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Reuter S, Raspe J, Taube C. Microbes little helpers and suppliers for therapeutic asthma approaches. Respir Res 2024; 25:29. [PMID: 38218816 PMCID: PMC10787474 DOI: 10.1186/s12931-023-02660-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 12/28/2023] [Indexed: 01/15/2024] Open
Abstract
Bronchial asthma is a prevalent and increasingly chronic inflammatory lung disease affecting over 300 million people globally. Initially considered an allergic disorder driven by mast cells and eosinophils, asthma is now recognized as a complex syndrome with various clinical phenotypes and immunological endotypes. These encompass type 2 inflammatory endotypes characterized by interleukin (IL)-4, IL-5, and IL-13 dominance, alongside others featuring mixed or non-eosinophilic inflammation. Therapeutic success varies significantly based on asthma phenotypes, with inhaled corticosteroids and beta-2 agonists effective for milder forms, but limited in severe cases. Novel antibody-based therapies have shown promise, primarily for severe allergic and type 2-high asthma. To address this gap, novel treatment strategies are essential for better control of asthma pathology, prevention, and exacerbation reduction. One promising approach involves stimulating endogenous anti-inflammatory responses through regulatory T cells (Tregs). Tregs play a vital role in maintaining immune homeostasis, preventing autoimmunity, and mitigating excessive inflammation after pathogenic encounters. Tregs have demonstrated their ability to control both type 2-high and type 2-low inflammation in murine models and dampen human cell-dependent allergic airway inflammation. Furthermore, microbes, typically associated with disease development, have shown immune-dampening properties that could be harnessed for therapeutic benefits. Both commensal microbiota and pathogenic microbes have demonstrated potential in bacterial-host interactions for therapeutic purposes. This review explores microbe-associated approaches as potential treatments for inflammatory diseases, shedding light on current and future therapeutics.
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Affiliation(s)
- Sebastian Reuter
- Department of Pulmonary Medicine, University Hospital Essen-Ruhrlandklinik, Tüschener Weg 40, 45239, Essen, Germany.
| | - Jonas Raspe
- Department of Pulmonary Medicine, University Hospital Essen-Ruhrlandklinik, Tüschener Weg 40, 45239, Essen, Germany
| | - Christian Taube
- Department of Pulmonary Medicine, University Hospital Essen-Ruhrlandklinik, Tüschener Weg 40, 45239, Essen, Germany
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Alvarez CS, Avilés-Santa ML, Freedman ND, Perreira KM, Garcia-Bedoya O, Kaplan RC, Daviglus ML, Graubard BI, Talavera GA, Thyagarajan B, Camargo MC. Associations of Helicobacter pylori and hepatitis A seropositivity with asthma in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL): addressing the hygiene hypothesis. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2021; 17:120. [PMID: 34819160 PMCID: PMC8611872 DOI: 10.1186/s13223-021-00625-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 11/08/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND The hygiene hypothesis posits that microbial exposure reduces risk of asthma and other respiratory-related diseases. Helicobacter pylori and hepatitis A virus (HAV) are common fecal-oral infections. Our study aimed to examine associations of seropositivity to these agents with asthma in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). METHODS A total of 12,471 HCHS/SOL participants with baseline data on self-reported physician-diagnosed asthma, and antibodies anti-H. pylori and anti-HAV were included in this cross-sectional analysis. Multivariable logistic regression models were used to estimate the odds ratios and 95% confidence intervals for the overall associations of seropositivity to each agent with asthma. Analyses were also stratified by Hispanic/Latino background. Effect modification by smoking status and nativity were tested. An analysis restricted to individuals with spirometry-defined chronic obstructive pulmonary disease (COPD) was also considered. RESULTS The weighted overall prevalence of asthma was 16.6%. The weighted seroprevalence of H. pylori was 56.6% and of HAV was 76.6%, and they significantly differed by Hispanic/Latino background. After accounting for age, sex, education and other key confounders, we found no associations between H. pylori or HAV seropositivity with asthma (with and without COPD), either for all individuals combined or for any of the six specific backgrounds. There were no significant interactions by smoking and nativity. CONCLUSION Our findings did not provide support for the role of H. pylori or HAV, as evidence of the hygiene hypothesis in asthma among the large and diverse Hispanic/Latino populations of the HCHS/SOL. Trial registration NCT02060344.
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Affiliation(s)
- Christian S Alvarez
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA.
| | - M Larissa Avilés-Santa
- Division of Clinical and Health Services Research, National Institute on Minority Health and Health Disparities, Rockville, MD, USA
| | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Krista M Perreira
- Department of Social Medicine, UNC School of Medicine, Chapel Hill, NC, USA
| | - Olga Garcia-Bedoya
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA
- Academic Internal Medicine and Geriatrics, Department of Medicine , University of Illinois at Chicago, Chicago, IL, USA
| | - Robert C Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Barry I Graubard
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Gregory A Talavera
- South Bay Latino Research Center, Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - M Constanza Camargo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
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Durazzo M, Adriani A, Fagoonee S, Saracco GM, Pellicano R. Helicobacter pylori and Respiratory Diseases: 2021 Update. Microorganisms 2021; 9:2033. [PMID: 34683354 PMCID: PMC8537719 DOI: 10.3390/microorganisms9102033] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/15/2021] [Accepted: 09/23/2021] [Indexed: 12/13/2022] Open
Abstract
Helicobacter pylori (H. pylori) is a Gram-negative bacterium involved in the development of gastritis, peptic ulcer disease, gastric adenocarcinoma, and gastric mucosa-associated lymphoid tissue. Unexplained iron deficiency anemia, idiopathic thrombocytopenic purpura and vitamin B12 deficiency have also been related to H. pylori infection, whereas for other extra-gastric diseases, the debate is still open. In this review, we evaluate and discuss the potential involvement of H. pylori infection in the pathogenesis of several respiratory diseases. A MEDLINE search of all studies published in English from 1965 to 2021 was carried out. Controversial findings have been reported in patients with bronchial asthma, chronic obstructive pulmonary disease, bronchiectasis, lung cancer, tuberculosis, cystic fibrosis, and sarcoidosis. Most of the available literature is concerned with case-control studies based on seroprevalence, with a small sample size and low consideration of confounders, which represents a potential issue. So far, there is no clear evidence of a causal association between H. pylori infection and respiratory diseases, and larger studies with appropriate epidemiological design are required.
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Affiliation(s)
- Marilena Durazzo
- Department of Medical Sciences, University of Turin, C.so A.M. Dogliotti 14, 10126 Turin, Italy; (M.D.); (A.A.); (G.M.S.)
| | - Alessandro Adriani
- Department of Medical Sciences, University of Turin, C.so A.M. Dogliotti 14, 10126 Turin, Italy; (M.D.); (A.A.); (G.M.S.)
- Unit of Gastroenterology, Molinette Hospital, Città della Salute e della Scienza, C.so Bramante 88, 10126 Turin, Italy
| | - Sharmila Fagoonee
- Institute of Biostructure and Bioimaging, National Research Council, Molecular Biotechnology Center, Via Nizza 52, 10126 Turin, Italy;
| | - Giorgio Maria Saracco
- Department of Medical Sciences, University of Turin, C.so A.M. Dogliotti 14, 10126 Turin, Italy; (M.D.); (A.A.); (G.M.S.)
- Unit of Gastroenterology, Molinette Hospital, Città della Salute e della Scienza, C.so Bramante 88, 10126 Turin, Italy
| | - Rinaldo Pellicano
- Unit of Gastroenterology, Molinette Hospital, Città della Salute e della Scienza, C.so Bramante 88, 10126 Turin, Italy
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He M, Zheng Y, Ma A, Zhang C, Yu Y, Wang H, Chen Y, Xiang M, Tao K, Shen J. Helicobacter pylori is associated with weakened pulmonary function and reduced incidence of allergic conditions in patients with chronic cough. Exp Ther Med 2020; 20:47. [PMID: 32952638 PMCID: PMC7480139 DOI: 10.3892/etm.2020.9176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 06/10/2020] [Indexed: 12/05/2022] Open
Abstract
The present study aimed to investigate the potential association between Helicobacter pylori (a H. pylori) positive state and chronic cough. A clinical observational study with systematic analysis was performed, including 278 patients with complaints of chronic cough and 148 healthy controls. a H. pylori positive state was present in 61.2% of the patients in the chronic cough group and 68.9% in the chronic refractory cough group, as opposed to 43.9% in the control group. There was a significant improvement in 65.5% of the patients with chronic refractory cough following successful a H. pylori eradication therapy. In addition, patients with chronic cough exposed to a H. pylori exhibited decreased pulmonary function with a decrease in forced expiratory volume in 1 sec by 84 ml, a decrease in the forced vital capacity by 53 ml and a decrease in maximal vital capacity by 46 ml. The difference was even more obvious in the chronic refractory cough group. The allergy status differed significantly according to age between a H. pylori-positive and -negative cases in the cough variant asthma and allergic cough groups. Among patients aged <40 years, a H. pylori-positive cases had a lower prevalence of atopy and lower total serum immunoglobin E levels compared with a H. pylori-negative cases. However, there was no significant association between a H. pylori status and C-reactive protein levels, erythrocyte sedimentation rate or eosinophil count in the peripheral blood. In conclusion, the present study demonstrated that a H. pylori infection may be a factor associated with chronic cough and it may be associated with a decline in pulmonary function and reduced incidence of allergic conditions. Thus, a H. pylori may represent a target for the treatment of chronic cough.
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Affiliation(s)
- Meng He
- Department of Respiratory Medicine, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Zhejiang University School of Medicine, Shaoxing, Zhejiang 312000, P.R. China
| | - Yuanyuan Zheng
- Department of Gastroenterology, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Zhejiang University School of Medicine, Shaoxing, Zhejiang 312000, P.R. China
| | - A'Huo Ma
- Department of Gastroenterology, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Zhejiang University School of Medicine, Shaoxing, Zhejiang 312000, P.R. China
| | - Chunyi Zhang
- Department of Respiratory Medicine, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Zhejiang University School of Medicine, Shaoxing, Zhejiang 312000, P.R. China
| | - Yuefang Yu
- Department of Respiratory Medicine, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Zhejiang University School of Medicine, Shaoxing, Zhejiang 312000, P.R. China
| | - Hua Wang
- Department of Respiratory Medicine, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Zhejiang University School of Medicine, Shaoxing, Zhejiang 312000, P.R. China
| | - Yefeng Chen
- Department of Respiratory Medicine, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Zhejiang University School of Medicine, Shaoxing, Zhejiang 312000, P.R. China
| | - Min Xiang
- Department of Respiratory Medicine, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Zhejiang University School of Medicine, Shaoxing, Zhejiang 312000, P.R. China
| | - Kelong Tao
- Department of Gastrointestinal Surgery, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Zhejiang University School of Medicine, Shaoxing, Zhejiang 312000, P.R. China
| | - Juxin Shen
- Department of Respiratory Medicine, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Zhejiang University School of Medicine, Shaoxing, Zhejiang 312000, P.R. China
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Suárez-Medina R, Venero-Fernández S, Alvarez-Valdés V, Sardiñas-Baez N, Cristina C, Loinaz-Gonzalez M, Verdecia-Pérez Z, Corona-Tamayo B, Betancourt-López M, Britton J, Fogarty AW. Prevalence and risk factors for wheeze, decreased forced expiratory volume in 1 s and bronchoconstriction in young children living in Havana, Cuba: a population-based cohort study. BMJ Open 2020; 10:e034192. [PMID: 32327475 PMCID: PMC7204937 DOI: 10.1136/bmjopen-2019-034192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES Asthma has not been extensively studied in low-income and middle-income countries, where risk factors and access to treatment may differ from more affluent countries. We aimed to identify the prevalence of asthma and local risk factors in Havana, Cuba. SETTING Four municipalities in Havana, Cuba. PARTICIPANTS A population-based cohort study design of young children living in Havana, Cuba. Children were recruited from primary care centres at age 12-15 months. PRIMARY AND SECONDARY OUTCOME MEASURES Data on wheeze in the past 12 months, asthma treatment and environmental exposures collected regularly until the age of 6 years, when forced expiratory volume in 1 s (FEV1) and reversibility to aerosolised salbutamol were also measured. RESULTS 1106 children provided data at the age of 6 years old. The prevalence of wheeze in the previous 12 months was 422 (38%), and 294 (33%) of the study population had bronchodilatation of 12% or more in FEV1 after administration of inhaled salbutamol. In the previous 12 months, 182 (16%) of the children had received inhaled corticosteroids, 416 (38%) salbutamol inhalers and 283 (26%) a course of systemic steroids.Wheeze in the first year and a family history of asthma were both positively associated with bronchodilatation to inhaled salbutamol (1.94%; 95% CI 0.81 to 3.08 and 1.85%; CI 0.14 to 3.57, respectively), while paracetamol use in the first year was associated with wheeze at 6 years (OR 1.64, 95% CI 1.14 to 2.35). There were large differences in FEV1, bronchodilatation and risk of wheeze across different geographical areas. CONCLUSIONS Asthma is common in young children living in Havana, and the high prevalence of systemic steroids administrated is likely to reflect the underuse of regular inhaled corticosteroids. If replicated in other comparable low-income and middle-income countries, this represents an important global public health issue.
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Affiliation(s)
- Ramón Suárez-Medina
- Instituto Nacional de Higiene, Epidemiología y Microbiología, La Habana, Cuba
| | | | - Vilma Alvarez-Valdés
- Dirección Municipal de Salud Pública municipios Cerro y Arroyo Naranjo, Habana, Cuba
| | - Nieves Sardiñas-Baez
- Dirección Municipal de Salud Pública municipios Cerro y Arroyo Naranjo, Habana, Cuba
| | - Carmona Cristina
- Dirección Municipal de Salud Pública municipios Cerro y Arroyo Naranjo, Habana, Cuba
| | - Maria Loinaz-Gonzalez
- Dirección Municipal de Salud Pública municipios Cerro y Arroyo Naranjo, Habana, Cuba
| | | | - Barbara Corona-Tamayo
- Dirección Municipal de Salud Pública municipios Cerro y Arroyo Naranjo, Habana, Cuba
| | | | - John Britton
- Division of Epidemiology and Public Health, UK Center for Tobacco and Alcohol Studies, University of Nottingham, Nottingham, UK
| | - Andrew W Fogarty
- NIHR Nottingham Biomedical Research Unit, Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
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Fouda EM, Kamel TB, Nabih ES, Abdelazem AA. Helicobacter pylori seropositivity protects against childhood asthma and inversely correlates to its clinical and functional severity. Allergol Immunopathol (Madr) 2018. [PMID: 28645881 DOI: 10.1016/j.aller.2017.03.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND In recent years, the prevalence of asthma has risen in developed countries, and its extent related to a change in our indigenous microbiota. Helicobacter pylori disappearance across the population represents a fundamental change in our human microbiota and has preceded the rise in asthma prevalence. OBJECTIVE To assess the relationship between childhood asthma and Helicobacter pylori infection. METHODS Quantitative determination of Helicobacter pylori IgG among 90 asthmatic children and 90 - age and gender - matched non-atopic, non-asthmatic healthy children was performed using ELISA in serum of all participants. RESULTS Helicobacter pylori IgG seropositivity was found in 25.6% of asthmatics compared to 44.4% of controls. Asthmatics showed lower median Helicobacter pylori IgG titre compared to healthy controls. We also detected a significant inverse relationship between Helicobacter pylori IgG titre and asthma severity. CONCLUSION Helicobacter pylori seropositivity protects against childhood asthma and inversely correlates to its clinical and functional severity.
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Affiliation(s)
- E M Fouda
- Department of Pediatrics, Ain Shams University, Egypt.
| | - T B Kamel
- Department of Pediatrics, Ain Shams University, Egypt
| | - E S Nabih
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Ain Shams University, Egypt
| | - A A Abdelazem
- Department of Pediatrics, Ain Shams University, Egypt
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7
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Taye B, Enquselassie F, Tsegaye A, Amberbir A, Medhin G, Fogarty A, Robinson K, Davey G. Association between infection with Helicobacter pylori and atopy in young Ethiopian children: A longitudinal study. Clin Exp Allergy 2017; 47:1299-1308. [PMID: 28787771 DOI: 10.1111/cea.12995] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 06/07/2017] [Accepted: 07/26/2017] [Indexed: 01/01/2023]
Abstract
BACKGROUND Epidemiological evidence from developed countries indicates that Helicobacter pylori infection correlates with a reduced risk of atopy and allergic disorders; however, limited data are available from low-income countries. OBJECTIVE We examined associations between H. pylori infection in early childhood and atopy and reported allergic disorders at the age of 6.5 years in an Ethiopian birth cohort. METHODS A total of 856 children (85.1% of the 1006 original singletons in a population-based birth cohort) were followed up at age six and half years. An interviewer-led questionnaire administered to mothers provided information on demographic and lifestyle variables. Questions on allergic disease symptoms were based on the International Study of Asthma and Allergies in Children (ISAAC) core allergy and environmental questionnaire. Serum samples were analysed for total IgE levels and anti-H. pylori cytotoxin-associated gene A (CagA) IgG antibody using commercially available ELISA kits. Stool samples were analysed for H. pylori antigen using a rapid immunochromatographic test. The independent effects of H. pylori infection (measured at age of 3, 5 and 6.5 years) on prevalence and incidence of atopy and reported allergic disorders (measured at age of 6.5 years) were determined using multiple logistic regression. RESULTS In cross-sectional analysis, current H. pylori infection at age 6.5 years was inversely, though not significantly, related to prevalence of atopy and "any allergic condition" at age 6.5 years. However, detection of H. pylori infection at any point up to age 6.5 years was associated with a significantly reduced odds of both atopy and "any allergic condition" (adjusted OR AOR, 95% CI, 0.54; 0.32-0.92, P = .02, and .31; 0.10-0.94, P = .04, respectively). In longitudinal analyses, H. pylori infection at age 3 was inversely associated with incidence of atopy (AOR, 95% CI, 0.49; 0.27-0.89, P = .02). Furthermore, among H. pylori-infected children, those with a CagA+ strain had a more pronounced reduction in odds of atopy (AOR = 0.35 vs 0.63 for CagA+ vs CagA-), and this reduction reached borderline significance. CONCLUSION These data are consistent with the hypothesis that early exposure to H. pylori is inversely associated with atopy and allergic conditions. A possible modest protective association against atopy was observed in those infected with a more virulent CagA+ strain of H. pylori.
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Affiliation(s)
- B Taye
- Department of Biology, Colgate University, Hamilton, NY, USA
| | - F Enquselassie
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - A Tsegaye
- School of Allied Health Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - G Medhin
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - A Fogarty
- Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
| | - K Robinson
- Nottingham Digestive Diseases Biomedical Research Centre, School of Medicine, University of Nottingham, Nottingham, UK
| | - G Davey
- Wellcome Trust Centre for Global Health Research, Brighton & Sussex Medical School, Brighton, UK
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Accumulated evidence on Helicobacter pylori infection and the risk of asthma: A meta-analysis. Ann Allergy Asthma Immunol 2017. [PMID: 28634020 DOI: 10.1016/j.anai.2017.05.021] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Helicobacter pylori (H pylori) infection has been suggested to be related to a decreased risk of asthma, but findings in the literature are inconsistent. OBJECTIVE To quantitatively summarize the existing evidence on the association between H pylori infection and asthma risk. METHODS The PubMed database was searched for observational studies of H pylori infection in relation to the risk of asthma published in English through May 2017. Measurements of association were pooled using a meta-analytic approach and expressed as odds ratios (ORs) with 95% confidence intervals (95% CIs). RESULTS Twenty-four studies were identified in this meta-analysis, including 8 case-control studies composed of 1,247 cases and 2,410 controls, and 16 cross-sectional studies composed of 50,290 participants (4,185 cases and 46,105 noncases). The average H pylori infection rates were 40.01% and 48.74% in case-control and cross-sectional studies, respectively. Five studies subcategorized H pylori infection according to CagA status, in which 59.37% of H pylori-infected participants were identified as having CagA positivity. Helicobacter pylori infection was significantly inversely associated with the risk of asthma in case-control studies (OR 0.83, 95% CI 0.71-0.98) but was borderline significant in cross-sectional studies (OR 0.88, 95% CI 0.76-1.02). The observed inverse association persisted for CagA-positive H pylori infection (OR 0.77, 95% CI 0.63-0.93, P for interaction = .03) but not for CagA-negative strains (OR 1.08, 95% CI 0.66-1.78). No significant difference was observed across age or region subgroups. CONCLUSION The accumulated evidence supports that H pylori infection, especially CagA-positive H pylori infection, is inversely associated with the risk of asthma.
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Helicobacter pylori infection increases the risk of adult-onset asthma: a nationwide cohort study. Eur J Clin Microbiol Infect Dis 2017; 36:1587-1594. [DOI: 10.1007/s10096-017-2972-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 03/22/2017] [Indexed: 12/29/2022]
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Semper RP, Gerhard M. The Lost Friend: H. pylori. BIRKHÄUSER ADVANCES IN INFECTIOUS DISEASES 2017:69-97. [DOI: 10.1007/978-3-319-69968-4_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2025]
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Lee HY, Kim JW, Lee JK, Heo EY, Chung HS, Kim DK. Association between Helicobacter pylori seropositivity and mild to moderate COPD: clinical implications in an Asian country with a high prevalence of H. pylori. Int J Chron Obstruct Pulmon Dis 2016; 11:2055-62. [PMID: 27621611 PMCID: PMC5012608 DOI: 10.2147/copd.s106922] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background Helicobacter pylori infection is a major cause of gastric diseases. The clinical implications of H. pylori infection in various diseases outside the gastrointestinal system have also been reported, including in some respiratory disorders. In this study, we investigated the seroprevalence of H. pylori in patients with mild to moderate COPD in an Asian country with a high prevalence of H. pylori infection. Also, we aimed to elucidate the association between the seroprevalence of H. pylori and the decline of lung function in patients with COPD. Methods Participants who underwent a medical checkup for H. pylori at a referral hospital in Korea were recruited for this study. All participants were tested for H. pylori infection using an immunoassay of the H. pylori-specific immunoglobulin G (IgG) concentration and a rapid urease test at the time of endoscopy with a gastric mucosal specimen. We assessed the decline in lung function using the spirometric data of those who underwent spirometry more than three times. Results In total, 603 participants (201 patients with COPD and 402 controls) were analyzed. The seroprevalence of H. pylori IgG in the patients and controls was 45.8% and 52.2%, respectively (P=0.134). The H. pylori IgG level in patients with COPD was not significantly different from that of the controls (114.8 and 109.6 units/mL, respectively; P=0.549). In addition, there were no significant differences in the annual forced expiratory volume in 1 second or forced vital capacity between the participants with H. pylori seropositivity and seronegativity. Conclusion This study showed no relationship between H. pylori infection and COPD in a country with a high burden of H. pylori infection. Furthermore, H. pylori infection did not affect the rate of lung function decline in this study population.
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Affiliation(s)
- Ha Youn Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital; Department of Internal Medicine, Seoul National University College of Medicine
| | - Ji Won Kim
- Department of Internal Medicine, Seoul National University College of Medicine; Division of Gastroenterology
| | - Jung Kyu Lee
- Department of Internal Medicine, Seoul National University College of Medicine; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Eun Young Heo
- Department of Internal Medicine, Seoul National University College of Medicine; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Hee Soon Chung
- Department of Internal Medicine, Seoul National University College of Medicine; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Deog Keom Kim
- Department of Internal Medicine, Seoul National University College of Medicine; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea
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Hussain K, Letley DP, Greenaway AB, Kenefeck R, Winter JA, Tomlinson W, Rhead J, Staples E, Kaneko K, Atherton JC, Robinson K. Helicobacter pylori-Mediated Protection from Allergy Is Associated with IL-10-Secreting Peripheral Blood Regulatory T Cells. Front Immunol 2016; 7:71. [PMID: 27014260 PMCID: PMC4779884 DOI: 10.3389/fimmu.2016.00071] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 02/15/2016] [Indexed: 12/18/2022] Open
Abstract
Helicobacter pylori infections are usually established in early childhood and continuously stimulate immunity, including T-helper 1 (Th1), Th17, and regulatory T-cell (Treg) responses, throughout life. Although known to be the major cause of peptic ulcer disease and gastric cancer, disease occurs in a minority of those who are infected. Recently, there has been much interest in beneficial effects arising from infection with this pathogen. Published data robustly show that the infection is protective against asthma in mouse models. Epidemiological studies show that H. pylori is inversely associated with human allergy and asthma, but there is a paucity of mechanistic data to explain this. Since Th1 and Treg responses are reported to protect against allergic responses, we investigated if there were links between the human systemic Th1 and Treg response to H. pylori and allergen-specific IgE levels. The human cytokine and T-cell responses were examined using peripheral blood mononuclear cells (PBMCs) from 49 infected and 58 uninfected adult patients. Concentrations of total and allergen-specific plasma IgE were determined by ELISA and ImmunoCAP assays. These responses were analyzed according to major virulence factor genotypes of the patients' colonizing H. pylori strains. An in vitro assay was employed, using PBMCs from infected and uninfected donors, to determine the role of Treg cytokines in the suppression of IgE. Significantly higher frequencies of IL-10-secreting CD4(+)CD25(hi) Tregs, but not H. pylori-specific Th1 cells, were present in the peripheral blood of infected patients. Total and allergen-specific IgE concentrations were lower when there was a strong Treg response, and blocking IL-10 in vitro dramatically restored IgE responses. IgE concentrations were also significantly lower when patients were infected with CagA(+) strains or those expressing the more active i1 form of VacA. The systemic IL-10(+) Treg response is therefore likely to play a role in H. pylori-mediated protection against allergy in humans.
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Affiliation(s)
- Khiyam Hussain
- Nottingham Digestive Diseases Biomedical Research Unit, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, UK; Centre for Biomolecular Sciences, University of Nottingham, Nottingham, UK
| | - Darren P Letley
- Nottingham Digestive Diseases Biomedical Research Unit, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, UK; Centre for Biomolecular Sciences, University of Nottingham, Nottingham, UK
| | - A Borgel Greenaway
- Nottingham Digestive Diseases Biomedical Research Unit, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, UK; Centre for Biomolecular Sciences, University of Nottingham, Nottingham, UK
| | - Rupert Kenefeck
- Nottingham Digestive Diseases Biomedical Research Unit, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, UK; Centre for Biomolecular Sciences, University of Nottingham, Nottingham, UK
| | - Jody A Winter
- Nottingham Digestive Diseases Biomedical Research Unit, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, UK; Centre for Biomolecular Sciences, University of Nottingham, Nottingham, UK
| | - William Tomlinson
- Nottingham Digestive Diseases Biomedical Research Unit, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, UK; Centre for Biomolecular Sciences, University of Nottingham, Nottingham, UK
| | - Joanne Rhead
- Nottingham Digestive Diseases Biomedical Research Unit, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, UK; Centre for Biomolecular Sciences, University of Nottingham, Nottingham, UK
| | - Emily Staples
- Nottingham Digestive Diseases Biomedical Research Unit, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, UK; Centre for Biomolecular Sciences, University of Nottingham, Nottingham, UK
| | - Kazuyo Kaneko
- Nottingham Digestive Diseases Biomedical Research Unit, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, UK; Centre for Biomolecular Sciences, University of Nottingham, Nottingham, UK
| | - John C Atherton
- Nottingham Digestive Diseases Biomedical Research Unit, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, UK; Centre for Biomolecular Sciences, University of Nottingham, Nottingham, UK
| | - Karen Robinson
- Nottingham Digestive Diseases Biomedical Research Unit, Queen's Medical Centre, Nottingham University Hospitals, Nottingham, UK; Centre for Biomolecular Sciences, University of Nottingham, Nottingham, UK
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Lim JH, Kim N, Lim SH, Kwon JW, Shin CM, Chang YS, Kim JS, Jung HC, Cho SH. Inverse Relationship Between Helicobacter Pylori Infection and Asthma Among Adults Younger than 40 Years: A Cross-Sectional Study. Medicine (Baltimore) 2016; 95:e2609. [PMID: 26937899 PMCID: PMC4778996 DOI: 10.1097/md.0000000000002609] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Recent studies have suggested that Helicobacter pylori could prevent allergic disease, particularly in children. However, whether this is true in adults is controversial. The aim of this study was to investigate whether there is negative association between H. pylori infection and asthma among adults in an area with a high prevalence of H. pylori.This was a cross-sectional study using 2011 health surveillance data. Blood samples were taken from all participants to measure serum H. pylori IgG status. Information on demographics, socioeconomic status, and medical history, including asthma and other allergic conditions were collected by a questionnaire.Of the 15,032 patients, 9492 (63.1%) had a history of H. pylori infection, 359 (2.4%) had asthma, and 3277 (21.8%) had other allergic conditions. H. pylori infection was positively correlated with age (OR, 1.050; 95% CI, 1.047-1.053, P < 0.001). Asthma history was positively correlated with age (OR, 1.022; 95% CI, 1.013-1.032, P < 0.001). H. pylori and age were shown to have interaction on asthma in the total participants (OR, 1.041; 95% CI, 1.021-1.062, P < 0.001). In subgroup analysis, H. pylori infection among those < 40 years old was inversely correlated with asthma (OR, 0.503; 95% CI, 0.280-0.904, P = 0.021). Other allergic conditions were not related with H. pylori infection among the total and those <40 years old.The inverse association between H. pylori infection and asthma among young adults suggests that the underlying immune mechanism induced by H. pylori infection may affect allergic reactions associated with asthma in young adults.
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Affiliation(s)
- Joo Hyun Lim
- From the Seoul National University Hospital, Healthcare System Gangnam Center, Healthcare Research Institute, Seoul (JHL, SHL, JSK, S-HC); Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do (NK, CMS, Y-SC); College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu (J-WK); and Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea (LJH, NK, JSK, HCJ)
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Roberts SE, Morrison-Rees S, Samuel DG, Thorne K, Akbari A, Williams JG. Review article: the prevalence of Helicobacter pylori and the incidence of gastric cancer across Europe. Aliment Pharmacol Ther 2016; 43:334-45. [PMID: 26592801 DOI: 10.1111/apt.13474] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 03/15/2015] [Accepted: 10/22/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND There is little up-to-date review evidence on the prevalence of Helicobacter pylori across Europe. AIM To establish regional and national patterns in H. pylori prevalence across Europe. Secondly, to establish trends over time in H. pylori prevalence and gastric cancer incidence and, thirdly, to report on the relationship between H. pylori prevalence and age group across Europe. METHODS A review of H. pylori prevalence from unselected surveys of adult or general populations across 35 European countries and four European regions since 1990. Secondly, an analysis of trends over time in H. pylori prevalence and in gastric cancer incidence from cancer registry data. RESULTS Helicobacter pylori prevalence was lower in northern and western Europe than in eastern and southern Europe (P < 0.001). In 11 of 12 European studies that reported on trends, there were sharp reductions in H. pylori prevalence (mean annual reduction = 3.1%). The mean annual reduction in the incidence of gastric cancer across Europe from 1993 to 2007 was 2.1% with little variation regionally across Europe (north 2.2%, west 2.3%, east 1.9% and south 2.0%). Sharp increases in age-related prevalence of H. pylori often levelled off for middle age groups of about 50 years onwards, especially in areas with high prevalence. CONCLUSIONS This review shows that H. pylori prevalence is much higher in less affluent regions of Europe and that age-related increases in prevalence are confined to younger age groups in some areas. There were sharp reductions in both H. pylori prevalence and gastric cancer incidence throughout Europe.
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Affiliation(s)
- S E Roberts
- Medical School, Swansea University, Swansea, UK
| | | | - D G Samuel
- Medical School, Swansea University, Swansea, UK.,West Wales General Hospital, Carmarthen, UK
| | - K Thorne
- Medical School, Swansea University, Swansea, UK
| | - A Akbari
- Medical School, Swansea University, Swansea, UK
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15
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Ribaldone DG, Fagoonee S, Colombini J, Saracco G, Astegiano M, Pellicano R. Helicobacter pyloriinfection and asthma: Is there a direct or an inverse association? A meta-analysis. World J Meta-Anal 2016; 4:63. [DOI: 10.13105/wjma.v4.i3.63] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Revised: 05/18/2016] [Accepted: 06/03/2016] [Indexed: 02/05/2023] Open
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Daugule I, Zavoronkova J, Santare D. Helicobacter pylori and allergy: Update of research. World J Methodol 2015; 5:203-211. [PMID: 26713280 PMCID: PMC4686417 DOI: 10.5662/wjm.v5.i4.203] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 07/16/2015] [Accepted: 10/19/2015] [Indexed: 02/06/2023] Open
Abstract
Recently a lot of literature has been published about the possible preventive action of Helicobacter pylori (H. pylori) against allergy. The present review summarizes research data about the association between H. pylori and allergic diseases, as well as discusses possible hypotheses about the preventive action of H. pylori against atopy. There is evidence from observational studies to support a weak inverse association between prevalence of H. pylori infection and allergy. However, confounders like some unidentified socioeconomic factors, antibiotic use and others could bias the association. Although data from cohort studies point to a possible association of H. pylori with some of the allergic diseases, no definite proof for causal relationship has been clearly demonstrated yet. A biological mechanism proposed to explain the preventive action of H. pylori to allergy is reduced exposure to a major stimulus for the generation of Treg cells in individuals without H. pylori infection. In addition, H. pylori could be an indicator for changes in gut microbiome, reflecting the complex interaction between microbes and immune system.
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17
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Fogarty AW. Does Helicobacter pylori infection modify lung development, height or simply reflect shared environmental exposures? Thorax 2015; 70:918. [PMID: 26123658 DOI: 10.1136/thoraxjnl-2015-207270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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18
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Khamechian T, Movahedian AH, Ebrahimi Eskandari G, Heidarzadeh Arani M, Mohammadi A. Evaluation of the Correlation Between Childhood Asthma and Helicobacter pylori in Kashan. Jundishapur J Microbiol 2015; 8:e17842. [PMID: 26310565 PMCID: PMC4545572 DOI: 10.5812/jjm.8(6)2015.17842] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 06/14/2014] [Accepted: 06/26/2014] [Indexed: 12/30/2022] Open
Abstract
Background: Asthma is a chronic inflammatory air-way disease with increasing prevalence rate during the recent years. There are studies about the relationship between asthma and infectious diseases, including the association between asthma and Helicobacter pylori. According to the latest studies, there is an epidemiological correlation between asthma prevalence and prevalence of H. pylori. Objectives: The aim of this research was to study the correlation between H. pylori and asthma by biopsy in five to eighteen year-old children who had undergone endoscopy at Shahid Beheshti Hospital. Patients and Methods: Three hundred children (5 to 18 years old) undergoing endoscopy owing to gastro-intestinal problems at Shahid Beheshti Hospital were observed for childhood asthma using the Gina 2010 questionnaire which included 24 questions with “yes” and “no” answers to identify asthmatic patients with five positive answers. Next, the patients were referred to an allergy and asthma specialist for clinical examinations, spirometry and post bronchodilator test (Post BD). Results: Among 138 H. pylori positive patients, eight cases (5.8 %) were asthmatic while of the 162 H. pylori negative patients 28 (17.3%) were asthmatic. This difference was statistically significant (P Value = 0.002). The correlation between H. pylori and asthma was studied after controlling the confounding variables including, gender, age and family history. The results obtained for the above-mentioned variables were significant (P Values of 0.004, 0.005 and 0.002, and Odd-Ratio Mantel Haenszel (ORMH) of 3.38, 3.24 and 4.06, respectively). Conclusions: Our findings showed that there is an inverse correlation between H. pylori and asthma. Performing more studies with larger sample sizes is necessary to confirm these results.
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Affiliation(s)
- Tahere Khamechian
- Anatomical Sciences Research Centre, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Amir Hossein Movahedian
- Pediatric Department, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, IR Iran
| | | | - Marzieh Heidarzadeh Arani
- Pediatric Department, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, IR Iran
- Corresponding author: Marzieh Heidarzadeh Arani, Pediatric Department, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-9122146635, Fax: +98-3615558900, E-mail:
| | - Abouzar Mohammadi
- Surgical Technology Department, Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, IR Iran
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19
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Evaluation of the Correlation Between Childhood Asthma and Helicobacter pylori in Kashan. Jundishapur J Microbiol 2015. [DOI: 10.5812/jjm.8(5)2015.17842] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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20
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Taye B, Enquselassie F, Tsegaye A, Medhin G, Davey G, Venn A. Is Helicobacter Pylori
infection inversely associated with atopy? A systematic review and meta-analysis. Clin Exp Allergy 2015; 45:882-890. [DOI: 10.1111/cea.12404] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 07/23/2014] [Accepted: 07/28/2014] [Indexed: 12/16/2022]
Affiliation(s)
- B. Taye
- School of Public Health; College of Health Sciences; Addis Ababa University; Addis Ababa Ethiopia
| | - F. Enquselassie
- School of Public Health; College of Health Sciences; Addis Ababa University; Addis Ababa Ethiopia
| | - A. Tsegaye
- School of Allied Health Sciences; College of Health Sciences; Addis Ababa University; Addis Ababa Ethiopia
| | - G. Medhin
- Aklilu Lemma Institute of Pathobiology; College of Health Sciences; Addis Ababa University; Addis Ababa Ethiopia
| | - G. Davey
- Brighton & Sussex Medical School; Brighton UK
| | - A. Venn
- Division of Epidemiology and Public Health; University of Nottingham; Nottingham UK
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21
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Robinson K. Helicobacter pylori-Mediated Protection against Extra-Gastric Immune and Inflammatory Disorders: The Evidence and Controversies. Diseases 2015; 3:34-55. [PMID: 28943607 PMCID: PMC5548235 DOI: 10.3390/diseases3020034] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 03/03/2015] [Accepted: 03/05/2015] [Indexed: 12/11/2022] Open
Abstract
A large number of studies link H. pylori infection with a reduced risk of developing extra-gastric conditions such as allergy, asthma, inflammatory bowel disease, coeliac disease and multiple sclerosis. The strength of the evidence for these protective associations is quite variable, and published studies often do not agree. This review article discusses some of the reasons for these discrepancies, and the difficulties faced when designing studies. Examples of some protective disease associations are described in detail, where the evidence is most abundant and thought to be more reliable. The most convincing of these are supported by published mechanistic data, for example with animal models, or incidence of disease exacerbation in humans following H. pylori eradication. Although controversial, this field is very important as the prevalence of H. pylori is decreasing throughout the world whilst many chronic diseases are becoming more common. These trends are likely to continue in the future, therefore it is important that we fully understand if and how H. pylori confers protection.
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Affiliation(s)
- Karen Robinson
- Nottingham Digestive Diseases Biomedical Research Unit, School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK.
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22
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Wang F, Liu J, Zhang Y, Lei P. Association of Helicobacter pylori infection with chronic obstructive pulmonary disease and chronic bronchitis: a meta-analysis of 16 studies. Infect Dis (Lond) 2015; 47:597-603. [PMID: 25797276 DOI: 10.3109/00365548.2014.989539] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) and chronic bronchitis (CB) are common respiratory diseases globally. The aim of this meta-analysis was to quantify the risk of these two diseases being associated with Helicobacter pylori infection. METHODS A literature search was performed to identify studies published before 5 June 2014 for relevant risk estimates. Fixed and random effect meta-analytical techniques were conducted for COPD and CB. RESULTS Sixteen observational studies involving 1390 patients with COPD, 734 with CB and more than 13 000 controls were included. Helicobacter pylori infection was associated with an increased risk of COPD and CB [odds ratio (OR) 2.07, 95% confidence interval (CI) 1.81-2.36, p for heterogeneity = 0.05; and OR 1.57, 95% CI 1.33-1.86, p for heterogeneity = 0.08]. We discovered a significant association between CagA-positive strains and risk for COPD (OR 3.46, 95% CI 2.29-5.25, p for heterogeneity = 0.20). CONCLUSIONS Our meta-analysis suggested a potential relationship between H. pylori infection and the development of COPD and CB.
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Affiliation(s)
- Feng Wang
- From the Department of Gerontology, General Hospital of Tianjin Medical University , Tianjin , PR China
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23
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Amberbir A, Medhin G, Abegaz WE, Hanlon C, Robinson K, Fogarty A, Britton J, Venn A, Davey G. Exposure to Helicobacter pylori infection in early childhood and the risk of allergic disease and atopic sensitization: a longitudinal birth cohort study. Clin Exp Allergy 2014; 44:563-71. [PMID: 24528371 PMCID: PMC4164268 DOI: 10.1111/cea.12289] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Revised: 12/21/2013] [Accepted: 01/12/2014] [Indexed: 12/21/2022]
Abstract
Background An inverse relation between Helicobacter pylori infection and allergic disease has been reported by a range of independent epidemiological studies, but evidence from longitudinal studies is scarce. Objective We have investigated the effects of H. pylori infection on the incidence and prevalence of allergic diseases and sensitization in a low-income birth cohort. Methods In 2005/2006, a population-based birth cohort was established in Butajira, Ethiopia, and the 1006 singleton babies born were followed up at ages 1, 3, and 5. Symptoms of allergic disease were collected using the ISAAC questionnaire, allergen skin tests performed, and stool samples analysed for H. pylori antigen and geohelminths. Multiple logistic regression was used to determine the independent effects of H. pylori measured at age 3 on the incidence of each outcome between ages 3 and 5 years (in those without the outcome at age 3), controlling for potential confounders, and to additionally assess cross-sectional associations. Results A total of 863 children were followed up to age 5. H. pylori infection was found in 25% of the children at both ages 3 and 5, in 21% at age 5 but not 3, and in 17% at age 3 but not at age 5. H. pylori infection at age 3 was significantly associated with a decreased risk of incident eczema between ages 3 and 5 (adjusted OR, 95% CI, 0.31; 0.10–0.94, P = 0.02). Cross-sectionally at age 5, H. pylori infection was inversely associated with skin sensitization (adjusted OR, 95% CI, 0.26; 0.07–0.92, P = 0.02). Conclusion and clinical relevance These findings provide further evidence to suggest that early-life exposure to H. pylori may play a protective role in the development of allergy.
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Affiliation(s)
- A Amberbir
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK; Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK
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Samareh Fekri M, Hashemi Bajgani SM, Rasti A, Yazdani R, Mollaie HR. Detection of helicobacter pylori in bronchoalveolar lavage of patients with chronic obstructive pulmonary disease by real time polymerase chain reaction. Jundishapur J Microbiol 2014; 8:e14551. [PMID: 25789128 PMCID: PMC4350048 DOI: 10.5812/jjm.14551] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Revised: 01/11/2014] [Accepted: 01/20/2014] [Indexed: 12/21/2022] Open
Abstract
Background: Chronic obstructive pulmonary disease (COPD) is one of the most important causes of disability and mortality in the world. Although cigarette smoking and environmental pollutants have been recognized as the major causes of COPD, the role of infection in the pathogenesis and progression of COPD has also been reported. Objectives: The aim of the present study was to find the relationship between Helicobacter Pylori infection and COPD through anti H. pylori IgG serology, real time PCR of bronchoalveolar lavage and trans bronchial biopsy urease tests. Patients and Methods: This descriptive cross-sectional study was carried out on 60 adults with COPD. After obtaining the patient’s history, physical examination, spirometry and confirmation of COPD diagnosis by pulmonologist, subjects were selected through convenience sampling. In order to determine the severity and prognosis of disease, the global initiative for chronic obstructive lung disease (GOLD) criteria and BODE index were used. Subjects underwent bronchoscopy for obtaining bronchoalveolar lavage (BAL) samples and biopsy was performed. Biopsy and BAL samples were investigated respectively by urease test and real time PCR. Moreover, patients’ serum samples were serologically studied for detection of anti H. pylori IgG. Results: Mean age of the participants was 60.65 ± 9.15 years, and 25% were female and 75% were male. The prevalence rate of H. pylori in COPD patients was 10% according to real time PCR, 88.3% according to the serology test and 0% based on the urease test. According to the results of PCR and considering the severity of disease based on the GOLD criteria, from those with a positive PCR, one patient (16.6%) had very severe obstruction, three (50%) had severe obstruction and two patients (33.3%) had moderate obstruction. The relationship between H. pylori presence (based on PCR) and disease severity and prognosis was not statistically significant. Conclusions: These findings can justify the hypothesis of direct injury and chronic inflammation via inhalation and aspiration resulting in H. pylori colonization. In fact, it is thought that H. Pylori infection, beside the host genetic vulnerability and other environmental risk factors might make the patient susceptible to COPD or lead to COPD worsening. Although we found H. pylori infection in some patients with COPD, the results of this study, could not explain the pathogenic mechanisms of COPD.
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Affiliation(s)
- Mitra Samareh Fekri
- Physiology Research Center (PRC), Kerman University of Medical Sciences, Kerman, IR Iran
| | | | - Atefe Rasti
- Physiology Research Center (PRC), Kerman University of Medical Sciences, Kerman, IR Iran
- Corresponding author: Atefe Rasti, Physiology Research Center (PRC), Kerman University of Medical Sciences, Kerman, IR Iran. Tel: +98-9177108194, Fax: +98-3432264097, E-mail:
| | - Rostam Yazdani
- Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, IR Iran
| | - Hamid Reza Mollaie
- Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, IR Iran
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25
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Association Between Chronic Respiratory Diseases and Helicobacter pylori: A Meta-Analysis. Arch Bronconeumol 2014; 51:273-8. [PMID: 24998026 DOI: 10.1016/j.arbres.2014.03.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 03/26/2014] [Accepted: 03/31/2014] [Indexed: 01/08/2023]
Abstract
BACKGROUND The prevalence of chronic respiratory diseases (CRDs), including chronic bronchitis and chronic obstructive pulmonary disease (COPD), has increased significantly over the past decades. Several studies suggest that Helicobacter pylori infection may be related to the development of CRDs, but the results were not consistent. We carried out a meta-analysis to evaluate the potential association of H.pylori infection with CRDs. METHODS We conducted a systematic literature search in PubMed, Embase, Ovid, Google Scholar and CNKI from inception to October 31, 2013. The following search terms were used: "chronic respiratory disease," "chronic bronchitis," "chronic obstructive pulmonary disease" or "COPD" in combination with "Helicobacter pylori" or "Campylobacter pylori." According to established inclusion criteria, we selected all eligible published papers and then extracted essential data. To evaluate the association of H.pylori with chronic bronchitis and COPD, an overall analysis and subgroup analyses were conducted. RESULTS A total of 9 case-control studies comprising 782 cases and 815 controls were included in the study. Pooled ORs were 2.30 (95%CI: 1.85-2.85) in the overall analysis, 2.90 (95%CI: 2.04-4.13) in the chronic bronchitis subgroup, and 2.11 (95%CI: 1.35-3.29) in the COPD subgroup. CONCLUSIONS The results of the overall analysis and subgroup analyzed suggest a significant association between H.pylori and CRDs. Further studies are needed to clarify the pathogenetic mechanisms involved.
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Lender N, Talley NJ, Enck P, Haag S, Zipfel S, Morrison M, Holtmann GJ. Review article: Associations between Helicobacter pylori and obesity--an ecological study. Aliment Pharmacol Ther 2014; 40:24-31. [PMID: 24832176 DOI: 10.1111/apt.12790] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Revised: 09/18/2013] [Accepted: 04/21/2014] [Indexed: 02/06/2023]
Abstract
BACKGROUND There is emerging debate over the effect of Helicobacter pylori infection on body mass index (BMI). A recent study demonstrated that individuals who underwent H. pylori eradication developed significant weight gain as compared to subjects with untreated H. pylori colonisation. AIM To elucidate the association between H. pylori colonisation and the prevalence of overweight and obesity in developed countries. METHODS The literature was searched for publications reporting data on H. pylori prevalence rates and obesity prevalence rates. Studies selected reported H. pylori prevalence in random population samples with sample sizes of more than 100 subjects in developed countries (GDP >25,000 US$/person/year). Corresponding BMI distributions for corresponding countries and regions were identified. Nonparametric tests were used to compare the association between H. pylori and overweight and obesity rates. RESULTS Forty-nine studies with data from 10 European countries, Japan, the US and Australia were identified. The mean H. pylori rate was 44.1% (range 17-75%), the mean rates for obesity and overweight were 46.6 (± 16)% and 14.2 (± 8.9)%. The rate of obesity and overweight were inversely and significantly (r = 0.29, P < 0.001) correlated with the prevalence of H. pylori infection. CONCLUSIONS There is an inverse correlation between H. pylori prevalence and rate of overweight/obesity in countries of the developed world. Thus, the gradual decrease of the H. pylori colonisation that has been observed in recent decades (or factors associated with decrease of) could be causally related to the obesity endemic observed in the Western world.
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Affiliation(s)
- N Lender
- Department of Gastroenterology & Hepatology, Princess Alexandra Hospital, Woolloongabba, Qld, Australia; Faculty of Medicine and Biomedicine & Faculty of Health and Behavioural Sciences, University of Queensland, St Lucia, Qld, Australia
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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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Asthma and Microbes: A New Paradigm. THE ROLE OF MICROBES IN COMMON NON-INFECTIOUS DISEASES 2014. [PMCID: PMC7120979 DOI: 10.1007/978-1-4939-1670-2_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Asthma is worldwide at pandemic levels for the past 30 years but is increasing at a greater rate in more affluent societies. It is a heterogeneous disorder caused by interaction between genetic predisposition, atopy, and environmental factors, including allergens, air pollution, and respiratory infections. The pathological aspects and pathophysiological mechanisms are reviewed in this chapter. Allergens or infectious agents may stimulate Th-2 inflammation which causes activation of IL-13, eosinophils, and increase IgE levels, subsequently leading to bronchial smooth muscle hypercontraction. Respiratory viral infections are well-known causes of precipitation of acute asthma exacerbations in 50–60 % of attacks. There is also increasing evidence that bacterial infections, Chlamydia pneumoniae, and Mycoplasma pneumoniae, may contribute to the onset and course of asthma. The two main hypothesis of microbial genesis of asthma that has arisen in the past 20–30 years appears to be incongruous, but are not, are the hygiene hypothesis of asthma, and the virus-related asthma, early onset of viral bronchiolitis in the susceptible hosts being responsible for later development of asthma. The clinical and experimental evidences to support these contentions are reviewed and critiqued.
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Pawar S, Reddy SR, Chelluri LK, Prasad CE. Detection of Helicobacter pylori infection in patients with obstructive airway diseases with sero techniques using highly specific IgG antibodies for Helicobacter pylori antigen. ASIAN PACIFIC JOURNAL OF TROPICAL DISEASE 2014. [DOI: 10.1016/s2222-1808(14)60472-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Abstract
There is a commonly held perception that Helicobacter pylori related diseases are declining, however these are still associated with a high risk of morbidity and mortality. In recent years worrying themes have emerged such as increasing levels of antibiotic resistance and falling cure rates which illustrate there is no room for complacency with respect to H. pylori. In addition there are many significant issues which have not been elucidated regarding the role played by H. pylori in very serious pathologies such as gastric and esophageal cancer and other more benign disorders common in the developed world such as gastroesophageal reflux disease, functional dyspepsia and perhaps obesity which carry a significant impact both economically and as regards to symptoms. Future guidelines aimed at European practitioners and patients will need to address the questions raised by these issues as well as the more familiar areas such as constituents and duration of therapy.
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Affiliation(s)
- Anthony O'Connor
- Department of Gastroenterology, University of Dublin, Trinity College Dublin, Ireland.
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Coelho LG, Maguinilk I, Zaterka S, Parente JM, do Carmo Friche Passos M, Moraes-Filho JPP. 3rd Brazilian Consensus on Helicobacter pylori. ARQUIVOS DE GASTROENTEROLOGIA 2013; 50:S0004-28032013005000113. [PMID: 23748591 DOI: 10.1590/s0004-28032013005000001] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Accepted: 02/14/2013] [Indexed: 12/11/2022]
Abstract
Signicant progress has been obtained since the Second Brazilian Consensus Conference on Helicobacter pylori Infection held in 2004, in São Paulo, SP, Brazil, and justify a third meeting to establish updated guidelines on the current management of H. pylori infection. The Third Brazilian Consensus Conference on H pylori Infection was organized by the Brazilian Nucleus for the Study of Helicobacter, a Department of the Brazilian Federation of Gastroenterology and took place on April 12-15, 2011, in Bento Gonçalves, RS, Brazil. Thirty-one delegates coming from the five Brazilian regions and one international guest, including gastroenterologists, pathologists, epidemiologists, and pediatricians undertook the meeting. The participants were allocated in one of the five main topics of the meeting: H pylori, functional dyspepsia and diagnosis; H pylori and gastric cancer; H pylori and other associated disorders; H pylori treatment and retreatment; and, epidemiology of H pylori infection in Brazil. The results of each subgroup were submitted to a final consensus voting to all participants. Relevant data were presented, and the quality of evidence, strength of recommendation, and level of consensus were graded. Seventy per cent and more votes were considered as acceptance for the final statement. This article presents the main recommendations and conclusions to guide Brazilian doctors involved in the management of H pylori infection.
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Affiliation(s)
- Luiz Gonzaga Coelho
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
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Deng B, Li Y, Zhang Y, Bai L, Yang P. Helicobacter pylori infection and lung cancer: a review of an emerging hypothesis. Carcinogenesis 2013; 34:1189-95. [PMID: 23568955 DOI: 10.1093/carcin/bgt114] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Helicobacter pylori (Hp) is one of the most common bacteria infecting humans. Recently, certain extragastric manifestations, linked to Hp infection, have been widely investigated, suggesting that Hp infection might be a 'systemic' disease. Accumulating, yet limited, evidence points to a potential association between Hp infection and lung cancer risk. Epidemiologic studies have shown that odds ratios (estimated relative risks) of lung cancer with Hp infection range from 1.24 to 17.78 compared with the controls, suggesting an increased lung cancer risk in the population exposed to Hp infection although far from supporting a causal relationship between Hp and lung cancer. Many studies have demonstrated the existence of Hp in the mucosa of the upper respiratory tract with no direct evidence of Hp-localization in lung tissue in the published literatures, rendering the possible functional mechanism underlying the association an open question. We followed the classic hypothesis-generating path, where we have thoroughly reviewed the publications on lung cancer and Hp infection from serological association to possible mechanisms as: (i) p130cas activated by Src kinase following Hp-host communication and p130cas-related carcinogenesis as in various malignancies; and (ii) gastroesophageal reflux and inhalation of urease or gastrin, which are Hp-related carcinogenic factors and present in lung tissues. We propose rigorous investigations regarding the Hp-lung cancer association and, if confirmed, the mechanisms of Hp infection leading to lung cancer development and progression. Clarification on Hp-lung cancer association is important for the understanding of lung cancer beyond tobacco-smoking-related carcinogenesis.
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Affiliation(s)
- Bo Deng
- Department of Health Sciences Research, Mayo Clinic, College of Medicine, Rochester, MN 55905, USA
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Abstract
OBJECTIVE Helicobacter pylori infection is recognized as a worldwide public health threat. Some studies have suggested that individuals with asthma have a lower rate of H. pylori infection, but the relation remains controversial. This meta-analysis was carried out to quantify the association between H. pylori infection and asthma. METHODS Published information on the prevalence of H. pylori in individuals with asthma was collected to assess the potential associations between H. pylori infection and the risk of asthma. Fourteen eligible studies were selected for analysis. Data on the study populations, detection method of H. pylori, and publication year were summarized. Meta-regression models and subgroup analyses were established to screen the factors resulting in heterogeneity. RESULTS Of the 106 articles retrieved, 14 fulfilled the inclusion criteria. The 14 studies involved 28 283 patients, with a total H. pylori infection rate of 40.53%. This meta-analysis found a significantly lower rate of H. pylori infection in the asthmatics than in the controls (odds ratio=0.84, 95% confidence interval: 0.73-0.96, P=0.013). Subgroup analysis indicated a similar infection rate of CagA-positive H. pylori infection in the asthmatic group and the control group (odds ratio=0.73, 95% confidence interval: 0.41-1.28, P=0.03). CONCLUSION The pooled data suggest that asthmatics have a significantly lower rate of H. pylori infection. Large-scale and multicenter studies should be carried out to further determine the relation between this bacterium and allergic disorders.
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Abstract
OBJECTIVE The severity and incidence of asthma have increased drastically in the developed nations of the world over the last decades. Currently, some evidences indicate an inverse association between Helicobacter pylori and asthma, but some studies did not get the same conclusion. To make this question clear, we systematically reviewed the published evidence for an association between H. pylori infection and asthma. METHODS Medline and SCI databases up to April 2012 were searched to identify studies that evaluated the association between H. pylori and asthma. Relevant publications were searched using the following keywords or synonyms: asthma or Helicobacter pylori. Methodologic quality was scored by using a standardized list of criteria, and meta-analysis was conducted to calculate crude odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS Nineteen studies met our inclusion criteria: nine cross-sectional studies, seven case-control studies, and three prospective cohort studies. The overall methodologic quality score was high. Pooled ORs for the association between asthma and H. pylori infection were 0.84 (95% CI: 0.74-0.96) in nine cross-sectional studies, 0.94 (95% CI: 0.79-1.12) in seven case-control studies, and 0.82 (95% CI: 0.53-1.27) in three cohort studies. The pooled OR for all included studies was 0.81 (95% CI: 0.72-0.91) in children and 0.88 (95% CI: 0.71-1.08) in adults. CONCLUSIONS We found a weak evidence for an inverse association between asthma and H. pylori infection both in children and in adults.
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Affiliation(s)
- Qiang Wang
- The Second Clinical Department, Tongji Hospital, Tongji Medical College, HuazhongUniversity of Science & Technology, Xue zi yuan 508-520, Hangkong Road 13#, Wuhan 430030, Hubei, China.
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Arram EO, Shahin DA, Sherif MM. Asthma is inversely associated with Helicobacter pylori status. EGYPTIAN JOURNAL OF CHEST DISEASES AND TUBERCULOSIS 2012. [DOI: 10.1016/j.ejcdt.2012.10.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Zevit N, Balicer RD, Cohen HA, Karsh D, Niv Y, Shamir R. Inverse association between Helicobacter pylori and pediatric asthma in a high-prevalence population. Helicobacter 2012; 17:30-5. [PMID: 22221613 DOI: 10.1111/j.1523-5378.2011.00895.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Helicobacter pylori-associated disease has led to aggressive diagnostic and eradication protocols that are partially responsible for the decrease in prevalence of H. pylori carriage. Recent evidence indicates that in low-prevalence populations, H. pylori may have protective effects on allergic diseases. The aim of this study was to explore the relationship between pediatric asthma and H. pylori infection in a population with high prevalence of H. pylori infection. MATERIALS AND METHODS A national referral laboratory was screened for all (13) C urea breath tests performed in children aged 5-18 years between 2007 and 2008, for patient demographics and physician-diagnosed asthma. Data concerning asthma-associated medication usage were extracted from electronic medical records and databases. Data were analyzed using a stepwise logistic regression model. RESULTS During the study period, 6959 patients underwent urea breath testing (average age 12.4±3.5years). Of these, 3175/6959 (45.6%) were positive for H. pylori, and 578/6959 (8.3%) had asthma. Rates of asthma in H. pylori-positive and H. pylori-negative children were 7.3 and 9.1%, respectively (odds ratio 0.82; 95% confidence interval (CI) 0.69-0.98; p=.032). We also confirmed that male gender, urban residence, and age are associated with childhood asthma. CONCLUSIONS We demonstrate an inverse association between H. pylori and pediatric asthma in a population with a high prevalence of H. pylori.
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Affiliation(s)
- Noam Zevit
- Institute of Gastroenterology, Nutrition, and Liver Diseases, Schneider Children's Medical Center of Israel, Petach-Tikva, Israel.
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Wang Y, Bi Y, Zhang L, Wang C. Is Helicobacter pylori infection associated with asthma risk? A meta-analysis based on 770 cases and 785 controls. Int J Med Sci 2012; 9:603-10. [PMID: 23028243 PMCID: PMC3461765 DOI: 10.7150/ijms.4970] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Accepted: 09/06/2012] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Helicobacter pylori (H. pylori) infection has been thought to play a critical role in disorders such as gastric and lung cancer. A number of studies have been devoted to the relationship between H. pylori infection and asthma risk, which have generated inconclusive results. In this study we aimed to derive a more precise estimation of the relationship. METHODS Meta-analyses evaluating the association of H. pylori infection and asthma risk were conducted and subgroup analyses on ethnicity and source of controls as well as CagA status were further conducted. Eligible studies were identified for the period up to Jul 2012. RESULTS A total of five case-control studies comprising 770 cases and 785 controls were lastly selected for analysis. The overall data failed to indicate a significant association of H. pylori infection and asthma risk (OR=1.01; 95%CI=0.82-1.24). Likewise, in the subgroup analysis regarding ethnicity, source of controls and CagA status, no associations could be observed. CONCLUSIONS The pooled data failed to suggest a marked association between H. pylori infection and asthma risk. Future studies are needed to confirm this conclusion.
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Affiliation(s)
- Yan Wang
- Institute of Respiratory Diseases, Xinqiao Hospital, Third Military Medical University, Chongqing, China.
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Amberbir A, Medhin G, Erku W, Alem A, Simms R, Robinson K, Fogarty A, Britton J, Venn A, Davey G. Effects of Helicobacter pylori, geohelminth infection and selected commensal bacteria on the risk of allergic disease and sensitization in 3-year-old Ethiopian children. Clin Exp Allergy 2011; 41:1422-30. [PMID: 21831135 DOI: 10.1111/j.1365-2222.2011.03831.x] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Epidemiological studies have suggested that gastro-intestinal infections including Helicobacter pylori, intestinal microflora (commensal bacteria) and geohelminths may influence the risk of asthma and allergy but data from early life are lacking. OBJECTIVE We aimed to determine the independent effects of these infections on allergic disease symptoms and sensitization in an Ethiopian birth cohort. METHODS In 2008/09, 878 children (87% of the 1006 original singletons in a population-based birth cohort) were followed up at age 3 and interview data obtained on allergic symptoms and potential confounders. Allergen skin tests to Dermatophagoides pteronyssinus and cockroach were performed, levels of Der p 1 and Bla g 1 in the child's bedding measured and stool samples analysed for geohelminths and, in a random subsample, enterococci, lactobacilli, bifidobacteria and H. pylori antigen. The independent effects of each exposure on wheeze, eczema, hayfever and sensitization were determined using multiple logistic regression. RESULTS Children were commonly infected with H. pylori (41%; 253/616), enterococci (38.1%; 207/544), lactobacilli (31.1%; 169/544) and bifidobacteria (18.9%; 103/544) whereas geohelminths were only found in 8.5% (75/866). H. pylori infection was associated with a borderline significant reduced risk of eczema (adjusted OR 0.49, 95% CI 0.24-1.01, P=0.05) and D. pteronyssinus sensitization (adjusted OR 0.42, 95% CI 0.17-1.08, P=0.07). Geohelminths and intestinal microflora were not significantly associated with any of the outcomes measured. CONCLUSION AND CLINICAL RELEVANCE Among young children in a developing country, we found evidence to support the hypothesis of a protective effect of H. pylori infection on the risk of allergic disease. Further investigation of the mechanism of this effect is therefore of potential therapeutic and preventive value.
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Affiliation(s)
- A Amberbir
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia.
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BPCO e malattie dell’apparato digerente. ITALIAN JOURNAL OF MEDICINE 2011. [DOI: 10.1016/j.itjm.2011.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Theory of gastric CO2 ventilation and its control during respiratory acidosis: Implications for central chemosensitivity, pH regulation, and diseases causing chronic CO2 retention. Respir Physiol Neurobiol 2011; 175:189-209. [DOI: 10.1016/j.resp.2010.12.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2010] [Revised: 12/01/2010] [Accepted: 12/01/2010] [Indexed: 01/16/2023]
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Abstract
A relationship between infections and allergic airway disease has long been recognized, and many reviews have been written on this topic. However, both clinical and basic science studies published in the last 3 years provide new insights into the relationship between infection and allergic conditions. In this review, we focus on these very recent studies, which address the role of infection in the development, maintenance, and exacerbation of asthma. Bacterial, viral, fungal, and parasitic infections have each been examined and provide a framework for these novel concepts.
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Affiliation(s)
- C M Sevin
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232-2650, USA
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Figura N, Franceschi F, Santucci A, Bernardini G, Gasbarrini G, Gasbarrini A. Extragastric manifestations of Helicobacter pylori infection. Helicobacter 2010; 15 Suppl 1:60-8. [PMID: 21054655 DOI: 10.1111/j.1523-5378.2010.00778.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The possible role of Helicobacter pylori as a trigger for some extragastric diseases has been largely investigated in the last year. There are, in fact, several studies concerning cardiovascular diseases, neurological disorders, diabetes mellitus, ear and eyes diseases, immunological and hematological disorders, liver and bile tract diseases, gynecological and respiratory tract pathologies. Among them, idiopathic sideropenic anemia and idiopathic thrombocytopenic purpura still remain the extragastric diseases showing the most convincing results. Concerning ischemic heart disease, there are new interesting data playing in favor of the association, even though there are still some open issues to be clarified. For the other diseases, more studies are needed to clarify the reality of the proposed association.
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Affiliation(s)
- Natale Figura
- Internal Medicine Department, University of Siena, Largo A. Gemelli 8, Rome, Italy
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Scott M, Raza A, Karmaus W, Mitchell F, Grundy J, Kurukulaaratchy RJ, Arshad SH, Roberts G. Influence of atopy and asthma on exhaled nitric oxide in an unselected birth cohort study. Thorax 2010; 65:258-62. [PMID: 20335297 PMCID: PMC2890070 DOI: 10.1136/thx.2009.125443] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Asthma is considered to be associated with elevated levels of exhaled nitric oxide (FeNO). The nature of this relationship and how it is influenced by atopy are still not resolved. METHODS The Isle of Wight birth cohort (N=1456) was reassessed at 18 years of age. Participants able to attend the research centre were assessed by questionnaires, skin prick testing and FeNO in order to explore the interrelationship between asthma, atopy and FeNO. RESULTS Atopy was significantly associated with higher levels of FeNO. However, the level of FeNO for non-atopic asthmatic participants was no different to the non-atopic no-asthma group. The highest levels of FeNO were seen in subjects with both atopy and asthma. In addition, FeNO was positively associated with increasing atopic burden as evidenced by increasing FeNO with increasing skin prick testing positivity, and with increasing severity of atopic asthma as evidenced by the number of attacks of wheezing. FeNO and current inhaled corticosteroid use were not significantly associated. CONCLUSIONS FeNO behaves as a biomarker of atopy and the "allergic asthma" phenotype rather than asthma itself. This may explain why FeNO-guided asthma treatment outcomes have proved to be of limited success where atopic status has not been considered and accounted for.
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Affiliation(s)
- Martha Scott
- The David Hide Asthma and Allergy Research Centre, St Mary’s Hospital, Newport, Isle of Wight, UK
- School of Medicine, University of Southampton, Southampton, UK
| | - Abid Raza
- The David Hide Asthma and Allergy Research Centre, St Mary’s Hospital, Newport, Isle of Wight, UK
- School of Medicine, University of Southampton, Southampton, UK
| | - Wilfried Karmaus
- Epidemiology and Biostatistics Department, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Frances Mitchell
- The David Hide Asthma and Allergy Research Centre, St Mary’s Hospital, Newport, Isle of Wight, UK
| | - Jane Grundy
- The David Hide Asthma and Allergy Research Centre, St Mary’s Hospital, Newport, Isle of Wight, UK
| | - Ramesh J Kurukulaaratchy
- The David Hide Asthma and Allergy Research Centre, St Mary’s Hospital, Newport, Isle of Wight, UK
- School of Medicine, University of Southampton, Southampton, UK
| | - S Hasan Arshad
- The David Hide Asthma and Allergy Research Centre, St Mary’s Hospital, Newport, Isle of Wight, UK
- School of Medicine, University of Southampton, Southampton, UK
| | - Graham Roberts
- The David Hide Asthma and Allergy Research Centre, St Mary’s Hospital, Newport, Isle of Wight, UK
- School of Medicine, University of Southampton, Southampton, UK
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Pellicano R, Franceschi F, Saracco G, Fagoonee S, Roccarina D, Gasbarrini A. Helicobacters and extragastric diseases. Helicobacter 2009; 14 Suppl 1:58-68. [PMID: 19712170 DOI: 10.1111/j.1523-5378.2009.00699.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
For two decades, Helicobacter pylori has been considered as the culprit in many extragastric manifestations. However, for several of these supposed associations the hypothesis of an etiological role has not yet been fully investigated. This may be due to a series of factors linked to the epidemiological features of the studies and to the diseases investigated. This review attempts to highlight the main reported associations of H. pylori with extragastric manifestations during the last year. The most convincing data arise in the field of idiopathic thrombocytopenic purpura (ITP) and sideropenic anemia. Long-term follow-up studies have shown that 50% of subjects with ITP maintain a hematological response after H. pylori eradication. There is also growing evidence of the role of H. pylori in other diseases, including ischemic heart disease even though results are not conclusive.
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