Seroprevalence of Helicobacter Pylori in Patients with Chronic Obstructive Pulmonary Disease and its Relation to Pulmonary Function Tests
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- Category: Vol. 78, June 2010
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Seroprevalence of Helicobacter Pylori in Patients with Chronic Obstructive Pulmonary Disease and its Relation to Pulmonary Function Tests,NAHLA F. KHATTAB, NEHAD A. EL-NASHAR, NESSRIEN M. EL-MARGOSHY and LILIAN N. HENNA
Abstract
Recent studies suggest an epidemiological association between Helicobacter pylori (H. pylori) infection and several extragastroduodenal pathologies, including cardiovascular, rheumatic, skin and liver diseases. The observed associations might be explained by the ability of H. pylori to secrete a variety of inflammatory mediators which plays an important role in the pathogenesis of certain extradigestive disorders. In patients with ischemic heart disease, an extremely high prevalence of the cytotoxin-associated gene-A (CagA) positive virulent strain of H. pylori has also been reported. CagA positive are those strains that induce increased local and systemic, humoral and cellular inflammatory response. More-over, it has been reported that the risk of chronic bronchitis may be increased in H. pylori infected patients. The aim of the present study was to assess the seroprevalence of H. pylori and in particular of CagA positive virulent strains in patients with chronic obstructive pulmonary disease. This study enrolled 30 patients with chronic obstructive pulmonary diseases (20 men and 10 women), aged 59.22±6.63 years and 20 healthy control subjects (12 men and 8 women), aged 58.35±7.18 years matched for age and sex. The prevalence of H. pylori infection in patients and controls was 76.6% and 55%, respec-tively (p<0:001) and that of CagA-positive H. pylori infection was 53.3% and 35%, respectively (p<0:001). Moreover, COPD patients had a significantly increased mean serum concentration of both anti-H. pylori IgG (107.12±68.81 vs.54.00±39.76 U/ml, p<0:001) and anti-CagA IgG antibodies (34.38±21.49 vs. 18.30±11.12 U/ml, p<0:001). A comparison between pul-monary function tests of COPD patients and controls were carried out in this study. They were significantly lower among the COPD patients (p<0.001) when compared to the controls. In this study, FEV1, one of the respiratory parameters indicating airway damage and the severity of inflammation, was lower in H. pylori-seropositive COPD patients comparing to H.pylori seronegative COPD patients and controls, suggesting that H.pylori is associated with airway inflammation. In conclusion, H. pylori infection may be associated with COPD especially (CagA) positive strain which suggest that the activation of inflammatory mediators by H. pylori infection might be the pathogenetic mechanism underlying the observed association. Further studies should be undertaken to clarify the potential underlying pathogenetic mechanisms.