Helicobacter pyloriinfection and inflammatory bowel disease: Is there a link?

Abstract

Helicobacter pylori (H. pylori) infection is one of the most widely spread infectious diseases in humans. It can cause chronic gastritis, peptic ulcer disease and gastric malignancies and has been associated with extra-gastric disorders. H. pylori elicit a chronic systemic inflammatory response which, under certain conditions, may trigger autoimmune reactions and may be implicated in the pathogenesis of autoimmune diseases. Although the pathogenesis of inflammatory bowel disease (IBD) is unknown, it is thought to result from complex interactions between environmental factors and microbiota in the gut of individuals who are genetically susceptible. Several bacterial and viral agents have been implicated in the aetiology of IBD. In theory, H. pylori infection could be involved in the pathogenesis of IBD by inducing alterations in gastric and/or intestinal permeability or by causing immunological derangements resulting in absorption of antigenic material and autoimmunity via various immunological pathways. Similar mechanisms may also be responsible for the co-existence of IBD with other autoimmune diseases and/or extra-intestinal manifestations. However, the epidemiological data fail to support this association. In fact, various studies indicate that the prevalence of H. pylori infection is low in patients with IBD, suggesting a protective role for this infection in the development of IBD. In this report, we aim to shed light on proposed mechanisms and confounding factors underlying the potential link between H. pylori infection and IBD.

An overview of the bacterial contribution to Crohn disease pathogenesis

“…A role for Helicobacter species in IBD has also been proposed (Papamichael et al, 2014) (Table 2). However, findings are varied and, to date, have failed to support a definitive association in IBD (Hold et al, 2014).…”

Pathogenesis of Crohn’s disease: Bug or no bug

“…Case reports and epidemiological studies have observed that IBD may appear quickly after HP eradication, possibly due to a shift in the Th pattern. However, other studies have exposed that this lower preva-lence of HP in IBD might be secondary to HP "spontaneous eradication" with 5-ASA or antibiotic treatment [65] . Other Helicobacter species, like Helicobacter hepaticus, have shown their capability of inducing colitis in animals, mainly in immunocompromised ones.…”

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].…”

“…Helicobacter pylori (H. pylori) infection was also found to reveal a number of host immune responses which results in chronic inflammation [9]. The protective role of H. pylori infection on some autoimmune chronic inflammatory diseases such as inflammatory bowel disease was also reported [10]. Besides, H. pylori infection was found to take part in the pathogenesis of Rheumatoid arthritis (RA) [11].…”