Meta-Analysis
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World J Gastroenterol. Dec 14, 2014; 20(46): 17635-17647
Published online Dec 14, 2014. doi: 10.3748/wjg.v20.i46.17635
Helicobacter pylori infection and atopic diseases: Is there a relationship? A systematic review and meta-analysis
Elena Lionetti, Salvatore Leonardi, Angela Lanzafame, Maria Teresa Garozzo, Martina Filippelli, Stefania Tomarchio, Viviana Ferrara, Carmelo Salpietro, Alfredo Pulvirenti, Ruggiero Francavilla, Carlo Catassi
Elena Lionetti, Salvatore Leonardi, Angela Lanzafame, Maria Teresa Garozzo, Martina Filippelli, Stefania Tomarchio, Viviana Ferrara, Department of Pediatrics, University of Catania, 95100 Catania, Italy
Carmelo Salpietro, Department of Pediatrics, Unit of Pediatric Genetics and Immunology, University of Messina, 98125 Messina, Italy
Alfredo Pulvirenti, Department of Clinical and Molecular Biomedicine, University of Catania, 95100 Catania, Italy
Ruggiero Francavilla, Department of Developmental Medicine, University of Bari, 70124 Bari, Italy
Carlo Catassi, Department of Pediatrics, Università Politecnica delle Marche, 60123 Ancona, Italy
Author contributions: All authors equally contributed to this paper.
Correspondence to: Elena Lionetti, MD, PhD, Department of Pediatrics, University of Catania, Via S. Sofia 78, 95100 Catania, Italy. elenalionetti@inwind.it
Telephone: +39-953-781782 Fax: +39-320-1125476
Received: May 29, 2014
Revised: July 19, 2014
Accepted: September 5, 2014
Published online: December 14, 2014
Abstract

AIM: To review and conduct a meta-analysis of the existing literature on the relationship between Helicobacter pylori (H. pylori), atopy and allergic diseases.

METHODS: Studies published in English assessing the prevalence of atopy and/or allergic diseases in patients with H. pylori infection and the prevalence of H. pylori infection in patients with atopy and/or allergic diseases were identified through a MEDLINE search (1950-2014). Random-effect model was used for the meta-analysis.

RESULTS: Pooled results of case-control studies showed a significant inverse association of H. pylori infection with atopy/allergic disease or with exclusively atopy, but not with allergic disease, whereas pooled results of cross-sectional studies showed only a significant association between allergic disease and H. pylori infection.

CONCLUSION: There is some evidence of an inverse association between atopy/allergic diseases and H. pylori infection, although further studied are needed.

Keywords: Atopy, Allergic diseases, Helicobacter pylori, Hygiene hypothesis, Infection

Core tip: As the hygiene hypothesis affirms, the most important factor connected with the large spreading of atopic disease is the decreased exposure to food born and oro-fecal infections, including Helicobacter pylori (H. pylori) infection, due to the improvement of hygienic condition occurred in developed countries. The aim of this article was to review and conduct a meta-analysis of the existing literature on the relationship between H. pylori, atopy and allergic diseases. There is some evidence of an inverse association between atopy/allergic diseases and H. pylori infection, although further studied are needed.