Helicobacter Pylori infection in children with inflammatory bowel disease: a prospective multicenter study.
Humans
Helicobacter Infections
/ complications
Child
Male
Female
Adolescent
Prospective Studies
Helicobacter pylori
Child, Preschool
Colitis, Ulcerative
/ complications
Crohn Disease
/ complications
Severity of Illness Index
Inflammatory Bowel Diseases
/ complications
Gastroscopy
Follow-Up Studies
Anti-Bacterial Agents
/ therapeutic use
H. pylori gastritis
Helicobacter pylori infection
Children
Inflammatory Bowel Disease
Journal
BMC pediatrics
ISSN: 1471-2431
Titre abrégé: BMC Pediatr
Pays: England
ID NLM: 100967804
Informations de publication
Date de publication:
29 Jun 2024
29 Jun 2024
Historique:
received:
01
11
2023
accepted:
20
06
2024
medline:
2
7
2024
pubmed:
2
7
2024
entrez:
2
7
2024
Statut:
epublish
Résumé
The relationship between Helicobacter-pylori(Hp)infection and inflammatory-bowel-disease(IBD) in pediatric-patients remains controversial. We aimed to assess the Hp-infection occurrence in newly-diagnosed pediatric-patients with IBD compared to no-IBD patients. Additionally, we aimed to examine differences in clinical-activity-index(CAI) and endoscopic-severity-score(ESS)between IBD-patients with and without Hp-infection, at baseline and at 1-year-follow-up(FU), after eradication-therapy(ET). IBD diagnosis was based on Porto-criteria, and all patients underwent gastroscopy at baseline and 1-year FU. For Crohn's-disease(CD) and ulcerative colitis(UC), IBD-CAI and -ESS were classified using PCDAI/SES-CD and PUCAI/UCEIS, respectively. 76 IBD-patients were included in the study[35 F(46.1%),median-age 12(range 2-17)]. CD and UC were diagnosed in 29(38.2%) and 45(59.2%)patients, respectively, and unclassified-IBD in two(2.6%)patients. Non-IBD patients were 148[71 F(48.0%),median-age 12(range 1-17)]. Hp-infection at baseline was reported in 7(9.2%) and 18(12.2%)IBD and non-IBD patients, respectively(p = 0.5065). The 7 IBD patients with Hp infection were compared to 69 IBD patients without Hp-infection at baseline evaluation, and no significant differences were reported considering CAI and ESS in these two groups. At 1-year FU, after ET, IBD patients with Hp infection improved, both for CAI and ESS, but statistical significance was not reached. The occurrence of Hp-infection did not differ between IBD and no-IBD patients. No differences in CAI or ESS were observed at the diagnosis, and after ET no worsening of CAI or ESS was noted at one-year FU, between Hp-positive and -negative IBD patients.
Sections du résumé
BACKGROUND
BACKGROUND
The relationship between Helicobacter-pylori(Hp)infection and inflammatory-bowel-disease(IBD) in pediatric-patients remains controversial. We aimed to assess the Hp-infection occurrence in newly-diagnosed pediatric-patients with IBD compared to no-IBD patients. Additionally, we aimed to examine differences in clinical-activity-index(CAI) and endoscopic-severity-score(ESS)between IBD-patients with and without Hp-infection, at baseline and at 1-year-follow-up(FU), after eradication-therapy(ET).
METHODS
METHODS
IBD diagnosis was based on Porto-criteria, and all patients underwent gastroscopy at baseline and 1-year FU. For Crohn's-disease(CD) and ulcerative colitis(UC), IBD-CAI and -ESS were classified using PCDAI/SES-CD and PUCAI/UCEIS, respectively.
RESULTS
RESULTS
76 IBD-patients were included in the study[35 F(46.1%),median-age 12(range 2-17)]. CD and UC were diagnosed in 29(38.2%) and 45(59.2%)patients, respectively, and unclassified-IBD in two(2.6%)patients. Non-IBD patients were 148[71 F(48.0%),median-age 12(range 1-17)]. Hp-infection at baseline was reported in 7(9.2%) and 18(12.2%)IBD and non-IBD patients, respectively(p = 0.5065). The 7 IBD patients with Hp infection were compared to 69 IBD patients without Hp-infection at baseline evaluation, and no significant differences were reported considering CAI and ESS in these two groups. At 1-year FU, after ET, IBD patients with Hp infection improved, both for CAI and ESS, but statistical significance was not reached.
CONCLUSION
CONCLUSIONS
The occurrence of Hp-infection did not differ between IBD and no-IBD patients. No differences in CAI or ESS were observed at the diagnosis, and after ET no worsening of CAI or ESS was noted at one-year FU, between Hp-positive and -negative IBD patients.
Identifiants
pubmed: 38951792
doi: 10.1186/s12887-024-04902-z
pii: 10.1186/s12887-024-04902-z
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
417Informations de copyright
© 2024. The Author(s).
Références
Shirzad-Aski H, Besharat S, Kienesberger S, Sohrabi A, Roshandel G, Amiriani T, et al. Association between helicobacter pylori colonization and inflammatory bowel disease: a systematic review and meta-analysis. J Clin Gastroenterol. 2021;55(5):380–92.
doi: 10.1097/MCG.0000000000001415
pubmed: 32833699
Sonnenberg A, Genta RM. Low prevalence of Helicobacter pylori infection among patients with inflammatory bowel disease. Aliment Pharmacol Ther. 2012;35(4):469–76.
doi: 10.1111/j.1365-2036.2011.04969.x
pubmed: 22221289
Tursi A. Onset of Crohn’s disease after helicobacter pylori eradication. Inflamm Bowel Dis. 2006;12(10):1008–9.
doi: 10.1097/01.mib.0000235100.09231.d7
pubmed: 17012975
Jovanovic IR, Milosavjevic TN, Jankovic GP, Micev MM, Dugalic PD, Saranovic D, et al. Clinical onset of the Crohn’s disease after eradication therapy of Helicobacter pylori infection. Does Helicobacter pylori infection interact with natural history of inflammatory bowel diseases? Med Sci Monit Int Med J Exp Clin Res. 2001;7(1):137–41.
Chiba M, Tsuji T, Takahashi K, Komatsu M, Sugawara T, Ono I. Onset of Ulcerative Colitis after Helicobacter pylori Eradication Therapy: A Case Report. Perm J. 2016;20(2):e115-118.
doi: 10.7812/TPP/15-085
pubmed: 27043835
pmcid: 4867841
Fujita Y, Tominaga K, Tanaka T, Sugaya T, Yoshihara S. Ulcerative colitis relapse after Helicobacter pylori eradication in a 12-year-old boy with duodenal ulcer. BMC Gastroenterol. 2021;21(1):424.
doi: 10.1186/s12876-021-02010-1
pubmed: 34758726
pmcid: 8579552
von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Int J Surg Lond Engl. 2014;12(12):1495–9.
doi: 10.1016/j.ijsu.2014.07.013
Levine A, Koletzko S, Turner D, Escher JC, Cucchiara S, de Ridder L, et al. ESPGHAN revised porto criteria for the diagnosis of inflammatory bowel disease in children and adolescents. J Pediatr Gastroenterol Nutr. 2014;58(6):795–806.
doi: 10.1097/MPG.0000000000000239
pubmed: 24231644
Hyams JS, Ferry GD, Mandel FS, Gryboski JD, Kibort PM, Kirschner BS, et al. Development and validation of a pediatric Crohn’s disease activity index. J Pediatr Gastroenterol Nutr. 1991;12(4):439–47.
pubmed: 1678008
Turner D, Otley AR, Mack D, Hyams J, de Bruijne J, Uusoue K, et al. Development, validation, and evaluation of a pediatric ulcerative colitis activity index: a prospective multicenter study. Gastroenterology. 2007;133(2):423–32.
doi: 10.1053/j.gastro.2007.05.029
pubmed: 17681163
Norsa L, Ferrari A, Arrigo S, Bramuzzo M, Deganello Saccomani M, Di Nardo G, et al. Scoring Endoscopy in Pediatric Inflammatory Bowel Disease: A Way to Improve Quality. J Pediatr Gastroenterol Nutr. 2021;73(1):48–53.
doi: 10.1097/MPG.0000000000003090
pubmed: 33720096
Turner D, Ruemmele FM, Orlanski-Meyer E, Griffiths AM, de Carpi JM, Bronsky J, et al. Management of paediatric ulcerative colitis, part 1: ambulatory care-an evidence-based guideline from european crohn’s and colitis organization and european society of paediatric gastroenterology, hepatology and nutrition. J Pediatr Gastroenterol Nutr. 2018;67(2):257–91.
doi: 10.1097/MPG.0000000000002035
pubmed: 30044357
van Rheenen PF, Aloi M, Assa A, Bronsky J, Escher JC, Fagerberg UL, et al. The Medical Management of Paediatric Crohn’s Disease: an ECCO-ESPGHAN Guideline Update. J Crohns Colitis. 2020;7:jjaa161.
Dixon MF, Genta RM, Yardley JH, Correa P. Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994. Am J Surg Pathol. 1996;20(10):1161–81.
doi: 10.1097/00000478-199610000-00001
pubmed: 8827022
Jones NL, Koletzko S, Goodman K, Bontems P, Cadranel S, Casswall T, et al. Joint ESPGHAN/NASPGHAN Guidelines for the Management of Helicobacter pylori in Children and Adolescents (Update 2016). J Pediatr Gastroenterol Nutr. 2017;64(6):991–1003.
doi: 10.1097/MPG.0000000000001594
pubmed: 28541262
Francavilla R, Lionetti E, Castellaneta SP, Magistà AM, Boscarelli G, Piscitelli D, et al. Improved efficacy of 10-Day sequential treatment for Helicobacter pylori eradication in children: a randomized trial. Gastroenterology. 2005;129(5):1414–9.
doi: 10.1053/j.gastro.2005.09.007
pubmed: 16285942
Roka K, Roubani A, Stefanaki K, Panayotou I, Roma E, Chouliaras G. The prevalence of Helicobacter pylori gastritis in newly diagnosed children with inflammatory bowel disease. Helicobacter. 2014;19(5):400–5.
doi: 10.1111/hel.12141
pubmed: 24827117
Parente F, Molteni P, Bollani S, Maconi G, Vago L, Duca PG, et al. Prevalence of Helicobacter pylori infection and related upper gastrointestinal lesions in patients with inflammatory bowel diseases. A cross-sectional study with matching. Scand J Gastroenterol. 1997 Nov; 32(11):1140–6.
doi: 10.3109/00365529709002994
pubmed: 9399396
Ando T, Watanabe O, Ishiguro K, Maeda O, Ishikawa D, Minami M, et al. Relationships between Helicobacter pylori infection status, endoscopic, histopathological findings, and cytokine production in the duodenum of Crohn’s disease patients. J Gastroenterol Hepatol. 2008;23(Suppl 2):S193-197.
pubmed: 19120897
Ali I, Abdo Q, Al-Hihi SM, Shawabkeh A. Association between ulcerative colitis and Helicobacter pylori infection: A case-control study. Heliyon. 2022;8(2):e08930.
doi: 10.1016/j.heliyon.2022.e08930
pubmed: 35198786
pmcid: 8841358
Song MJ, Park DI, Hwang SJ, Kim ER, Kim YH, Jang BI, et al. The prevalence of Helicobacter pylori infection in Korean patients with inflammatory bowel disease, a multicenter study. Korean J Gastroenterol Taehan Sohwagi Hakhoe Chi. 2009;53(6):341–7.
doi: 10.4166/kjg.2009.53.6.341
pubmed: 19556840
Robinson K. Helicobacter pylori-Mediated Protection against Extra-Gastric Immune and Inflammatory Disorders: The Evidence and Controversies. Dis Basel Switz. 2015;3(2):34–55.
Rook GAW. Hygiene hypothesis and autoimmune diseases. Clin Rev Allergy Immunol. 2012;42(1):5–15.
doi: 10.1007/s12016-011-8285-8
pubmed: 22090147
Rook GA. Regulation of the immune system by biodiversity from the natural environment: an ecosystem service essential to health. Proc Natl Acad Sci U S A. 2013;110(46):18360–7.
doi: 10.1073/pnas.1313731110
pubmed: 24154724
pmcid: 3831972
Trujillo C, Erb KJ. Inhibition of allergic disorders by infection with bacteria or the exposure to bacterial products. Int J Med Microbiol IJMM. 2003;293(2–3):123–31.
doi: 10.1078/1438-4221-00257
pubmed: 12868649
Matricardi PM, Rosmini F, Riondino S, Fortini M, Ferrigno L, Rapicetta M, et al. Exposure to foodborne and orofecal microbes versus airborne viruses in relation to atopy and allergic asthma: epidemiological study. BMJ. 2000;320(7232):412–7.
doi: 10.1136/bmj.320.7232.412
pubmed: 10669445
pmcid: 27285
Araújo MI, Hoppe BS, Medeiros M, Carvalho EM. Schistosoma mansoni infection modulates the immune response against allergic and auto-immune diseases. Mem Inst Oswaldo Cruz. 2004;99(5 Suppl 1):27–32.
doi: 10.1590/S0074-02762004000900005
pubmed: 15486631
Mortimer K, Brown A, Feary J, Jagger C, Lewis S, Antoniak M, et al. Dose-ranging study for trials of therapeutic infection with Necator americanus in humans. Am J Trop Med Hyg. 2006;75(5):914–20.
doi: 10.4269/ajtmh.2006.75.914
pubmed: 17123987
Chen YC, Malfertheiner P, Yu HT, Kuo CL, Chang YY, Meng FT, et al. Global Prevalence of Helicobacter pylori Infection and Incidence of Gastric Cancer Between 1980 and 2022. Gastroenterology. 2024;166(4):605–19.
doi: 10.1053/j.gastro.2023.12.022
pubmed: 38176660
Major G, Spiller R. Irritable bowel syndrome, inflammatory bowel disease and the microbiome. Curr Opin Endocrinol Diabetes Obes. 2014;21(1):15–21.
doi: 10.1097/MED.0000000000000032
pubmed: 24296462
pmcid: 3871405
Hussain K, Letley DP, Greenaway AB, Kenefeck R, Winter JA, Tomlinson W, et al. Helicobacter pylori-Mediated Protection from Allergy Is Associated with IL-10-Secreting Peripheral Blood Regulatory T Cells. Front Immunol. 2016;7:71.
doi: 10.3389/fimmu.2016.00071
pubmed: 27014260
pmcid: 4779884
Takahashi M, Nakamura K, Honda K, Kitamura Y, Mizutani T, Araki Y, et al. An inverse correlation of human peripheral blood regulatory T cell frequency with the disease activity of ulcerative colitis. Dig Dis Sci. 2006;51(4):677–86.
doi: 10.1007/s10620-006-3191-2
pubmed: 16614988
Yokoyama Y, Fukunaga K, Fukuda Y, Tozawa K, Kamikozuru K, Ohnishi K, et al. Demonstration of low-regulatory CD25High+CD4+ and high-pro-inflammatory CD28-CD4+ T-Cell subsets in patients with ulcerative colitis: modified by selective granulocyte and monocyte adsorption apheresis. Dig Dis Sci. 2007;52(10):2725–31.
doi: 10.1007/s10620-006-9560-z
pubmed: 17404876
Maul J, Loddenkemper C, Mundt P, Berg E, Giese T, Stallmach A, et al. Peripheral and intestinal regulatory CD4+ CD25(high) T cells in inflammatory bowel disease. Gastroenterology. 2005;128(7):1868–78.
doi: 10.1053/j.gastro.2005.03.043
pubmed: 15940622
Papamichael K, Konstantopoulos P, Mantzaris GJ. Helicobacter pylori infection and inflammatory bowel disease: Is there a link? World J Gastroenterol WJG. 2014;20(21):6374–85.
doi: 10.3748/wjg.v20.i21.6374
pubmed: 24914359
Luther J, Dave M, Higgins PDR, Kao JY. Association between Helicobacter pylori infection and inflammatory bowel disease: a meta-analysis and systematic review of the literature. Inflamm Bowel Dis. 2010;16(6):1077–84.
doi: 10.1002/ibd.21116
pubmed: 19760778
Wu XW, Ji HZ, Yang MF, Wu L, Wang FY. Helicobacter pylori infection and inflammatory bowel disease in Asians: a meta-analysis. World J Gastroenterol. 2015;21(15):4750–6.
doi: 10.3748/wjg.v21.i15.4750
pubmed: 25914487
pmcid: 4402325
Rokkas T, Gisbert JP, Niv Y, O’Morain C. The association between Helicobacter pylori infection and inflammatory bowel disease based on meta-analysis. United Eur Gastroenterol J. 2015;3(6):539–50.
doi: 10.1177/2050640615580889