Exposure To Helicobacter Pylori Infection In Early Childhood And The Risk Of Allergic Disease And Atopic Sensitization: A Longitudinal Birth Cohort Study

Abstract

SummaryBackground 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 crosssectional 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.

Association between infection with Helicobacter pylori and atopy in young Ethiopian children: A longitudinal study

“…A detailed description of the cohort at years 1, 3 and 5 is reported elsewhere . At 6.5 years, a total of 856 singleton children were successfully followed up (85.1% of the original cohort at birth and 99.3% of those available at year 5 follow‐up), of whom 713 had total serum IgE measurement, and 848 had H. pylori data at the 6.5‐year follow‐up visit (Figure ).…”

“…Our previous work on the Butajira Birth Cohort in rural Ethiopia demonstrated an inverse association of H. pylori infection with skin sensitization to either Dermatophagoides pteronyssinus or cockroach allergen 37 measured by skin prick test at age 5. Although this method provides a convenient test for atopy in epidemiological studies, 38 and the allergens used are believed to be predominant in Ethiopian populations, 8 this approach will not necessarily identify all cases of atopy.…”

The risk ofHelicobacter pyloriinfection for adverse pregnancy outcomes: A systematic review and meta‐analysis

“…Interestingly, there is proof suggesting H pylori infection in fetus period may have beneficial effect. Two cohort studies provided further evidence that exposure to H pylori infection in fetal life played a protective role in the development of atopy and allergy. Inflammatory response induced by H pylori is relevant with Th1‐mediated cellular response, and the protective effect of H pylori against atopy and allergy is also mediated by secretion of regulatory T cell .…”

Perspectives on Physiology and Medicine from Nobel Prize Winners: The 64th Lindau Nobel Laureate Meeting

“…Connecting the immune system with infectious disease and dermatology, Marshall discussed evidence suggesting that childhood infection with H. pylori protects against atopic diseases, including asthma and atopic dermatitis. He believes that more research into a possible link between H. pylori and regulation of the immune system in atopy is needed; a recent longitudinal birth cohort study supports this association (Amberbir et al, 2014).…”