Dietary Composition Influences Incidence of Helicobacter pylori-Induced Iron Deficiency Anemia and Gastric Ulceration

Abstract

Epidemiologic studies have provided conflicting data regarding an association between Helicobacter pylori infection and iron deficiency anemia (IDA) in humans. Here, a Mongolian gerbil model was used to investigate a potential role of H. pylori infection, as well as a possible role of diet, in H. pylori-associated IDA. Mongolian gerbils (either H. pylori infected or uninfected) received a normal diet or one of three diets associated with increased H. pylori virulence: high-salt, low-iron, or a combination of a high-salt and low-iron diet. In an analysis of all infected animals compared to uninfected animals (independent of diet), H. pylori-infected gerbils had significantly lower hemoglobin values than their uninfected counterparts at 16 weeks postinfection (P < 0.0001). The mean corpuscular volume (MCV) and serum ferritin values were significantly lower in H. pylori-infected gerbils than in uninfected gerbils, consistent with IDA. Leukocytosis and thrombocytosis were also detected in infected gerbils, indicating the presence of a systemic inflammatory response. In comparison to uninfected gerbils, H. pylori-infected gerbils had a higher gastric pH, a higher incidence of gastric ulcers, and a higher incidence of fecal occult blood loss. Anemia was associated with the presence of gastric ulceration but not gastric cancer. Infected gerbils consuming diets with a high salt content developed gastric ulcers significantly more frequently than gerbils consuming a normal-salt diet, and the lowest hemoglobin levels were in infected gerbils consuming a high-salt/low-iron diet. These data indicate that H. pylori infection can cause IDA and that the composition of the diet influences the incidence and severity of H. pylori-induced IDA.A nemia affects up to 1.6 billion people worldwide, potentially resulting in fatigue, decreased productivity, increased susceptibility to infection, or death (1-5). A wide variety of infectious processes can be primary causes of anemia or can exacerbate anemia arising from noninfectious etiologies. For example, intestinal parasitic infections can cause chronic blood loss, leading to iron deficiency anemia (IDA; i.e., anemia due to iron deficiency) (3, 6). Anemia arises in patients with malaria because the parasites invade erythrocytes (2), and bacterial toxins can cause hemolysis (7). In addition, chronic infections, chronic immune activation, and cancer can cause a form of anemia known as "anemia of chronic disease" (8).Colonization of the human stomach with the gastric bacterium Helicobacter pylori is another potential cause of anemia. Anemia often occurs in the setting of symptomatic H. pylori-associated diseases (peptic ulcer disease or gastric cancer), but it has been suggested that H. pylori may also be a cause of IDA in asymptomatic persons with no evidence of peptic ulcer disease or gastric cancer (9). H. pylori has been linked to several other hematologic diseases, including pernicious anemia (vitamin B 12 deficiency arising through an autoimmune-mediated process) and idiopathic throm...

Climate engineering by mimicking natural dust climate control: the iron salt aerosol method

“…Iron deficiency in humans has been associated with heart failure (Avni et al, 2012;Cohen-Solal et al, 2014); gastric ulceration and anemia induced by Helicobacter pylori (Beckett et al, 2016); negative impacts on skeletal integrity (Medeiros, 2016); and cognitive disorders (Ünüsan, 2013). Iron deficiency in infancy leads to long-term deficits in executive function and recognition memory (Lukowski et al, 2013).…”

Identification and Characterization of a Family of Outer Membrane Proteins of Helicobacter pylori, which Scavenge Iron from Human Sources

“…In this work we are presenting the first insights that attempt to explain how the expression of a family of outer membrane proteins is regulated by the iron source. H. pylori is a human pathogen that requires a high concentration of iron because it has been reported that it can cause anemia when it is infecting humans [21,44,45]. This can explain why H. pylori has several genes, which express many proteins involved in iron acquisition such as FrpB1, FrpB2 or FrpB3 [27].…”

Helicobacter pylori infection and low dietary iron alter behavior, induce iron deficiency anemia, and modulate hippocampal gene expression in female C57BL/6 mice

“…A different gerbil study found that H . pylori -infected gerbils had higher gastric pH, higher incidence of gastric ulceration, and higher incidence of fecal occult blood loss, in addition to lower Hgb and MCV than uninfected animals [55]. …”