A Review of the Postulated Mechanisms Concerning the Association of Helicobacter pylori with Ischemic Heart Disease

Abstract

Since its discovery, Helicobacter pylori has been implicated in the pathogenesis of several diseases, both digestive and extradigestive. Interestingly, the majority of the extradigestive-related literature is focused on two vascular manifestations: stroke and ischemic heart disease. Potential mechanisms for the establishment of a H. pylori-induced ischemic heart disease have been proposed with regard to chronic inflammation, molecular mimicry, oxidative modifications, endothelial dysfunction, direct effect of the microorganism on atherosclerotic plaques as well as changes regarding traditional or novel risk factors for ischemic heart disease or even platelet-H. pylori interactions. A positive link between H. pylori infection and ischemic heart disease has been suggested by a series of studies focusing on epidemiologic evidence, dyslipidemic alterations, upregulation of inflammatory markers or homocysteine levels, induction of hypercoagulability, oxidation of low-density lipoprotein, causation of impaired endothelial function, detection of H. pylori DNA in atherosclerotic plaques, and participation of certain antigens and antibodies in a cross-reactivity model. There are studies, however, which investigated the relationship between H. pylori and ischemic heart disease with regard to the same parameters and failed to confirm the suggested positive association. Further studies in the direction of interaction between H. pylori and the host's genotype as well as a quest for evidence towards novel risk factors for ischemic heart disease such as oxidative stress, vascular remodeling, vascular calcification, or vasomotor activity, may reveal a field of great interest, thus contributing to the determination of new potential mechanisms.

Infection by CagA-Positive Helicobacter pylori Strains may Contribute to Alter the Sperm Quality of Men with Fertility Disorders and Increase the Systemic Levels of TNF-α

“…Helicobacter pylori infection is putatively associated with extra-digestive disorders [2][3][4][5][6][7][8] and may also play a role in the development of autoimmune diseases [9][10][11].…”

On Lipid Profile and Helicobacter Pylori Infection

“…Helicobacter pylori, the major causal agent of several acute and chronic gastroduodenal disease, has been involved in various aspects of many extragastric manifestations, such as ischemic heart disease 3) . Kowalski et al elucidated that Helicobacter pylori DNA was significantly found in atherosclerotic plaques of patients with severe coronary artery disease and Helicobacter pylori infection could progress and destabilize coronary artery plaque in a direct manner 4) .…”

Influence of CagA-positive Helicobacter pylori strains on atherosclerotic carotid disease

“…Several possible pathogenetic models have been presented to explain the relationship between HP infection and atherosclerosis, including induction of an atherogenic modified lipid profile, systemic increase of inflammatory markers, establishment of a hypercoagulabile state, changes regarding homocysteine levels, direct effect of HP on the progression and instability of atherosclerotic plaques, and induction of platelet aggregation [18]. Especially intriguing is the autoimmune hypothesis of possible antigen mimicry between HP antigens and antigens within atherosclerotic plaque.…”