Helicobacter pylori as a trigger and aggravating factor in rheumatoid arthritis and other rheumatic diseases

One of the main features of modern medicine is the fact that most somatic diseases lose their mononosological character, acquiring the status of comorbidity. Comorbidity has become a separate research area in various specialties of medicine and is currently being formalized into a system of knowledge about the patterns of combination of diseases. With regard to infectious pathology, the term "comorbidity" is rarely mentioned. In the conventional sense, comorbidity is understood as a combination of two or more diseases in a patient at the same time.In our opinion, the term "comorbidity" can be applied from the standpoint of the simultaneous combination of somatic and infectious diseases, but with a certain addition. In particular, it can be used in relation to somatic pathology with simultaneous combination with both monoinfection and polyetiologic. This is "complex comorbidity", which should be understood as "a complex pathological condition of a person, characterized by a simultaneous or sequential combination of psychosomatic and infectious pathology. It can take place when one or more infectious diseases are combined in combination with psychosomatic nosologies consisting of one or more units. "Over the past decade, a significant number of works have appeared on the role of H. pylori in the etiology and pathogenesis of a large number of somatic diseases. H. pylori plays in the development of many diseases - both associated with the stomach and determining the damage to other organs and systems. The clinical significance of this infection is determined by its leading role in the formation of chronic gastritis, gastric ulcer and duodenal ulcer, MALT lymphoma, and gastric adenocarcinoma. There is good evidence for the association of H. pylori infection with idiopathic iron deficiency anemia and idiopathic thrombocytopenic purpura. The clinical aspects of H. pylori infection are heterogeneous and include a wide range of pathologies, the evidence base for which at both the pathogenetic and clinical levels continues to expand.

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The role of <i>Helicobacter pylori</i> in complex human comorbidity

Sergeeva

Шкарин

Ковалишена

2021

Russian Journal of Infection and Immunity

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Peculiarities of laboratory parameters dynamics during helicobacter pylori eradication in patients with rheumatoid arthritis

Aleksandrov,

Zagorodneva,

Aleksandrova

et al. 2024

Medicinskij alfavit

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Helicobacter pylori (H. pylori) is able to participate in the pathogenesis of a number of autoimmune diseases, actively maintains chronic inflammation and stimulates the systemic immune response. The virulence factor of H. pylori is cytotoxin-associated gene A (CagA) is associated with more severe inflammatory reactions, increased risk of poor clinical outcomes and is able to influence the efficacy of infection eradication in patients with rheumatoid arthritis (RA).Purpose of the study. To evaluate laboratory parameters of H. pylori eradication efficacy in RA patients with chronic infection with the strain encoding cytotoxin-associated gene A.Materials and methods. Forty women with RA and confirmed chronic H. pylori infection were included in the study (mean age 55.5±8.7 years; mean disease duration 13.9±9.1 years; DAS-28–3.96±0.56). CagA-IgG associated H. pylori infection was diagnosed in 22 (group I, CagA+) and not diagnosed in 18 (group II, CagA-) patients. All RA patients underwent a course of H. pylori eradication therapy.Results. The process of H. pylori eradication had the most significant effect on laboratory parameters of CagA-negative RA patients (group II). In this group the levels of rheumatoid factor (p=0,028), C-reactive protein (CRP, p=0.001), interleukin-6 (IL-6, p=0.002), tumor necrosis factor alpha (p=0,023), angiopoietinlike protein type 3 (p=0.026) and antibodies to cyclic citrullinated peptide (ACCP, p=0,016) decreased significantly. In patients from group I (CagA+) most parameters remained practically unchanged (p>0.05), except for CRP (p=0.01) and IL-6 (p=0.011). In the short term, the success of eradication in CagA+ patients was significantly lower than in CagA- patients (p=0.033). Moreover, confirmation of successful eradication of H. pylori within the established period of time was extremely rare (p=0.009) in the combination of CagA+ and high titers of ACCP and antibodies to modified citrullinated vimentin.Conclusions. The effectiveness of H. pylori eradication in RA patients depends on the presence of chronic infection with the strain encoding the cytotoxin-associated gene A and the level of antibodies to citrullinated proteins, which should be taken into account when choosing the therapeutic effect on H. pylori in this group.

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Helicobacter pylori as a trigger and aggravating factor in rheumatoid arthritis and other rheumatic diseases

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The role of <i>Helicobacter pylori</i> in complex human comorbidity

The role of <i>Helicobacter pylori</i> in complex human comorbidity

Peculiarities of laboratory parameters dynamics during helicobacter pylori eradication in patients with rheumatoid arthritis

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