Relationship Between Helicobacter Pylori Infection and Chronic Respiratory Disease: A Two-sample Mendelian Randomization Study

Abstract

Background Although many studies have found an association between Helicobacter pylori (H. pylori) infection and chronic respiratory disease, the conclusions are not uniform across studies and the exact relationship remains unclear. Methods We explored the bidirectional causal relationship between H. pylori infection and chronic respiratory disease using a two-sample Mendelian Randomization (MR) method. Data on exposure and outcomes were obtained from the publicly available genome-wide association study (GWAS) database, data on H. pylori infection were obtained from the European Bioinformatics Institute (EBI) database, while chronic respiratory disease from the FinnGen database. The inverse variance weighting (IVW) was used as the primary statistical method. Results MR analyses showed that genetically predicted H. pylori infection had no effect on any of the five chronic respiratory diseases under the Wald ratio and IVW methods. The three MR methods, IVW, MR-Egger, and weighted median (WM), showed that H. pylori infection did not have an effect on any of the four chronic respiratory diseases (asthma, chronic obstructive pulmonary disease (COPD), lung cancer, and bronchiectasis). The IVW method showed that idiopathic pulmonary fibrosis (IPF) was associated with a H. pylori infection risk reduction (OR = 0.97; p = 0.041), which was not significant using the MR-Egger and WM methods. Conclusion Our results found that H. pylori infection had no effect on chronic respiratory diseases, and asthma, COPD, lung cancer, and bronchiectasis have no effect on H. pylori infection, whereas IPF has a mild protective effect against H. pylori infection.