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Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 28, 2020; 26(28): 4076-4093
Published online Jul 28, 2020. doi: 10.3748/wjg.v26.i28.4076
Helicobacter pylori infection: Beyond gastric manifestations
Maria Luísa Cordeiro Santos, Breno Bittencourt de Brito, Filipe Antônio França da Silva, Mariana Miranda Sampaio, Hanna Santos Marques, Natália Oliveira e Silva, Dulciene Maria de Magalhães Queiroz, Fabrício Freire de Melo
Maria Luísa Cordeiro Santos, Breno Bittencourt de Brito, Filipe Antônio França da Silva, Mariana Miranda Sampaio, Natália Oliveira e Silva, Fabrício Freire de Melo, Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
Hanna Santos Marques, Universidade Estadual da Bahia, Vitória da Conquista 45083-900, Bahia, Brazil
Dulciene Maria de Magalhães Queiroz, Laboratory of Research in Bacteriology, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Minas Gerais, Brazil
Author contributions: All authors equally contributed to this paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Fabrício Freire de Melo, PhD, Postdoctoral Fellow, Professor, Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Rua Hormindo Barros, 58, Quadra 17, Lote 58, Vitória da Conquista 45029-094, Bahia, Brazil. freiremelo@yahoo.com.br
Received: March 28, 2020
Peer-review started: March 28, 2020
First decision: April 25, 2020
Revised: May 29, 2020
Accepted: July 14, 2020
Article in press: July 14, 2020
Published online: July 28, 2020
Processing time: 122 Days and 10.2 Hours
Abstract

Helicobacter pylori (H. pylori) is a bacterium that infects more than a half of world’s population. Although it is mainly related to the development of gastroduodenal diseases, several studies have shown that such infection may also influence the development and severity of various extragastric diseases. According to the current evidence, whereas this bacterium is a risk factor for some of these manifestations, it might play a protective role in other pathological conditions. In that context, when considered the gastrointestinal tract, H. pylori positivity have been related to Inflammatory Bowel Disease, Gastroesophageal Reflux Disease, Non-Alcoholic Fatty Liver Disease, Hepatic Carcinoma, Cholelithiasis, and Cholecystitis. Moreover, lower serum levels of iron and vitamin B12 have been found in patients with H. pylori infection, leading to the emergence of anemias in a portion of them. With regards to neurological manifestations, a growing number of studies have associated that bacterium with multiple sclerosis, Alzheimer’s disease, Parkinson’s disease, and Guillain-Barré syndrome. Interestingly, the risk of developing cardiovascular disorders, such as atherosclerosis, is also influenced by the infection. Besides that, the H. pylori-associated inflammation may also lead to increased insulin resistance, leading to a higher risk of diabetes mellitus among infected individuals. Finally, the occurrence of dermatological and ophthalmic disorders have also been related to that microorganism. In this sense, this minireview aims to gather the main studies associating H. pylori infection with extragastric conditions, and also to explore the main mechanisms that may explain the role of H. pylori in those diseases.

Keywords: Helicobacter pylori; Extragastric; Neurological; Cardiovascular; Autoimmune; Ophthalmic; Diabetes; Timeline; Treatment

Core tip:Helicobacter pylori is a bacterium that is known to infect the gastric environment and to be related to gastroduodenal diseases, including peptic ulcer and gastric adenocarcinoma. However, since the 80s the relationship between this infection and manifestations that affect not only the gastric system has been studied, such as inflammatory bowel disease, iron and B12 deficiency, non-alcoholic fatty liver disease, hepatic carcinoma, multiple sclerosis, Alzheimer’s disease, Parkinson’s disease, and Guillain-Barré syndrome. In this sense, this study made a survey of these manifestations and their physiopathology.