameters was evaluated. RESULTS The BMI standard derivation scores of groups I and II were significantly lower than those of asymptomatic controls independent of their H. pylori status. A significant difference in height for age standard derivation scores was observed only between groups I and IV. When we compared the BMI and height for age standard derivation scores of group III and group IV combined with that of the endoscopically normal children in the recurrent abdominal pain group, there was no significant difference between the two groups. CONCLUSION Recurrent abdominal pain associated with gastric mucosal injury plays a role in a decrease in BMI independent of H. pylori infection. However, if recurrent abdominal pain originates from H. pylori infection, it appears that linear growth is also affected.
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Affiliation(s)
- Mahir Gulcan
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Yeditepe University Medical Faculty, Istanbul, Turkey
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Chi H, Bair MJ, Wu MS, Chiu NC, Hsiao YC, Chang KY. Prevalence of Helicobacter pylori infection in high-school students on Lanyu Island, Taiwan: risk factor analysis and effect on growth. J Formos Med Assoc 2010; 108:929-36. [PMID: 20040457 DOI: 10.1016/s0929-6646(10)60005-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND/PURPOSE The Yami inhabit Lanyu Island and are the smallest and most primitive aboriginal tribe in Taiwan. Lanyu Island is a closed environment and little information is available on the prevalence of Helicobacter pylori infection there. This study aimed to establish the prevalence of H. pylori infection in high-school students on Lanyu Island and its risk factors and effect on growth. METHODS A cross-sectional population-based study was conducted among high-school students to determine the prevalence of H. pylori infection by using the 13C urea breath test. A questionnaire was administered to the recruited population. Relevant personal and socioeconomic data for risk factors of infection were collected. Body height and weight of the recruited adolescents in relation to H. pylori infection were analyzed. RESULTS A total of 106 high-school students (55 boys and 51 girls), with a mean age of 14.3 +/- 1.4 years were enrolled. The overall prevalence of H. pylori infection was 54.7%. Those residing in Dongcing village had the highest rate of H. pylori infection (73.3%). There was no difference in the prevalence of H. pylori infection according to sex, ethnicity, socioeconomic level or parental education. Sixty-two students (54.8%) were completely asymptomatic and the others had at least one gastrointestinal symptom. H. pylori infection was asymptomatic in 56.8% and symptomatic in 53.2% of students. There was no significant difference between infected and uninfected children with regard to body weight, height and body mass index. CONCLUSION The prevalence of H. pylori infection is high among high-school students on Lanyu Island. There is no evidence that infection is related to growth failure.
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Affiliation(s)
- Hsin Chi
- Department of Pediatrics, Mackay Memorial Hospital, College of Mackay Medicine, Nursing and Management College, National Taiwan University College of Medicine, Taiwan
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Jackson L, Britton J, Lewis SA, McKeever TM, Atherton J, Fullerton D, Fogarty AW. A population-based epidemiologic study of Helicobacter pylori infection and its association with systemic inflammation. Helicobacter 2009; 14:108-13. [PMID: 19751435 DOI: 10.1111/j.1523-5378.2009.00711.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Infection with Helicobacter pylori is associated with a variety of non-gastrointestinal sequelae. These may be mediated by an increase in systemic inflammation. We assessed if serologic evidence of infection with H. pylori is associated with increased serum C-reactive protein (CRP) levels. METHODS The study design consisted of a randomly selected, cross-sectional population-based study of 2633 individuals phenotyped in 1991, of whom 2361 participants provided serum samples to permit measurement of H. pylori's serologic status and CRP levels. RESULTS Male gender (odds ratio (OR): 1.65; 95% confidence interval (CI): 1.23-2.21), age (OR per year: 1.05; 95% CI: 1.04-1.06), height (OR per meter: 0.05; 95% CI: 0.01-0.24), current smoking habit (compared with never smokers, OR: 1.46; 95% CI: 1.13-1.88), and less affluent socioeconomic status were associated with increased odds of being seropositive for H. pylori. Helicobacter pylori infection was associated with increased risk of having an elevated serum CRP (above 3 mg/L) after adjustment for gender, age, height, smoking status, and socioeconomic status (OR: 1.32; 95% CI: 1.05-1.67). Similar associations were seen using a threshold for elevated serum CRP of greater than 1 mg/L. CONCLUSIONS Our data suggest that infection with H. pylori is associated with increased systemic inflammation. This suggests one potential mechanism to explain the extra-gastrointestinal conditions associated with H. pylori infection.
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Affiliation(s)
- Louisa Jackson
- Division of Epidemiology and Public Health, University of Nottingham, Clinical Sciences Building, City Hospital, Nottingham NG5 1BP, UK
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Ferrara M, Capozzi L, Russo R. Influence of Helicobacter pylori infection associated with iron deficiency anaemia on growth in pre-adolescent children. ACTA ACUST UNITED AC 2009; 14:173-6. [PMID: 19490764 DOI: 10.1179/102453309x402287] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In 102 children of both genders aged between 10 and 12 years affected by iron deficiency anaemia (IDA) from various causes, a retrospective study from 1999 to 2007 has been performed to investigate possible relationships between IDA and physical growth. Patients were divided into two groups according to gender. Hb, MCV, ferritin levels, HSDS and body mass index (BMI) were recorded to confirm the diagnosis and the height standard deviation scores were also evaluated. The causes of IDA were investigated. At study entry, both groups of patients, regardless of IDA etiology, had microcytic hypochromic anaemia with low ferritin level. Anthropometric parameters were also reduced. Significant differences of anthropometric parameters were found in both groups in relationship to various causes of IDA (p<0.05) (ANOVA). We conclude that IDA may influence physical growth and etiological factors play an important role on growth delay.
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Affiliation(s)
- M Ferrara
- Department of Pediatrics, The 2nd University of Naples, Naples, Italy.
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Doroudchi M, Dehaghani AS, Ghaderi A. Preferential placental transfer of Helicobacter pylori specific IgG. J Matern Fetal Neonatal Med 2009. [PMID: 15621547 DOI: 10.1080/jmf.16.5.297.301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- M Doroudchi
- Department of Immunology, Shiraz Medical School Shiraz University of Medical Sciences P.O. Box: 71345-1798 Shiraz Iran
| | - A Samsami Dehaghani
- Department of Obstetrics and Gynecology, Medical School Shiraz University of Medical Sciences P.O. Box: 71345-1798 Shiraz Iran
| | - A Ghaderi
- Shiraz Institute for Cancer Research P.O. Box: 71345-3119 Shiraz Iran
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Sung J, Song YM, Lawlor DA, Smith GD, Ebrahim S. Height and site-specific cancer risk: A cohort study of a korean adult population. Am J Epidemiol 2009; 170:53-64. [PMID: 19403842 DOI: 10.1093/aje/kwp088] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
To evaluate the association between height and risk of cancer in an East Asian, middle-income population, the authors followed up a cohort of 788,789 Koreans (449,214 men and 339,575 women) aged 40-64 years for cancer incidence between 1994 and 2003. Cox proportional hazards regression analysis was used to evaluate the association. Each 5-cm increment in height was associated with 5% and 7% higher risk of all-sites cancer in men and women, respectively, after adjustment for age, body mass index, and behavioral and socioeconomic factors. When the associations were evaluated for site-specific cancers, a positive association was observed for cancer of the colon and thyroid in both men and women. Among gender-specific cancers, prostate cancer was positively associated with height in men. In women, there was a positive association between height and cancers of the breast and ovary, which did not change even after additional adjustment for reproductive factors. Although more clarification is needed for some site-specific cancers, the same positive association of height with cancer in a middle-income Korean population as found in high-income Western populations supports the influence of early life environment on cancer development in adulthood.
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Affiliation(s)
- Joohon Sung
- Department of Epidemiology, Institute of Health and Environment, Seoul National University, South Korea
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Mandeville KL, Krabshuis J, Ladep NG, Mulder CJJ, Quigley EMM, Khan SA. Gastroenterology in developing countries: issues and advances. World J Gastroenterol 2009; 15:2839-54. [PMID: 19533805 PMCID: PMC2699001 DOI: 10.3748/wjg.15.2839] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2009] [Revised: 04/21/2009] [Accepted: 04/28/2009] [Indexed: 02/06/2023] Open
Abstract
Developing countries shoulder a considerable burden of gastroenterological disease. Infectious diseases in particular cause enormous morbidity and mortality. Diseases which afflict both western and developing countries are often seen in more florid forms in poorer countries. Innovative techniques continuously improve and update gastroenterological practice. However, advances in diagnosis and treatment which are commonplace in the West, have yet to reach many developing countries. Clinical guidelines, based on these advances and collated in resource-rich environments, lose their relevance outside these settings. In this two-part review, we first highlight the global burden of gastroenterological disease in three major areas: diarrhoeal diseases, hepatitis B, and Helicobacter pylori. Recent progress in their management is explored, with consideration of future solutions. The second part of the review focuses on the delivery of clinical services in developing countries. Inadequate numbers of healthcare workers hamper efforts to combat gastroenterological disease. Reasons for this shortage are examined, along with possibilities for increased specialist training. Endoscopy services, the mainstay of gastroenterology in the West, are in their infancy in many developing countries. The challenges faced by those setting up a service are illustrated by the example of a Nigerian endoscopy unit. Finally, we highlight the limited scope of many clinical guidelines produced in western countries. Guidelines which take account of resource limitations in the form of "cascades" are advocated in order to make these guidelines truly global. Recognition of the different working conditions facing practitioners worldwide is an important step towards narrowing the gap between gastroenterology in rich and poor countries.
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Rajindrajith S, Devanarayana NM, de Silva HJ. Helicobacter pylori infection in children. Saudi J Gastroenterol 2009; 15:86-94. [PMID: 19568571 PMCID: PMC2702974 DOI: 10.4103/1319-3767.48964] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2008] [Accepted: 11/02/2008] [Indexed: 12/11/2022] Open
Abstract
Helicobacter pylori infection is a common problem in pediatric practice, and its acquisition is related with poor socioeconomic conditions. Although the organism is thought to be responsible for many diseases, only a handful of them have a direct causal relationship. At present, only a small number of children with well-defined clinical syndromes are benefited from testing and treatment. The treatment should include at least two antibiotics with a proton pump inhibitor.
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Affiliation(s)
- Shaman Rajindrajith
- Department of Paediatrics, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.
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Fullerton D, Britton JR, Lewis SA, Pavord ID, McKeever TM, Fogarty AW. Helicobacter pylori and lung function, asthma, atopy and allergic disease--A population-based cross-sectional study in adults. Int J Epidemiol 2008; 38:419-26. [DOI: 10.1093/ije/dyn348] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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Soylu OB, Ozturk Y. Helicobacter pylori infection: effect on malnutrition and growth failure in dyspeptic children. Eur J Pediatr 2008; 167:557-62. [PMID: 17618457 DOI: 10.1007/s00431-007-0552-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2007] [Revised: 05/25/2007] [Accepted: 06/09/2007] [Indexed: 12/13/2022]
Abstract
There are conflicting reports regarding the association of Helicobacter pylori (H. pylori) infection with growth failure. We evaluated the role of H. pylori infection on malnutrition and growth failure in dyspeptic children. The study cases included 108 dyspeptic children and were evaluated by endoscopic gastric biopsy, while 50 healthy children constituted the control group. The study cases were grouped as H. pylori [+] (n = 57) and H. pylori [-] (n = 51) by the presence or absence of microorganism in gastric tissue, respectively. Age, gender, height for age (H/A), weight for height (W/H), body mass index (BMI), weight and height z scores and the daily calorie intake of the children were recorded. Malnutrition and growth failure were evaluated by the Waterlow criteria and height z score, respectively. Then, the H. pylori [+], H. pylori [-] and control groups were compared in relation to the variables defined above. All groups were similar with respect to gender and age. The daily calorie intake was lower in dyspeptic children. Although anthropometric variables were similar in the H. pylori [+] and [-] groups, the control cases had higher W/H compared to both H. pylori [+] (p = 0.030) and H. pylori [-] (p = 0.000) cases, and higher BMI (p = 0.001) and weight z scores (p = 0.014) than those in the H. pylori [-] group. The malnutrition rate was similar in the H. pylori [+] and [-] groups. However, mild acute (p = 0.033) and general malnutrition rates (p = 0.000) were lower in the control cases compared to the study cases. The short stature rate was not different significantly in all three groups. In conclusion, the results of this study do not support the data that H. pylori infection plays an extra role in malnutrition and growth failure in children presenting with dyspeptic complaints. However, as a major cause of dyspepsia, H. pylori infection might be considered to cause malnutrition secondary to decreased calorie intake associated with dyspepsia.
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Affiliation(s)
- Ozlem Bekem Soylu
- Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Dokuz Eylul University Medical Faculty, Camliçay Mahallesi, 5182 sokak, No: 12/A, Urla, 35700 Izmir, Turkey.
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Cantor JM, Kuban ME, Blak T, Klassen PE, Dickey R, Blanchard R. Physical height in pedophilic and hebephilic sexual offenders. SEXUAL ABUSE : A JOURNAL OF RESEARCH AND TREATMENT 2007; 19:395-407. [PMID: 17952597 DOI: 10.1177/107906320701900405] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2007] [Accepted: 10/02/2007] [Indexed: 05/25/2023]
Abstract
Adult men's height reflects, not only their genetic endowment, but also the conditions that were present during their development in utero and in childhood. We compared the adult heights of men who committed one or more sexual offenses and who were erotically interested in prepubescent children (pedophilic sexual offenders; n=223), those who were erotically interested in pubescent children (hebephilic sexual offenders; n=615), and those who were erotically interested in adults (teleiophilic sexual offenders; n=187), as well as men who had no known sexual offenses and who were erotically interested in adults (teleiophilic nonoffender controls; n=156). The pedophilic and the hebephilic sexual offenders were significantly shorter than the teleiophilic nonoffender controls. The teleiophilic sexual offenders were intermediate in height between the nonoffenders and the pedophilic and hebephilic sexual offenders and not significantly different from any of the other groups. This suggests that-regardless of whatever psychological sequelae might also have followed from the conditions present during early development-pedophilic and hebephilic sexual offenders were subject to conditions capable of affecting their physiological development.
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Affiliation(s)
- James M Cantor
- Law and Mental Health Program, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON, M5T 1R8, Canada.
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Süoglu OD, Gökçe S, Saglam AT, Sökücü S, Saner G. Association of Helicobacter pylori infection with gastroduodenal disease, epidemiologic factors and iron-deficiency anemia in Turkish children undergoing endoscopy, and impact on growth. Pediatr Int 2007; 49:858-63. [PMID: 18045286 DOI: 10.1111/j.1442-200x.2007.02444.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The purpose of the present paper was to investigate the relationship between Helicobacter pylori infection and clinical symptomatology, breast-feeding and socioeconomic level. The relationship between H. pylori and iron-deficiency anemia (IDA) and the effect of H. pylori infection on growth were also investigated. METHODS The subjects consisted of 70 patients aged 4-16 years who underwent upper gastrointestinal endoscopy for recurrent abdominal pain, nausea, vomiting, and dyspeptic complaints during a 2 year period. Patients were divided into two groups according to presence of histological evidence of H. pylori infection (group 1, H. pylori positive; group 2, H. pylori negative) and groups were compared with respect to epidemiologic characteristics, gastrointestinal complaints, height and weight SD scores and IDA. RESULTS Thirty-five (50%) of the 70 patients participating in the study were H. pylori positive. The mean age of group 1 was significantly higher than that of group 2. There were similar characteristics and symptomatology between groups. The majority of the patients in group 1 belonged to low socioeconomic class (class I and II; P < 0.05). The number of the patients exclusively breast-fed for > or =4 months was significantly higher in group 2 than in group 1. Gastritis was significantly more frequent in group 1. Mean hemoglobin, serum Fe and ferritin levels were 11.6 +/- 1.7 g/dL, 45.0 +/- 23.2 microg/dL and 11.9 +/- 8.4 microg/dL, respectively, for group 1 and 12.2 +/- 0.7 g/dL, 79.3 +/- 26.4 microg/dL and 42.1 +/- 31.8 microg/dL, respectively, for group 2. The mean serum Fe and ferritin levels of group 2 were significantly higher than those of group 1. IDA was observed in 20 (57.1%) and six (17.1%) patients in groups 1 and 2, respectively. IDA was significantly more frequent in group 1. Helicobacter pylori infection was found to be the only variable that had significant effect on IDA. Mean SD height and weight for group 1 were lower than those of the group 2. When the patients were evaluated in four groups according to H. pylori and IDA status, mean height SD score of patients with both H. pylori infection and IDA was significantly lower than that of the patients negative for H. pylori and IDA concomitantly. CONCLUSION Low socioeconomic status seems to be an important risk factor for H. pylori infection. Exclusive breast-feeding at least for 4 months can have a protective role against H. pylori infection. Increased frequency of growth retardation and IDA in H. pylori-infected patients in the present study supports similar findings in the literature, although there is still need for detailed studies to clarify the causative mechanisms.
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Affiliation(s)
- Ozlem Durmaz Süoglu
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Istanbul University, Istanbul School of Medicine, Istanbul, Turkey.
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Gøbel R, Symonds EL, Butler RN, Tran CD. Association between Helicobacter pylori infection in mothers and birth weight. Dig Dis Sci 2007; 52:3049-53. [PMID: 17410433 DOI: 10.1007/s10620-007-9772-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2006] [Accepted: 01/17/2007] [Indexed: 12/22/2022]
Abstract
Helicobacter pylori infection may cause intrauterine growth restriction (IUGR). However, it is unknown whether the growth of children from H. pylori-infected mothers is also affected or whether transmission of infection from mother to child occurs. This study aimed to determine if maternal H. pylori infection was associated with IUGR and low birth weight in a mouse model, and whether transmission of infection from mother to infant occurs. Female C57BL/6 mice were inoculated with H. pylori (n = 18) or water (control; n = 18) via gavage. Mice were mated at 6 weeks postinfection, with half of the mice sacrificed after 2 weeks of gestation. The remaining mice gave birth and a third of the litter was weighed and sacrificed at birth, during milk feeding (1.5 weeks), and during solid feeding (4 weeks). Stomachs of all mice and whole foetuses were cultured for the presence of H. pylori. There were no differences in litter size or foetus weight between control and H. pylori-infected mice. Pups from infected mothers had a lower weight during milk feeding (control, 5.91 +/- 0.23 g; H. pylori, 4.59 +/- 0.16 g; p < 0.05) and solid feeding (control, 12.73 +/- 0.58 g; H. pylori, 10.01 +/- 1.02 g; p < 0.05). H. pylori was not detected by culture in the pups at any age. H. pylori infection in mothers was associated with a decrease in infant weight during milk feeding and after weaning. Transmission of infection from mother to infant was not detected by culture, suggesting that decreased baby weight may be due to decreased milk supply or altered nutrition from the mother.
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Affiliation(s)
- Rikke Gøbel
- Gastroenterology Unit, Children, Youth and Women's Health Service, 72 King William Road, North Adelaide, 5006 South Australia, Australia
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Changes in the intestinal microflora of children with Helicobacter pylori infection and after Helicobacter pylori eradication therapy. Chin Med J (Engl) 2007. [DOI: 10.1097/00029330-200705020-00014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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Kopácová M, Bures J, Koupil I, Rejchrt S, Vorísek V, Seifert B, Pozler O, Zivný P, Douda T, Palicka V, Holcík J. Body indices and basic vital signs in Helicobacter pylori positive and negative persons. Eur J Epidemiol 2006; 22:67-75. [PMID: 17195049 PMCID: PMC2799154 DOI: 10.1007/s10654-006-9090-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2005] [Accepted: 11/17/2006] [Indexed: 02/06/2023]
Abstract
It has been hypothesized that Helicobacter pylori (Hp) infection may contribute to reduced stature, risk of hypertension or obesity. The aim was to evaluate body indices in Hp positive and negative persons. A total of 2436 subjects (4–100 years old) were tested for Hp status by 13Curea breath test. Data on height and weight were collected for 84%, and blood pressure for 80% of the study subjects. The prevalence of Hp infection was 41.6%. The odds ratio for a 10-year increase in age was 1.21 (95% CI 1.17–1.25, p-value <0.001). Statistically significant negative association of Hp positivity with body height was most pronounced in the younger age groups, while a positive association of Hp positivity with body mass index was only seen in those aged 15+ years. There was a negative effect of Hp positivity on systolic and diastolic blood pressure in subjects below 25 and a relatively strong positive effect on blood pressure in subjects over 65 years. Residual confounding by social characteristics as a possible explanation for the associations of Hp positivity with height and blood pressure cannot be excluded. Unmeasured factors related to social and family environment may cause the apparent association between Hp positivity and children’s growth and blood pressure.
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Affiliation(s)
- Marcela Kopácová
- 2nd Department of Medicine, Charles University in Praha, Faculty of Medicine at Hradec Králové, University Teaching Hospital, Sokolská 581, 500 05, Hradec Králové, Czech Republic.
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Hajikano M, Katsube Y, Takita Y, Okada T, Asai M, Fujimatsu M, Nishizawa Y, Kamisago M, Fujita T, Shioya T, Tokunaga A. Helicobacter pylori infection with a duodenal ulcer in a 6-year-old boy. J NIPPON MED SCH 2006; 73:292-6. [PMID: 17106182 DOI: 10.1272/jnms.73.292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A 6-year-old boy was hospitalized because of dark feces and facial pallor of 1 weeks duration. Other gastrointestinal symptoms, including vomiting and abdominal pain, were absent, but he felt dizziness when standing and fatigue on effort. Hematologic studies revealed iron-deficiency anemia, and endoscopy showed gastric erosions and a duodenal ulcer. All test results for Helicobacter pylori infection, including H. pylori antigen in stool, anti-H. pylori IgG immunoassay in serum, and the (13)C-urea breath test, were positive. Because an H. pylori-associated gastric ulcer had been diagnosed with endoscopy in the patients father 3 years earlier, father-son transmission was suspected. The patient was treated with triple-agent eradication therapy (proton pump inhibitor [lansoprazol], amoxicillin, and clarithromycin) for 2 weeks. One month after therapy was completed, eradication of H. pylori was confirmed by negative results on the stool antigen test. Peptic ulcer disease can occur in young children, as in this case. The stool antigen test kit is a useful and reliable method that can be used even in preschool children to diagnose H. pylori infection.
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Affiliation(s)
- Miharu Hajikano
- Department of Pediatrics, Nippon Medical School Graduate School of Medicine, Kanagawa, Japan.
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Chimonas MAR, Baggett HC, Parkinson AJ, Muth PT, Dunaway E, Gessner BD. Asymptomatic Helicobacter pylori infection and iron deficiency are not associated with decreased growth among Alaska Native children aged 7-11 years. Helicobacter 2006; 11:159-67. [PMID: 16684263 DOI: 10.1111/j.1523-5378.2006.00395.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Alaska Native children have high Helicobacter pylori infection and iron deficiency prevalences, and their average height-for-age is lower than US reference populations. During a clinical trial to determine the impact of H. pylori treatment on iron deficiency, we evaluated the effects of H. pylori infection and treatment on growth. MATERIALS AND METHODS We measured height and weight for children aged 7-11 years in western Alaska using village-based measuring devices. H. pylori infection was determined by urea breath test and iron deficiency using serum ferritin. Children with H. pylori infection and iron deficiency entered the treatment phase and received iron alone or iron plus triple therapy for H. pylori. Follow-up evaluations occurred at 2, 8, and 14 months. We evaluated the association between baseline H. pylori infection and growth; among children in the treatment phase, we also assessed the effect of H. pylori resolution on growth. RESULTS At baseline, 566 (87.1%) of 650 children were infected with H. pylori. Neither height and weight, nor body mass index differed by H. pylori infection status. Of 189 children in the treatment phase, 20 (10.6%) were uninfected at all three follow-up periods, and 54 (28.6%) were uninfected for one or two periods. Compared with continuously infected children, children in these two groups had little evidence of improvements in any of the measured growth outcomes. CONCLUSIONS H. pylori infection is not related to growth among Alaska Native children aged 7-11 years. Growth deficiency should not be considered an indication for H. pylori therapy.
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Affiliation(s)
- Marc-Andre R Chimonas
- US Centers for Disease Control and Prevention, Office of Workforce and Career Development, Epidemic Intelligence Service Officer, Alaska Division of Public Health, Anchorage, Alaska 99524, USA
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Leandro Liberato SV, Hernández Galindo M, Torroba Alvarez L, Sánchez Miramón F, Leandro Ciriza SE, Gómez Abadía A, Chueca Rodríguez P. [Helicobacter pylori infection in the child population in Spain: prevalence, related factors and influence on growth]. An Pediatr (Barc) 2006; 63:489-94. [PMID: 16324613 DOI: 10.1016/s1695-4033(05)70247-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION A causal relationship between Helicobacter pylori infection and the occurrence of digestive diseases in adults and children has been proven. Worldwide, the prevalence of H. pylori varies and it is possibly influenced by differences in the level of development. The goals of this study were a) to ascertain the prevalence of H. pylori infection in the child population in Spain, b) to study several factors related to this infection, and c) to establish its possible influence on growth. PATIENTS AND METHODS We performed a descriptive, cross-sectional survey of a representative sample of children aged 1 to 14 years old. The sample consisted of 284 children (prevalence 5 15 %; accuracy 5 4 %; CI > 95 %), selected at random and stratified by age and sex. A pre-coded questionnaire was used for data collection. Diagnosis of H. pylori was established by detection of H. pylori antigen in stools with enzyme immunoassay. RESULTS The sample consisted of 144 boys and 140 girls, with a mean age of 6.89 6 4.25 years. The prevalence of H. pylori infection was 15.8 % and progressively increased with age: 1- to 3-year-olds (8.4 %), 4- to 9-year-olds (13.9 %), 10- to 14-year-olds (24 %) (p < 0.05). The prevalence was significantly higher in boys (p < 0.01). Analysis of socio-environmental variables showed a higher H. pylori infection rate in children from families with a low socioeconomic level (p < 0.01), a high rate of overcrowding (p < 0.05), and in immigrants (p < 0.001). The H. pylori infection rate was higher in children with recurrent abdominal pain (p < 0.001) and in those whose parents had suffered from gastroduodenal disease (p < 0.001). H. pylori infection was more frequent in children aged 10 to 14 years old with weight and height percentiles below the 25th percentile (p < 0.05). Comparison of means revealed no significant differences. CONCLUSIONS The prevalence of H. pylori infection found in our study was slightly lower than that found in other studies carried out in Spain; our data were more similar to those of industrialized countries. H. pylori infection was linked to age, sex and deprived socioeconomic environments, and was more frequent in children with recurrent abdominal pain and in those whose parents suffered from gastroduodenal disease. H. pylori infection did not seem to negatively affect growth in our child population.
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Sood MR, Joshi S, Akobeng AK, Mitchell J, Thomas AG. Growth in children with Helicobacter pylori infection and dyspepsia. Arch Dis Child 2005; 90:1025-8. [PMID: 15956048 PMCID: PMC1720122 DOI: 10.1136/adc.2004.066803] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AIMS To compare the height, weight, and body mass index (BMI) of children presenting with dyspeptic symptoms and Helicobacter pylori infection, to those with dyspepsia but without the infection. METHODS A retrospective chart review of 257 children was performed. 13C urea breath test was performed to detect H pylori infection; weight and height were recorded and BMI was calculated. Weight, height, and BMI SD scores were determined using the 1990 UK normative data. The Index of Multiple Deprivation 2004 (IMD 2004) scores, which measure deprivation at small area level, were calculated from the patients' postcodes. RESULTS Ninety seven of the 257 children were H pylori positive. The mean age at diagnosis and presenting symptoms of H pylori positive and negative patients were similar. The mean IMD 2004 scores for children with H pylori infection were significantly higher compared to H pylori negative patients, suggesting that children with the infection came from relatively more deprived areas. The mean weight and height SD score were significantly lower for children with H pylori infection compared to those without. However, this difference was no longer significant after adjusting for socioeconomic deprivation and ethnic differences between the groups. CONCLUSION Children with dyspepsia and H pylori infection were shorter and lighter than patients with similar symptoms but no infection. The differences in anthropometry may be due to socioeconomic and ethnic factors rather than H pylori infection.
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Affiliation(s)
- M R Sood
- Division of Pediatric Gastroenterology and Nutrition, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
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Magistà AM, Ierardi E, Castellaneta S, Miniello VL, Lionetti E, Francavilla A, Ros P, Rigillo N, Di Leo A, Francavilla R. Helicobacter pylori status and symptom assessment two years after eradication in pediatric patients from a high prevalence area. J Pediatr Gastroenterol Nutr 2005; 40:312-318. [PMID: 15735485 DOI: 10.1097/01.mpg.0000154662.39488.77] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To establish the rate of Helicobacter pylori reinfection in children from an H. pylori high prevalence area, possible clinical features predictive of reinfection and the usefulness of re-treatment. METHODS 65 consecutive children attending the authors' department between 1998 and 2000 who had proven successful H. pylori eradication were enrolled; 52 took part. Patients and family members were invited to undergo C-urea breath testing and to complete a simple questionnaire regarding symptoms and socioeconomic status. Patients with H. pylori reinfection were offered treatment; eradication was assessed by C-urea breath test 8 weeks after completion of treatment. RESULTS Of 52 children, 15 (28.8%) were H. pylori positive. Variables predictive of reinfection were age at primary infection and presence of an infected sibling. Although reinfected children were more frequently symptomatic than non-reinfected patients, no specific symptom was associated with reinfection. Of the nine re-treated patients who returned 8 weeks after completing therapy, the bacterium was eradicated in five (56%). CONCLUSIONS The 12.8% per year reinfection rate in childhood at 2 years that we observed should prompt a re-evaluation of H. pylori status even after a successful eradication. Living in an H. pylori high prevalence area increases the annual risk of reinfection by approximately fourfold over the annual risk in H. pylori low prevalence areas.
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Miller LC. International adoption: infectious diseases issues. Clin Infect Dis 2004; 40:286-93. [PMID: 15655749 DOI: 10.1086/427109] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2004] [Accepted: 09/01/2004] [Indexed: 11/03/2022] Open
Abstract
Nearly 220,000 children have been adopted from other countries by American parents since 1986. Approximately 65,000 children have arrived from China and Russia, mostly in the past 6 years. Most of these children reside in orphanages before adoption, where they may experience malnutrition, environmental deprivation, neglect, and exposure to infectious diseases. After arrival to the United States, international adoptees should undergo specialized screening evaluation for infectious diseases and other conditions. Infectious conditions of special concern include hepatitis B and C, syphilis, human immunodeficiency virus infection, tuberculosis, and presence of intestinal parasites. Before the adoption occurs, the infectious disease consultant may be asked to assist the primary care provider and the adoptive family with advice about travel and review of preadoptive medical records. After the adoption, the infectious diseases consultant may be asked to assess the adequacy of the child's vaccination record from the birth country and to assist in screening, evaluation, and management of infectious diseases.
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