The Contribution of Drugs and Helicobacter pylori to Gastric Mucosa Changes in Patients with Systemic Lupus Erythematosus and Antiphospholipid Syndrome

Abstract

Background. The nature and rate of gastric mucosal (GM) damage in systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS) remain to be among the unsolved problems. Objective. To define the role of H. pylori and drugs in the development of GM damages in SLE and APS. Methods. A study was conducted on 85 patients with SLE and APS. All the patients underwent esophagogastroduodenoscopy with targeted biopsy of the mucosa of the gastric body and antrum. The presence of H. pylori in the gastric biopsy specimens was determined using polymerase chain reaction. Results. Endoscopic examination revealed that the patients with SLE and APS on admission had the following GM changes: antral gastritis (82.4%), erosions (24.7%), hemorrhages (8.2%), and pangastritis (8.2%). SLE and APS patients showed no direct correlation between the found GM damages and the presence of H. pylori. The use of glucocorticoid, low-dose acetylsalicylic acid, nonsteroidal anti-inflammatory drug, and anticoagulant in SLE and APS patients is accompanied by GM damage. Conclusion. There was no evidence of the role of H. pylori in GM damage in the SLE and APS patients. More frequent detection of H. pylori was observed in anticoagulants or low-dose acetylsalicylic acid users than in glucocorticoids and nonsteroidal anti-inflammatory drugs ones.

Helicobacter pylori and its association with autoimmune diseases: systemic lupus erythematosus, rheumatoid arthritis and Sjögren syndrome

“…Reshetnyak et al [ 55 ] found significant differences in the detection rate of H. pylori with respect to the drugs used to treat SLE; the rate is higher with anticoagulant therapy (P = 0.038; OR = 2.96; 95% CI, 1.01–8.68) and low-dose acetylsalicylic acid (P = 0.031; OR = 3.58; 95% CI, 1.05–12.17) than for glucocorticoid and NSAID users. Nevertheless, Mendoza-Pinto et al [ 46 ] reported that immunosuppressive or glucocorticoid therapy did not increase the prevalence of H. pylori infection in patients with SLE.…”

“…Furthermore, there is no higher prevalence of gastroduodenal mucosal lesions or reflux disease in SLE patients with H. pylori infection than in the general population [ 46 , 55 ].…”

“…H. pylori infections are of concern for patients with autoimmune diseases for several reasons. First, autoimmune diseases are related to low immune competence due to disease manifestations or pharmacologic treatment; thus, H. pylori infection risk increases [ 10 ]. Secondly, the side effects of non-steroidal anti-inflammatory drugs (NSAID) may cause additive damage [ 11 ].…”

Gastrointestinal Manifestations in Patients with Systemic Lupus Erythematosus

“…Those who tested H. pylori positive in a polymerase chain reaction test had a lower frequency of gastric erosions. 35 Additional research is required to assess the relationship between H. pylori infection and the risk of gastroduodenal ulcers in lupus patients. Moreover, it remains to be clarified whether the use of NSAIDs has a positive or negative effect on H. pylori .…”

On the 40^th anniversary of the discovery of Helicobacter pylori

“…Reshetnyak и соавт. [47] пред ставлены данные о роли H. pylori и лекарственных препаратов в разви ти и п овреж д ен ий слизистой оболочки желудка (СОЖ) у пациентов с системной красной волчанкой (СКВ) и антифосфолипидны м си ндром ом (АФ С). У п ац иентов с СКВ и АФС при эндоскопическом исследовании вы являлись следующ ие изменения СОЖ: антральны й гастрит -у 82.4%, эрозии -у 24.7%, геморрагии -у 8.2%, пангастрит -у 8.2% пациентов.…”