<i>Helicobacter pylori</i>infection and atopic diseases: Is there a relationship? A systematic review and meta-analysis

Lionetti, Elena; Leonardi, ﻿Salvatore; Lanzafame, Angela; Garozzo, Maria Teresa; Filippelli, Martina; Tomarchio, Salvatore D.; Ferrara, Viviana; Salpietro, Carmelo; Pulvirenti, Alfredo; Francavilla, Ruggiero; Catassi, Carlo

doi:10.3748/wjg.v20.i46.17635

Cited by 34 publications

(31 citation statements)

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“…In one subject with eosinophilic gastroenteritis as a co‐existing disease, abdominal pain transiently worsened after eradication. Some reports suggested a negative correlation between H pylori infection and allergic disease . Some studies also suggested a negative correlation between H pylori infection and eosinophilic gastroenteritis .…”

Section: Discussionmentioning

confidence: 99%

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Clinical features of Helicobacter pylori antibody‐positive junior high school students in Nagano Prefecture, Japan

et al. 2018

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Background Previously, we conducted an epidemiological study screening for Helicobacter pylori antibody positivity among Japanese junior high school students. In this study, we updated the epidemiological data and assessed the clinical features of H pylori antibody‐positive junior high school students. Materials and methods We assessed H pylori antibody‐positive subjects who were identified between 2012 and 2015 at four junior high schools in Nagano Prefecture, Japan. H pylori infection was confirmed by urea breath test (UBT) or endoscopic examination. Endoscopy was performed after obtaining consent from the subject and their guardians. Eradication therapy consisted of triple therapy with proton pump inhibitor (PPI), amoxicillin (AMPC), and clarithromycin (CAM) or metronidazole (MNZ) for seven days. Eradication of H pylori was confirmed by UBT. We reviewed subjects’ characteristics, endoscopic findings, histological findings, eradication regimes, outcomes, and adverse effects. Results The overall prevalence of H pylori antibody positivity was 3.2% (42/1298). We assessed thirteen H pylori antibody‐positive subjects. Eight subjects had a family history of H pylori infection. Six subjects had abdominal pain, and two subjects had iron deficiency anemia (IDA). Twelve subjects underwent endoscopy; one subject had duodenal ulcer, eleven subjects had antral nodular gastritis, and six subjects showed grade 2 closed type atrophic border according to the Kimura‐Takemoto classification. All subjects received eradication therapy; CAM was used in five subjects with CAM susceptibility as well as in three subjects with unknown information on CAM susceptibility, and MNZ was used in five subjects with CAM resistance. Eradication was successful in twelve subjects (one unconfirmed). There were three mild adverse effects (abdominal pain or diarrhea). Conclusions Helicobacter pylori test for junior high school students represents an opportunity to diagnose the peptic ulcer, iron deficiency anemia, and gastric atrophy.

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Section: Discussionmentioning

confidence: 99%

“…Some reports suggested a negative correlation between H pylori infection and allergic disease. 23,24 Some studies also suggested a negative correlation between H pylori infection and eosinophilic gastroenteritis. 25,26 However, further studies are needed to prove the association.…”

Section: Ta B L E 1 Characteristics Of Study Subjects (N = 13)mentioning

confidence: 99%

Clinical features of Helicobacter pylori antibody‐positive junior high school students in Nagano Prefecture, Japan

et al. 2018

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“…Meta-analyses are available regarding a possible link between H. pylori infection and atopy (Lionetti et al, 2014; Taye et al, 2015) or asthma (Wang et al, 2012, 2013; Zhou et al, 2013). Zhou et al pooled data from 14 studies (28,283 patients) and found that H. pylori infection was significantly less frequent among volunteers with asthma than among controls (OR 0.84; 95% CI 0.73–0.96, P = 0.013) (Zhou et al, 2013).…”

Section: Association Between H Pylori Infection and Atopy Allergy mentioning

confidence: 99%

Helicobacter, Hygiene, Atopy, and Asthma

et al. 2017

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The hygiene hypothesis links environmental and microbial exposures in early life to the prevalence of atopy, allergy, and asthma. Helicobacter pylori infection is typically acquired in childhood and acquisition of the infection is associated with poor household hygiene. Some population surveys have shown an inverse association between H. pylori infection and atopy, allergy, and asthma leading to the suggestion that H. pylori infection may be protective against disease; others consider it simply a biomarker for poor household hygiene. We review the relevant surveys, cohort studies, meta-analyses, and studies testing the protective hypothesis. Overall, the results of surveys and cohort studies are inconsistent, whereas meta-analyses show a significant but weak inverse correlation. In contrast, studies directly testing the protection hypothesis in relation to asthma in populations with poor hygiene and low H. pylori prevalence failed to confirm a protective effect. H. pylori is a major cause of human disease including chronic gastritis, peptic ulcer, and gastric malignancies. H. pylori infections most likely serve as a biomarker for poor hygienic conditions in childhood. We conclude that while synergistic interactions between environmental factors in childhood are important determinants of the pathogenesis of atopy, allergy, and asthma; H. pylori is inversely related to good hygiene and thus it's presence serves as a biomarker rather than for a specific prevention role for H. pylori or H. pylori antigens.

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“…However, a long-term evaluation was not conducted. Moreover, individuals without H. pylori infection present with few allergic diseases [16]. To date, the safety of H. pylori eradication therapy using proton-pump inhibitor and P-CAB in children is controversial.…”

Section: Introductionmentioning

confidence: 99%

Gut Microbiota Changes During Helicobacter Pylori Eradication with Vonoprazan-Containing Triple Therapy Among Adolescents: A Prospective Multicenter Study in Japan

Kakiuchi

Yamamoto

Imamura

et al. 2020

Preprint

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Background: Whether the screening and treatment of Helicobacter pylori infection are safe for children is debated in Japan. This study aimed to evaluate the safety of Helicobacter pylori eradication therapy by examining long-term changes in the gut microbiota during therapy among children.Methods: Children with anti-Helicobacter pylori antibody in the urine and Helicobacter pylori antigen in the feces were enrolled in this study. Their stool samples were collected at three time points, which were as follows: prior to treatment, 1–2 days after treatment, and time of judgment of eradication therapy. After treatment, the relative abundance, alpha-diversity, and beta-diversity of the gut microbiota were assessed.Results: In 16 students finally included in the study, the number of Actinobacteria isolated decreased immediately after eradication therapy, and it returned to pretreatment condition at the judgment point. There was no change at the genus level. The alpha-diversity was lost immediately after eradication therapy. However, it recovered at the time of eradication judgment, and it was restored before eradication therapy. Meanwhile, there was no change in beta-diversity, and none of the participants experienced serious adverse events.Conclusion: Helicobacter pylori eradication therapy is safe even for children in the view point of gut microbiota. Thus, further long-term evaluations of changes in the gut microbiota after eradication therapy and an assessment of healthy children without Helicobacter pylori must be performed. These will in turn promote screening and treatment among adolescents to prevent gastric cancer.Trial registration: This study was registered with the University Hospital Medical Information Network Clinical Trials Registry (no. UMIN000028726, https://upload.umin.ac.jp/cgi-bin/ctr_e/ctr_view.cgi?recptno=R000032873) on 18 August 2017.

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Helicobacter pyloriinfection and atopic diseases: Is there a relationship? A systematic review and meta-analysis

Abstract: There is some evidence of an inverse association between atopy/allergic diseases and H. pylori infection, although further studied are needed.

Cited by 34 publications

References 34 publications

Clinical features of Helicobacter pylori antibody‐positive junior high school students in Nagano Prefecture, Japan

Clinical features of Helicobacter pylori antibody‐positive junior high school students in Nagano Prefecture, Japan

Helicobacter, Hygiene, Atopy, and Asthma

Gut Microbiota Changes During Helicobacter Pylori Eradication with Vonoprazan-Containing Triple Therapy Among Adolescents: A Prospective Multicenter Study in Japan

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