Respiratory Diseases and <i>Helicobacter pylori</i> Infection: Is There a Link?

Abstract

Recent studies suggest an epidemiological association between Helicobacter pylori infection and several extragastroduodenal pathologies, including cardiovascular, rheumatic, skin and liver diseases. The observed associations might be explained by a role of H. pylori infection in the pathogenesis of certain extradigestive disorders, as a variety of inflammatory mediators are activated by H. pylori infection. The present review summarizes the current literature, including our own studies, concerning the association between respiratory diseases and H. pylori infection. A small number of epidemiological and serologic case-control studies suggest that patients with chronic obstructive pulmonary disease have an increased seroprevalence of H. pylori. A frequent coexistence of bronchiectasis and H. pylori infection has also been found. Moreover, recent studies have shown an increased prevalence of H. pylori infection in patients with pulmonary tuberculosis and in those with lung cancer. On the other hand, bronchial asthma does not seem to be related to H. pylori infection. At present, there is no definite proof of a causal relationship between H. pylori and respiratory diseases. The primary evidence rests on case-control studies, concerning relatively small numbers of patients. Future studies should be large enough for moderate-sized effects to be assessed or registered reliably. The activation of inflammatory mediators by H. pylori infection might be the pathogenetic mechanism underlying the observed associations. Therefore, the role of genetic predisposition of the infected host, the presence of strain-specific virulence factors and the serum concentration of proinflammatory markers in H. pylori-infected patients with respiratory diseases need further evaluation.

<I>HELICOBACTER PYLORI</I> INFECTION IN NEVER-SMOKING MALE PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND ITS RELATION TO LUNG FUNCTION

“…It is believed that the release of proinflammatory cytokines, e.g., Interleukin-1 (IL-1), IL-8, IL-17, IL-23 and Tumor Necrosis Factor-ά (TNF-ά), stimulated by H. pylori infection plays a role in the chronic inflammation of bronchi (Roussos et al, 2006;Jafarzadeh et al, 2009;Cornwell et al, 2010). Moreover, serum levels of these cytokines normalize following eradication therapy of H. pylori (Kountouras et al, 2000).…”

“…Helicobacter pylori (H. pylori) is a microaerophilic spiral-shaped gram negative bacterium that chronically infects the stomach of more than 50% of the human population (varying from over 70% in developing countries to less than 40% in developed countries) and represents the major cause of gastroduodenal pathologies Science Publications AJI (e.g., chronic active gastritis, peptic ulcer, B-cell lymphoma and gastric carcinoma) (Wotherspoon et al, 1999;Parsonnet et al, 1991;D'Elios et al, 1997). Some recent epidemiologic and serologic studies have reported a relationship between H. pylori seropositivity, especially of the high virulent cytotoxin-asssociated gene A (CagA) positive strains and extra-gastroduodenal diseases, such as vascular (coronary artery disease and stroke), metabolic (autoimmune atrophic thyroiditis), rheumatic (Henoch-Schönlein purpura), dermatologic (chronic urticaria and rosacea), as well as respiratory diseases (chronic bronchitis, COPD, bronchiectasis, asthma and lung cancer) (Whincup et al, 1996;Luis et al, 1998;Tsang et al, 1998;Roussos et al, 2006;Jun et al, 2006;Behroozian and Moradkhan, 2010). The activation of inflammatory mediators as a result of systemic immune response induced by H. pylori infection may be potential explanation for these associations (Kanbay et al, 2007).…”

The Impact of the Gut Microbiota on Human Health: An Integrative View

“…A Gram-negative pathogen linked with gastric ulcers and stomach cancer, H. pylori has been associated with humans for at least 58,000 years, although most of us carry it asymptomatically (Linz et al, 2007). Infection by H. pylori is intriguingly correlated with respiratory diseases such as chronic obstructive pulmonary disease (COPD) and pulmonary tuberculosis (Roussos et al, 2006). The evidence is, however, contradictory on the nature of this correlation: some studies show an increased risk of developing diseases in subjects infected by H. pylori (Roussos et al, 2002), but recent work by Perry and colleagues observed the opposite effect, where H. pylori confers protection against tuberculosis (Perry et al, 2010).…”

Helicobacter pylori seroprevalence in children with sleep-disordered breathing

“…According to known literature, studies indicate that the low rate of positivity for HP in patients with respiratory diseases suggests that HP infection has no role in recurrent respiratory tract infections in children and in adults [21,24]. According to statements by ESGHAN (2011), studies concerning the relationship between HP and respiratory tract symptoms are inadequate and there is currently insufficient evidence that HP infection is causally related to upper respiratory tract infections [13].…”

“…A high rate of seropositivity for antibodies against HP has been also found in many extra-gastrointestinal diseases including iron deficiency anaemia, rheumatic or liver diseases, as well as illnesses affecting the cardiovascular system or skin [22]. Respiratory consequences or effects of an HP infection have also been discussed [12,24]. The ability of HP to have multiple organ effects is derived from the rod's ability to stimulate a strong M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT generalized immune response by the release of various cytotoxic substances which are bacterial and host-dependent.…”