Helicobacter pyloriand autoimmune disease: Cause or bystander

Abstract

Helicobacter pylori (H. pylori) is the main cause of chronic gastritis and a major risk factor for gastric cancer. This pathogen has also been considered a potential trigger of gastric autoimmunity, and in particular of autoimmune gastritis. However, a considerable number of reports have attempted to link H. pylori infection with the development of extra-gastrointestinal autoimmune disorders, affecting organs not immediately relevant to the stomach. This review discusses the current evidence in support or against the role of H. pylori as a potential trigger of autoimmune rheumatic and skin diseases, as well as organ specific autoimmune diseases. We discuss epidemiological, serological, immunological and experimental evidence associating this pathogen with autoimmune diseases. Although over one hundred autoimmune diseases have been investigated in relation to H. pylori, we discuss a select number of papers with a larger literature base, and include Sjögrens syndrome, rheumatoid arthritis, systemic lupus erythematosus, vasculitides, autoimmune skin conditions, idiopathic thrombocytopenic purpura, autoimmune thyroid disease, multiple sclerosis, neuromyelitis optica and autoimmune liver diseases. Specific mention is given to those studies reporting an association of anti-H. pylori antibodies with the presence of autoimmune disease-specific clinical parameters, as well as those failing to find such associations. We also provide helpful hints for future research.

Helicobacter pylori infection reduces disease severity in an experimental model of multiple sclerosis

“…A recent case control study in Iran also reported that neurological disability was lower in H. pylori-seropositive than in seronegative MS patients (Mohebi et al, 2013), in agreement with a previous study in a Japanese MS patient cohort (Li et al, 2007). In contrast, some other studies have failed to find any association between H. pylori infection and MS (Danese et al, 2000), and there is strong serological evidence to support a positive association between H. pylori and neuromyelitis optica (NMO), an antibody-mediated, severe variant of MS that involves the spinal cord and the optic nerves (reviewed by Smyk et al, 2014).…”

The Impacts of Helicobacter Pylori Antigen Positivity on Ankylosing Spondylitis

“…So far, conflicting results about the role of infectious diseases in the pathogenesis and severity of several rheumatic diseases were reported in the literature [8][9][10][11]17]. H. pylori was investigated whether it is related with several autoimmune diseases or not and it was found to be associated with development and severity of Sjögren's syndrome, Systemic sclerosis and Psoriasis while no relation was found with RA, Systemic lupus erythematosus, vasculitides, chronic urticaria, Immune thrombocytopenic purpura and Hashimoto's thyroiditis [17]. On the other hand, several studies indicated H. pylori as a potential protective agent against Multiple Sclerosis [18,19].…”

Association of Helicobacter pylori Infection with Systemic Lupus Erythematosus

“…The overall prevalence of this bacterium is as high as 80% in many developing countries to 20-50% in industrialized countries [26]. H.pylori infection not only causes a several of gastrointestinal diseases including peptic ulcers, noncardia gastric adenocarcinoma and gastric mucosa associated lymphoid tissue (MALT) lymphoma, but also plays a role in the pathogenesis of various autoimmune disorders such as idiopathic thrombocytopenic purpura, rheumatoid arthritis (RA), autoimmune gastric atrophy, Sjogrenˊs syndrome and autoimmune thyroiditis [17,27]. This extended coexistence of H.pylori in humans may be in part beneficial to humans.…”

“…Amongst the various infectious agents proposed as autoimmunity triggering agents, Helicobacter pylori (H.pylori) is one of the most widely studied [15][16][17][18].…”