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EoE and H. pylori infection inversely associate

Written by Alfredo J Lucendo | Sunday, April 17th, 2016

von Arnim U, Wex T, Link A, Messerschmidt M, Venerito M, Miehlke S, Malfertheiner P. Helicobacter pylori infection is associated with a reduced risk of developing eosinophilic oesophagitis. Aliment Pharmacol Ther 2016;43(7):825-30

In the last two decades, a remarkable rise in incidence of eosinophilic esophagitis (EoE) has been observed. Since EoE is a chronic immune-mediated antigen mediated allergic disease of the esophagus it was postulated that environmental exposure play a pathogenentic role in developing EoE. In emerging nations early exposure to bacterial or viral infections are common due to low socioeconomic standard, family crowding and poor hygiene. These infections stimulate Th1 response, inhibiting the Th2 cytokines mediated allergic mechanism, representing the main pathogentic pathway of EoE. Furthermore, there is an established potential link between allergy and childhood infection especially with H. pylori and a protective role of H pylori has been attributed in several allergic conditions.
In a recently published paper Ulrike von Arnim and colleagues aimed to investigate in a case- control study whether H. pylori is associated with a reduced risk of developing EoE: 58 well documented EoE patients were compared to 116 age- and sex-matched control subjects. Serological evidence of H. pyliri was present in 5.2% of EoE patients and 8.6% reported prior eradication. In contrast, the seroprevalence in the control subjects was 37.9%, resulting in an Odds Ratio of 0.24 (95% confidence interval 0.11 – 0.50). This result indicates a strong inverse association between EoE and H. pylori. The results of this study may add a piece to the complex puzzle of pathomechanisms in epidemic EoE.
More information at: http://www.ncbi.nlm.nih.gov/pubmed/26898731