<i>Helicobacter pylori</i> Infection Affects Eosinophilic Cationic Protein in the Gastric Juice of Patients with Idiopathic Chronic Urticaria

Abstract

Background:Helicobacter pylori, the main cause of gastritis and peptic ulcer, has been associated with idiopathic chronic urticaria (ICU), an immunological skin disorder of unknown origin. Eosinophilic cationic protein (ECP) is a cytotoxic molecule secreted by the activated eosinophils involved in the pathogenesis of ICU. We assessed serum/gastric juice ECP levels and gastric mucosal eosinophil infiltration in ICU patients infected or not with H. pylori and evaluated the modification after bacterium eradication. Methods: 33 patients with ICU and 25 dyspeptic controls underwent upper gastrointestinal endoscopy for histological evaluation and assessment of H. pylori infection. One-week triple therapy was given to H. pylori-positive patients. Serum and gastric juice ECP levels, eosinophil infiltration from gastric mucosal sections and urticaria symptoms were evaluated in all patients at enrolment and 8 weeks after eradication. Results: 19 of 33 (57%) ICU patients and 16 of 25 (64%) controls were found to be infected with H. pylori. Serum ECP was significantly higher in ICU patients compared to controls, regardless of infectious status. Gastric juice ECP and gastric eosinophil infiltration were significantly higher in infected ICU patients when compared both to uninfected ICU patients and controls. H. pylori eradication determined a significant decrease in gastric juice ECP and gastric eosinophil infiltration only in ICU patients. Moreover, a total or partial remission of urticaria symptoms was observed only in ICU patients in whom the bacterium was eradicated. Conclusions: Although H. pylori infection affects gastric juice ECP and eosinophil infiltration of ICU patients, the role of the bacterium in the pathogenesis of this skin disorder still remains uncertain.

Eosinophil infiltration, gastric juice and serum eosinophil cationic protein levels in Helicobacter pylori‐associated chronic gastritis and gastric ulcer

“…We also found in accordance with the aforementioned studies that eosinophil infiltration in gastric mucosa and gastric juice ECP levels increased in H. pylori-positive patients. Ojetti et al 34 assessed serum/gastric juice ECP levels and gastric mucosal eosinophil infiltration in idiopathic chronic urticaria patients infected or not with H. pylori and evaluated the modification after bacterium eradication. However, they found that H. pylori infection affects gastric juice ECP and eosinophil infiltration of only idiopathic chronic urticaria patients.…”

Acquired angioedema and Helicobacter pylori infection in a child

“…Increased prevalence of H. pylori-associated gastritis in chronic urticaria is linked with the speculation of H. pylori production of enzymes, cytokines and direct histamine release [6,8]. There has been a well reported study on the subject of hereditary angioedema in adult patients, simultaneous prevalence of H. pylori and the effective H. pylori eradication in oedematous episodes [3].…”

“…Helicobacter pylori is a worldwide human pathogen that causes peptic ulceration and chronic gastritis in both adults and children [6,8]. The host immune reaction to H. pylori infection contributes to the final outcome of the disease.…”

Comorbidities in Chronic Spontaneous Urticaria

“…have been suspected to be triggering factors in patients with CSU [3]. Especially, Hp infection was popularly investigated in the pathogenesis of CSU [48,49]. It is thought that Hp infections could be a triggering factor in underlying autoimmune pathology of CSU [50], and there are studies showing that Hp infection is related to production of autoreactive IgM and IgG3 antibodies [51].…”