Detection of Helicobacter Pylori in Bronchoalveolar Lavage of Patients With Chronic Obstructive Pulmonary Disease by Real Time Polymerase Chain Reaction

Abstract

Background:Chronic obstructive pulmonary disease (COPD) is one of the most important causes of disability and mortality in the world. Although cigarette smoking and environmental pollutants have been recognized as the major causes of COPD, the role of infection in the pathogenesis and progression of COPD has also been reported.Objectives:The aim of the present study was to find the relationship between Helicobacter Pylori infection and COPD through anti H. pylori IgG serology, real time PCR of bronchoalveolar lavage and trans bronchial biopsy urease tests.Patients and Methods:This descriptive cross-sectional study was carried out on 60 adults with COPD. After obtaining the patient’s history, physical examination, spirometry and confirmation of COPD diagnosis by pulmonologist, subjects were selected through convenience sampling. In order to determine the severity and prognosis of disease, the global initiative for chronic obstructive lung disease (GOLD) criteria and BODE index were used. Subjects underwent bronchoscopy for obtaining bronchoalveolar lavage (BAL) samples and biopsy was performed. Biopsy and BAL samples were investigated respectively by urease test and real time PCR. Moreover, patients’ serum samples were serologically studied for detection of anti H. pylori IgG.Results:Mean age of the participants was 60.65 ± 9.15 years, and 25% were female and 75% were male. The prevalence rate of H. pylori in COPD patients was 10% according to real time PCR, 88.3% according to the serology test and 0% based on the urease test. According to the results of PCR and considering the severity of disease based on the GOLD criteria, from those with a positive PCR, one patient (16.6%) had very severe obstruction, three (50%) had severe obstruction and two patients (33.3%) had moderate obstruction. The relationship between H. pylori presence (based on PCR) and disease severity and prognosis was not statistically significant.Conclusions:These findings can justify the hypothesis of direct injury and chronic inflammation via inhalation and aspiration resulting in H. pylori colonization. In fact, it is thought that H. Pylori infection, beside the host genetic vulnerability and other environmental risk factors might make the patient susceptible to COPD or lead to COPD worsening. Although we found H. pylori infection in some patients with COPD, the results of this study, could not explain the pathogenic mechanisms of COPD.

Screening for <b><i>Helicobacter pylori</i></b> in Idiopathic Pulmonary Fibrosis Lung Biopsies

“…The discrepancy between HP seroprevalence as shown in the report by Bennett et al [22] and our negative results is in line with findings in other chronic lung diseases [16,27,28,29]. This leads to the hypothesis that HP microaspiration may not be directly involved in the induction or progression of fibrotic lung disease in IPF, but that gastric infection with HP initiates a systemic immune response that has an impact on the pulmonary system in susceptible patients.…”

“…Also, the small number of patients at risk of GER/microaspiration has to be considered, and it cannot be discounted that our cohort of patients at risk of microaspiration was not infected with HP. The major limitation of the current study, however, might be the absence of a control group with demonstration of positivity for HP in their lung specimens, even if this has recently been shown by others [23,24,29]. Furthermore, data on the seroprevalence of HP are missing due to the retrospective nature of our analyses.…”

“…First of all, there may be other explanations of why HP DNA was not detected in any of the IPF tissues, including possible technical reasons. In this regard, an important question raised by our results is whether HP is eliminated/dies shortly after microaspiration into the lungs, and whether this led to the negative findings of our study, even if HP has been isolated from tracheal secretions [32] and been detected by PCR in the upper and lower respiratory tract in other diseases, albeit inconsistently [29,33]. Also, the small number of patients at risk of GER/microaspiration has to be considered, and it cannot be discounted that our cohort of patients at risk of microaspiration was not infected with HP.…”

Detection of Helicobacter pylori in the Bronchoalveolar Lavage of Patients with Lung Cancer Using Real-Time PCR

“…This bacterium is associated with many respiratory diseases, including bronchiectasis, asthma, chronic bronchitis, pulmonary tuberculosis, and chronic obstructive pulmonary disease (COPD) (14-16). Prior to the identification of H. pylori , studies demonstrated a greater incidence of COPD and tuberculosis in patients with peptic ulcers compared with the general population (17).…”

Protective Effect of Eucalyptus Oil Against Pulmonary Destruction and Inflammation in COPD Rats

“…Chronic obstructive pulmonary disease (COPD) is characterised by chronic inflammation and irreversible airflow obstruction, mainly induced by cigarette smoking and noxious stimuli including infection [1]. Chronic and persistent inflammation results in emphysema and irreversible airway narrowing that resulted from protease, mucociliary dysfunction, oxidative stress or fibrosis around small airway.…”