Role of Helicobacter Pylori Infection and Lifestyle Habits in the Development of Gastroduodenal Diseases in a Population From the Brazilian Amazon

Abstract

-Context -Although more than half of the world's population is colonized with Helicobacter pylori, it remains unknown why this organism is able to produce severe disease in some hosts and be innocuous in others. The clinical outcome of infection is determined by several factors, including differences in the host response to bacterial stimulation, specific virulence factors of the organism and environmental influences, or a combination of these factors. Objectives -This study compared the prevalence of H. pylori infection and risk factors (infection with CagA+ strains, excessive alcohol consumption, smoking, and inadequate eating habits) between patients with different gastrointestinal disorders and associated these risk factors with the histopathological findings.Methods -In a prospective study, samples were collected from 442 patients and a standardized questionnaire regarding lifestyle habits (excessive alcohol consumption, smoking, and eating habits) was applied. The presence of H. pylori and of the cagA gene was investigated by polymerase chain reaction (PCR). Gastric biopsies were obtained for histological assessment. Results -The frequency of alcohol consumption, smoking, inadequate diet and infection with CagA+ H. pylori was higher among patients with peptic ulcer and adenocarcinoma when compared to those with gastritis. Gastric inflammation was more pronounced in patients infected with CagA+ strains. Conclusion -We conclude that infection with CagA+ H. pylori strains, excessive alcohol consumption, smoking and inadequate eating habits increase the risk of developing peptic ulcer and gastric carcinoma.

Helicobacter Pylori Infection in Patients With Different Gastrointestinal Diseases From Northern Brazil

“…Similar results have been reported in other studies conducted in the State of Pará (31,38) and in other Brazilian states, as well as in other countries (2,11,25,40) . When only H. pylori-positive patients were compared between the four groups studied, an even stronger association was observed between infection with cagA-positive H. pylori strains and gastrointestinal diseases.…”

“…Queiroz et al (24) found that, in Brazil, 95.0% and 62.3% of strains isolated from children with and without duodenal ulcers are cagA-positive, respectively. Other studies have reported a higher frequency of the cagA gene in H. pyloripositive patients with peptic ulcer and gastric cancer (17,33,38) . In the present study, 97.6% of the patients were infected with only one type of bacterial strain (monoinfection) and 2.4% were infected with more than one type of strain (mixed infection).…”

“…In this respect, some genotypes, such as alleles s1 and m1 of the vacA gene and presence of the cagA gene, are considered pathogenicity markers since they are associated with cytotoxin production and the induction of more intense epithelial lesions and inflammatory reactions. In many countries, these genotypes have been associated with the progression of infection to diseases such as peptic ulcer and gastric adenocarcinoma (1,3,10,12,14,22,31,38) .…”

Genes de patogenicidade de Helicobacter pylori, polimorfismos de citocinas e fatores ambientais afetam o desenvolvimento de doenças gástricas: uma visão geral

“…4 Inadequate dietary habits are associated with intense neutrophilia, higher degree of inflammation and with the development of gastric cancer. 20 Lastly, a recent study demonstrated a statistically significant increase in H. pylori infection among betel chewers compared to those who did not chew betel. This observation supports the hypothesis that betel chewing may affect periodontal health and thus predispose individuals to colonization with H. pylori.…”

“…Besides, factors as smoking, eating habits and alcohol consumption have been associated with a higher risk of the development of peptic ulcer and gastric cancer in people infected by H. pylori. [18][19][20] The aim of this review is to provide an overview of bacterial, environmental, and host factors that influence susceptibility to severe outcomes of H. pylori infection.…”