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Chronic infection with Helicobacter pylori does not provoke major systemic inflammation in healthy adults: results
H Brenner1, G Berg, M Fröhlich
1Department of Epidemiology, University of Ulm, Helmholtzstrasse 22, D-89081, Ulm, Germany. hermann.brenner@medizin.uni-ulm.de
Insights
Chronic Helicobacter pylori (H. pylori) infection, even with virulent CagA strains, did not correlate with major systemic inflammation markers like C-reactive protein. However, H. pylori infection showed an inverse relation with serum albumin levels.
Area of Science:
- Gastroenterology
- Cardiovascular Disease
- Immunology
Background:
- Chronic Helicobacter pylori (H. pylori) infection is hypothesized to increase coronary heart disease risk via persistent inflammation.
- Virulent H. pylori strains producing cytotoxin-associated protein (CagA) are of particular interest.
Purpose of the Study:
- To investigate the association between H. pylori infection serological markers and systemic inflammation.
- To determine if CagA-positive H. pylori strains are linked to increased inflammation.
Main Methods:
- Population-based study of 1834 adults (aged 18-88).
- Assessed serological markers for H. pylori infection (IgG) and CagA status.
- Measured C-reactive protein, leukocyte count, and serum albumin levels.
Main Results:
- 39.3% of participants showed positive H. pylori IgG response; a majority of these were CagA positive.
- H. pylori infection was not associated with C-reactive protein or leukocyte count, irrespective of CagA status.
- An inverse relationship was observed between H. pylori infection and serum albumin levels.
Conclusions:
- The study does not support the hypothesis that chronic H. pylori infection, even with virulent strains, causes significant systemic inflammation.
- The inverse association between H. pylori infection and serum albumin warrants further investigation into its mechanisms and clinical relevance.
Abstract:
It has been suggested that chronic infection with Helicobacter pylori (H. pylori), in particular infection with virulent strains producing the cytotoxin-associated protein CagA, may increase the risk of coronary heart disease by generation of a persistent low-grade inflammatory stimulus. We assessed the relation between serological markers of H. pylori infection and various markers of systemic inflammation in a population-based sample of 1834 men and women aged 18-88. A total of 39.3% of the sample had a positive IgG response, and among these a slight majority was CagA positive. Infection with H. pylori was unrelated to C-reactive protein and the leukocyte count, regardless of CagA status. There was an inverse relation between H. pylori infection and serum albumin. The adjusted OR (95% CI) of an albumin level in the bottom versus the top third were 2.2 (1.5-3.1) and 2.0 (1.4-3.1) for infection with CagA-positive and CagA-negative H. pylori strains, respectively. These results do not support the hypothesis that chronic infection with virulent H. pylori strains provokes major systemic inflammation. The mechanisms underlying the inverse association between H. pylori infection and serum albumin and the clinical relevance of this finding require further research.