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Helicobacter pylori and cardiovascular disease: update 2019
1Department of Hygiene, Epidemiology and Infectious Diseases, Faculty of Medicine, Trakia University, Stara Zagora, Bulgaria - imladenova@yahoo.com.
Insights
Helicobacter pylori (H. pylori) infection may contribute to ischemic heart disease (IHD) by promoting inflammation and atherosclerosis. However, the exact role of H. pylori in IHD pathogenesis remains unclear, requiring further research.
Area of Science:
- Cardiology
- Infectious Diseases
- Immunology
Background:
- Ischemic heart disease (IHD) is a leading cause of mortality, with traditional risk factors insufficient for prediction.
- The potential role of Helicobacter pylori (H. pylori) infection in extra-gastric diseases, including atherosclerosis and IHD, is under investigation.
- H. pylori infection elicits local and systemic immune responses, altering inflammatory markers and potentially contributing to cardiovascular disease.
Purpose of the Study:
- To explore the potential role of H. pylori infection in the pathogenesis of ischemic heart disease (IHD).
- To investigate the mechanisms by which H. pylori might contribute to atherosclerosis and a prothrombotic state.
- To evaluate the efficacy of H. pylori eradication as a cardiovascular prevention strategy.
Main Methods:
- Review of existing studies on H. pylori infection and its association with cardiovascular risk factors and inflammation.
- Exploration of proposed pathogenic mechanisms, including chronic inflammation, altered lipid profiles, and molecular mimicry.
- Analysis of studies investigating H. pylori eradication for cardiovascular prevention.
Main Results:
- The link between H. pylori and IHD pathogenesis remains controversial and requires further elucidation.
- H. pylori infection influences inflammatory markers (cytokines, CRP, HSP) and lipid profiles (triglycerides, HDL).
- Studies on H. pylori eradication for cardiovascular prevention have yielded results that are difficult to interpret.
Conclusions:
- The precise role of H. pylori in the development of IHD is not yet definitively established.
- Further well-designed cohort and interventional studies are necessary to clarify the relationship between H. pylori and IHD.
- H. pylori eradication as a cardiovascular prevention strategy requires more robust evidence.
Abstract:
Many studies have been performed concerning the potential role of Helicobacter pylori (H. pylori) in different extra-gastric diseases. Ischemic heart disease (IHD) remains the leading cause of mortality in developed countries. The traditional cardiovascular risk factors could not predict all cases of IHD. Hence, the scientists explore other potential etiologic factors, especially infections. H. pylori infection has been suspected to have a role in the pathogenesis of atherosclerosis. However, after 25 years from the first description, the role of the bacterium in the pathogenesis of IHD remains controversial and enigmatic. Since H. pylori infection is persistent and stimulates both a local and a systemic immune response that could cause significant changes in the markers of inflammation like cytokines, C-reactive protein, heat shock protein, fibrinogen, triglycerides, high density lipoprotein, it has been supposed that the outcomes of this process are atherosclerosis and a prothrombotic state which eventually leads to IHD. Alternative pathogenic mechanisms have been hypothesized, including the occurrence of molecular antigenicity. This hypothesis supposed that H. pylori could provoke autoimmunity as a result of molecular mimicry. The eradication of H. pylori infection as cardiovascular prevention strategy has been the object of some studies. However, the results are of difficult interpretation. Further studies, especially with a cohort and interventional design, have to be performed to reveal the potential relationship between H. pylori and IHD.
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