Helicobacter Pylori Infection in Sjögren’s Syndrome: Co-incidence or Causality?

Abstract

Background and Aim: Lymphoid cell infiltration and destruction of exocrine glands, specifically lacrimal and salivary glands are characteristics of Sjogren’s syndrome (SS). An etiological role has been proposed for Helicobacter pylori (H. pylori), interacting in the clinical course and complications of SS (including gastric cancer and lymphoma). The aim of this study was to identify the probable correlation between H. pylori infection and Sjogren’s syndrome (SS). Methods: In this case-control study, ELISA method was used to determine serum level of IgA and IgM anti H. pylori antibody in 43 subjects with SS according to the international criteria and 95 healthy subjects as control. SPSS-17 was used to analyze data with t-test. P value <.05 were considered significant. Results: Serum level of IgM (34.9% vs. 10.5%, p-value= 0.001) and IgA (67.4% vs. 46.3% p value= 0.021) anti H. pylori antibody were significantly higher in SS patients compared to the control group. There was a positive correlation between age and H. pylori infection (r=0.2, Pvalue= 0.05). Conclusion: Patients with SS had a higher prevalence of H. pylori infection compared to the normal population. Eradication of H. pylori is recommended particularly in older patients with SS.

Determination of Helicobacter Pylori Infection Prevalence by Non-invasive Methods

“…The IgM results were in accordance with those studies, reporting that 2.4%, 5.2%, and 5.81% of the subjects were positive for H. pylori (37,42,43). On the other hand, IgM seropositivity was 16.1% and 34.9% in some studies (44,41) that are inconsistent with our findings. The differences observed between various studies may be caused by the nature of the antigens used in the kits, infection stage, and sample size.…”

“…The results of IgA were consistent with an earlier study which was 2.64% (39). However, other studies found 18% and 67.4%, which are inconsistent with our results (40,41). The IgM results were in accordance with those studies, reporting that 2.4%, 5.2%, and 5.81% of the subjects were positive for H. pylori (37,42,43).…”

Helicobacter pylori-Related Extraintestinal Manifestations—Myth or Reality

“…H. pylori antibodies were found to be significantly increased in patients with primary Sjögren syndrome as compared to secondary type, other autoimmune diseases, and healthy controls [ 126 ]. Similar findings were reported by other authors [ 226 , 227 , 228 ]. Nevertheless, the benefit of H. pylori eradication in patients with this autoimmune condition remains controversial [ 134 ].…”

Helicobacter pylori and its association with autoimmune diseases: systemic lupus erythematosus, rheumatoid arthritis and Sjögren syndrome

“…Saghafi et al [ 85 ] compared serum IgM and IgA anti- H. pylori antibodies levels in 43 SS patients and 95 healthy controls, these antibodies were found to be significantly higher in SS patients (34.9% vs. 10.5% %, p = 0.001). El Miedany et al [ 86 ] also showed that the prevalence of H. pylori is higher in groups with SS than other connective tissue diseases and healthy controls.…”