High Prevalence of Cag‐A Positive <i>H. pylori</i> Strains in Ischemic Stroke: A Primary Care Multicenter Study

Bastiani, Rudy De; Gabrielli, Maurizio; Ubaldi, Enzo; Benedetto, Edoardo; Sanna, Guido; Cottone, Carmelo; Candelli, Marcello; Maria, Assunta Zocco; Saulnier, N.; Santoliquido, Angelo; Papaleo, Pierangelo; Gasbarrini, Giovanni; Gasbarrini, Antonio

doi:10.1111/j.1523-5378.2008.00610.x

Cited by 33 publications

(14 citation statements)

References 25 publications

(28 reference statements)

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“…Regarding stroke, in a primary care multicenter study, a trend toward a higher prevalence of active H. pylori infection in patients with ischemic stroke with respect to controls (63 vs 54%) has been found. This difference became significant when focusing on more virulent strains (OR: 2.69, 95% CI: 1.37–5.30) [16]. This is in agreement with another study that an infection with CagA‐positive H. pylori strains increases the risk of recurrent atherosclerotic stroke with a hazard ratio: 3.5 (95% CI: 1.9–6.4; p < .001) [17].…”

Section: Heart and Vascular Diseasessupporting

confidence: 85%

Helicobacters and Extragastric Diseases

et al. 2009

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For two decades, Helicobacter pylori has been considered as the culprit in many extragastric manifestations. However, for several of these supposed associations the hypothesis of an etiological role has not yet been fully investigated. This may be due to a series of factors linked to the epidemiological features of the studies and to the diseases investigated. This review attempts to highlight the main reported associations of H. pylori with extragastric manifestations during the last year. The most convincing data arise in the field of idiopathic thrombocytopenic purpura (ITP) and sideropenic anemia. Long-term follow-up studies have shown that 50% of subjects with ITP maintain a hematological response after H. pylori eradication. There is also growing evidence of the role of H. pylori in other diseases, including ischemic heart disease even though results are not conclusive.

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Section: Heart and Vascular Diseasessupporting

confidence: 85%

Helicobacters and Extragastric Diseases

et al. 2009

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“…168) Preeclampsia, a pregnancy-associated disorder characterized by hypertension and proteinuria, is another vascular disease related to cagA -positive H. pylori infection. 169) These studies indicated that CagA may also contribute to the development of extragastric diseases.…”

Section: Caga and Extragastric Disordersmentioning

confidence: 99%

Structure and function of <i>Helicobacter pylori</i> CagA, the first-identified bacterial protein involved in human cancer

Hatakeyama

2017

Proceedings of the Japan Academy. Ser. B: Physical and Biologic

181

143

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Chronic infection with Helicobacter pylori cagA-positive strains is the strongest risk factor of gastric cancer. The cagA gene-encoded CagA protein is delivered into gastric epithelial cells via bacterial type IV secretion, where it undergoes tyrosine phosphorylation at the Glu-Pro-Ile-Tyr-Ala (EPIYA) motifs. Delivered CagA then acts as a non-physiological scaffold/hub protein by interacting with multiple host signaling molecules, most notably the pro-oncogenic phosphatase SHP2 and the polarity-regulating kinase PAR1/MARK, in both tyrosine phosphorylation-dependent and -independent manners. CagA-mediated manipulation of intracellular signaling promotes neoplastic transformation of gastric epithelial cells. Transgenic expression of CagA in experimental animals has confirmed the oncogenic potential of the bacterial protein. Structural polymorphism of CagA influences its scaffold function, which may underlie the geographic difference in the incidence of gastric cancer. Since CagA is no longer required for the maintenance of established gastric cancer cells, studying the role of CagA during neoplastic transformation will provide an excellent opportunity to understand molecular processes underlying “Hit-and-Run” carcinogenesis.

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“…The association of H. pylori infection with ischemic atherosclerotic stroke has also been proposed. Several studies had found no association between chronic H. pylori infection and ischemic stroke, although the higher prevalence of the Cag A + H. pylori strain was demonstrated 56,57 . This result was further confirmed by Diomedi et al ., 58 in which Cag A + H. pylori infection was found to be associated with greater intima‐media thickness and a worse short‐term outcome according to the National Institute of Health Stroke Scale score.…”

Section: Neurological Diseasesmentioning

confidence: 78%

Extragastrointestinal manifestations of Helicobacter pylori infection: Facts or myth? A critical review

Tan

Goh

2012

J of Digest Diseases

101

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Helicobacter pylori (H. pylori) infection is reported to be associated with many extragastrointestinal manifestations, such as hematological diseases [idiopathic thrombocytopenic purpura (ITP) and unexplained iron deficiency anemia (IDA)], cardiovascular diseases (ischemic heart diseases), neurological disorders (stroke, Parkinson's disease, Alzheimer's disease), obesity and skin disorders. Among these, the best evidence so far is in ITP and unexplained IDA, with high‐quality studies showing the improvement of IDA and ITP after H. pylori eradication. The evidence of its association with coronary artery disease is weak and many of the results may be erroneous. The role of H. pylori infection in affecting serum leptin and ghrelin levels has attracted a lot of attention recently and available data to date have been conflicting. There have also been many uncontrolled, small sample studies suggesting an association between H. pylori infection and neurological disorders or chronic urticaria. However, more studies are required to clarify such proposed causal links.

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High Prevalence of Cag‐A Positive H. pylori Strains in Ischemic Stroke: A Primary Care Multicenter Study

Abstract: Our findings suggest that CagA-positive strains of H. pylori are significantly associated to atherosclerotic stroke. This is not a merely confirmative study since it has been performed for the first time in the primary care setting and included only subjects with an active infection.

Cited by 33 publications

References 25 publications

Helicobacters and Extragastric Diseases

Helicobacters and Extragastric Diseases

Structure and function of <i>Helicobacter pylori</i> CagA, the first-identified bacterial protein involved in human cancer

Extragastrointestinal manifestations of Helicobacter pylori infection: Facts or myth? A critical review

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