Association Between Patients’ Immunoglobulin E Levels and Difficulty Eradicating Helicobacter pylori

Abstract

Background: Helicobacter pylori is a cause of gastric cancer, and thus the eradication of this bacterium is very important. The success rate of primary eradication has been dramatically increased by the introduction of potassium-competitive acid blockers. However, H. pylori cannot be eradicated in all patients, and the contributing factors need to be clarified. Aim: Because allergy status may be a factor and considering research linking hay fever with eradication failure, the purpose of this study was to examine blood immunoglobulin E levels as a contributing factor in patients who were unable to eradicate H. pylori in a single eradication treatment and who underwent multiple eradication attempts. Methods: Questionnaire data were collected from 250 patients who visited the Department of Gastroenterology, Hamamatsu University School of Medicine, for H. pylori eradication. In addition, non-specific IgE levels in the blood were measured and analyzed with one-way analysis of variance. Multinomial logistic regression analysis was performed to examine the association between the number of eradication attempts and the IgE level (< 500 vs ≥ 500 IU/mL). Results:The mean IgE values were 188.4, 211.9, and 744.0 IU/mL in patients with one, two, and three or more eradication attempts, respectively (P < 0.05). The results of multinomial logistic regression analysis showed that attempting eradication three or more times was significantly associated with high levels of IgE, even after consideration of antibiotic sensitivity. Conclusion: H. pylori eradication was less likely in patients with high IgE. It is thus necessary to study the appropriate regimen for patients with high IgE levels.

Relationship of the Difficulty of Helicobacter pylori Eradication with Drinking Habits and Allergic Disease

“…Although the success rate of eradication has increased in recent years, some people still struggle to eradicate H. pylori , and this may be due to patient factors. In a previous study, we found that patients with high IgE levels were less likely to achieve eradication, even after taking into account their sensitivity to the antimicrobial agents used for eradication [ 8 ]. This study suggested that patients with allergic diseases may be more likely to experience eradication failure because they tend to have higher IgE levels.…”

“…We previously found that eradication failure is associated with hay fever in 2016 [ 6 ], with alcohol consumption in female patients in 2019 [ 7 ], and with high IgE levels taking into account antimicrobial susceptibility in 2021 [ 8 ]. Previous studies have thus shown that pollinosis, IgE levels, and alcohol consumption each affect the failure of H. pylori eradication, but the relationship between these factors and their mechanisms has not been clarified.…”

“…In this study, because high IgE levels are associated with bacteria eradication failure [ 8 ], we aimed to clarify the factors causing high IgE levels. In particular, we focused on patients with allergic diseases and their drinking habits, considering the possibility that a history of allergic diseases [ 6 ] and alcohol consumption [ 7 ] may be related, according to our previous work.…”