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Persistent and transient Helicobacter pylori infections in early childhood
Miguel L O'Ryan1, Yalda Lucero2, Marcela Rabello2
1Microbiology and Mycology Program, Institute of Biomedical Sciences.
Insights
Early childhood Helicobacter pylori (H. pylori) infection persistence is linked to specific factors. These include earlier acquisition, household size, breastfeeding duration, and host genetics, potentially influencing future disease risk.
Area of Science:
- Pediatric infectious diseases
- Gastroenterology
- Microbiome research
Background:
- Helicobacter pylori is a primary cause of peptic ulcer disease and gastric cancer in adults.
- H. pylori infection is typically acquired in early childhood.
- Factors influencing H. pylori persistence in infants remain largely unknown.
Purpose of the Study:
- To identify pathogen and host factors associated with persistent and transient H. pylori infections in infants.
- To understand the long-term implications of early-life H. pylori acquisition.
Main Methods:
- Longitudinal study of two cohorts of 313 healthy Chilean infants over 18-57 months.
- Stool ELISA testing to determine H. pylori infection status.
- Analysis of host factors (household size, breastfeeding, secretor status) and bacterial factors (cagA, vacA strains).
Main Results:
- 20% of infants experienced persistent H. pylori infection.
- Persistent infections were associated with earlier acquisition, larger households, shorter breastfeeding, and nonsecretor status.
- CagA-positive strains were more prevalent in persistent infections; nearly 60% of characterized persistent samples had cagA/vacAs1m1.
- Persistent infections correlated with a stronger serologic immune response and differential gene expression in children.
Conclusions:
- Early-life persistent H. pylori infections are linked to specific host and bacterial profiles.
- These associations may indicate a predisposition to future H. pylori-related diseases.
Background:
Helicobacter pylori, the main cause of peptic ulcer disease and gastric cancer in adult populations, is generally acquired during the first years of life. Infection can be persistent or transient and bacterial and host factors determining persistence are largely unknown and may prove relevant for future disease.
Methods:
Two cohorts of healthy Chilean infants (313 total) were evaluated every 3 months for 18-57 months to determine pathogen- and host-factors associated with persistent and transient infection.
Results:
One-third had at least one positive stool ELISA by age 3, with 20% overall persistence. Persistent infections were acquired at an earlier age, associated with more household members, decreased duration of breastfeeding, and nonsecretor status compared to transient infections. The cagA positive strains were more common in persistent stools, and nearly 60% of fully characterized persistent stool samples amplified cagA/vacAs1m1. Persistent children were more likely to elicit a serologic immune response, and both infection groups had differential gene expression profiles, including genes associated with cancer suppression when compared to healthy controls.
Conclusions:
These results indicate that persistent H. pylori infections acquired early in life are associated with specific host and/or strain profiles possibly associated with future disease occurrence.
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