Is Helicobacter pylori infection a risk factor for disease severity in systemic sclerosis?

Abstract

Helicobacter pylori (H. pylori) is suspected to be one of the factors triggering systemic sclerosis (SSc). Data on the possible role of H. pylori are lacking. The aim of this study was to assess the effect of H. pylori infection in SSc patients. Forty-two SSc patients without dyspeptic symptoms were recruited--26 were H. pylori-positive and 16 were H. pylori-negative on the basis of invasive test. We evaluated the disease severity using clinical and laboratory parameters according to the Medsger Severity Scale. The level of SSc activity was evaluated according to Valentini activity score. The prevalence of H. pylori infection in population of SSc patients is 62%. Severity of skin, gastrointestinal, and joint/tendon involvement was different between H. pylori-positive and -negative SSc patients (p < 0.001 for skin involvement, p = 0.002 and p = 0.03 for gastrointestinal and joint/tendon involvement, respectively) as well as erythrocyte sedimentation rate (p = 0.002). Severity score according to Medsger was higher in the H. pylori-positive than in the H. pylori-negative SSc patients (p < 0.001). Our data suggest that H. pylori infection correlates with severity of skin, gastrointestinal, and joint/tendon involvement in SSc patients. H. pylori-positive SSc patients showed higher severity score compared to H. pylori-negative. Therefore, H. pylori infection may play a role in the pathogenesis of SSc and also can provide some prognostic information.

Review article: pathogenesis and clinical manifestations of gastrointestinal involvement in systemic sclerosis

“…Evidence that a strong genetic component is linked to GIT SSc is highlighted by a study demonstrating that Canadian North American Native patients had more severe GIT involvement compared to Caucasian Americans . Studies have also demonstrated a high prevalence of Helicobacter pylori infection in SSc patients, supporting a role for an infectious aetiology . Fibroproliferative vasculopathy, immune dysfunction and fibrosis have been postulated as pathogenic mechanisms of GIT dysfunction and structural alterations in SSc (Figure ).…”

Gastrointestinal Involvement in Systemic Sclerosis: Overview, Neglected Aspects, Malnutrition, Body Composition and Management

“…Another study identified some haplotypes in an American native population (Choctaw Indians) strongly associated with SSc and more severe progression of this disease (HLA-DRB1*1602, DQB1*0301 and DQA1*0501) [8]. Some studies have also reported high prevalence of Helicobacter infection in SSc patients, supporting the hypothesis of infectious aetiology [9]. Smoking has been identified as the only environmental factor associated with increased severity of GIT symptoms in SSc [10].…”

“…Identify pathoorganisms triggering the disease (e.g. Helicobacter pylori[9]) Identify the insult/toxin triggering the disease (smoking, exposition to toxic substances, etc. )…”

Helicobacter pylori as a trigger and aggravating factor in rheumatoid arthritis and other rheumatic diseases

“…В относительно недавнем исследовании M. Radic и соавт. [48] выявили четкую связь между активностью ПСС (в част-ности, выраженностью кожного счета) и наличием H. pylori.…”