Helicobacter pylori in Inflammatory Bowel Diseases: Active Protagonist or Innocent Bystander?
Elisabetta Bretto1,2, Simone Frara1,2, Angelo Armandi1,2
1Department of Medical Sciences, University of Turin, 10126 Turin, Italy.
Abstract:
Helicobacter pylori (H. pylori) infection is a prominent entity within human infectious diseases which cause chronic gastritis, peptic ulcers, gastric malignancies, and extragastric disorders. Its persistent colonization can lead to a systemic inflammatory cascade, potentially instigating autoimmune responses and contributing to the pathogenesis of autoimmune diseases. While the specific etiopathogenesis of inflammatory bowel diseases (IBDs) is still unknown, it is widely recognized that immunological, genetic, and environmental factors are implicated. Various bacterial and viral pathogens have been implicated in the pathogenesis of IBDs. Numerous studies suggest a correlation between H. pylori infection and IBDs. While subject to debate, this link suggests that the bacterium's presence somehow impacts the progression of IBDs by modifying the diversity of the gut microbiota, consequently altering local chemical profiles and disrupting the pattern of gut immune response. However, epidemiological evidence indicates a protective role of H. pylori infection against the onset of autoimmune diseases. Additionally, laboratory findings demonstrate H. pylori's capacity to promote immune tolerance and restrict inflammatory reactions. The aim of this review is to elucidate the proposed mechanisms and confounding factors that underlie the potential association between H. pylori infection and IBDs.
Insights
Helicobacter pylori (H. pylori) infection
Area of Science:
- Gastroenterology and Immunology
Background:
- Helicobacter pylori (H. pylori) infection is linked to various gastrointestinal and extragastric conditions.
- The pathogenesis of Inflammatory Bowel Diseases (IBDs) involves genetic, environmental, and immunological factors.
- A potential correlation between H. pylori infection and IBDs is suggested, though debated.
Purpose of the Study:
- To review proposed mechanisms and confounding factors in the H. pylori-IBD association.
- To explore H. pylori's impact on gut microbiota and immune response in IBD.
- To reconcile conflicting evidence regarding H. pylori's role in autoimmune diseases.
Main Methods:
- Literature review of studies investigating H. pylori and IBD.
- Analysis of proposed pathogenetic mechanisms.
- Evaluation of epidemiological and laboratory findings.
Main Results:
- H. pylori infection may alter gut microbiota diversity and immune responses, potentially influencing IBD progression.
- Epidemiological data suggest H. pylori infection might protect against autoimmune diseases.
- Laboratory studies indicate H. pylori can induce immune tolerance and reduce inflammation.
Conclusions:
- The association between H. pylori infection and IBDs requires further elucidation.
- H. pylori's dual role in potentially exacerbating or protecting against immune-mediated diseases presents a complex clinical picture.
- Understanding these interactions is crucial for managing IBD and related conditions.
Related Concept Videos
01:24Pathophysiology of Peptic Ulcer Disease: Mucosal Defense Factors
01:17Gastritis-II: Pathophysiology
In acute gastritis, the gastric mucosa becomes swollen and red and undergoes superficial erosion. Superficial ulceration may lead to bleeding.
In chronic gastritis, persistent or repeated insults lead to chronic inflammatory changes and, eventually, thinning or atrophy of the gastric tissue.
Gastritis can stem from various causes, each...
01:22Pathophysiology of Peptic Ulcer Disease: Injurious Factors
In the antrum region, G cells secrete the gastrin hormone that binds to gastrin-cholecystokinin-B (CCK2) receptors on parietal and enterochromaffin-like (ECL) cells in the fundic glands. Simultaneously, the vagus nerve releases acetylcholine, which binds...
01:30Peptic Ulcer Disease I: Introduction
An acute ulcer, marked by superficial erosion and minimal inflammation, swiftly resolves upon identifying and addressing the underlying cause. In contrast, a chronic ulcer persists, potentially eroding through the muscular wall and forming fibrous tissue.
Peptic ulcers can also be...
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
01:28Peptic Ulcer Disease II: Pathophysiology
Damaging agents such as Helicobacter pylori, gastric acid, pepsin, and nonsteroidal anti-inflammatory drugs (NSAIDs) can weaken the mucosal defense, allowing hydrogen ions to infiltrate back and harm epithelial cells.