Helicobacter pylori infection is associated with a reduced risk of developing eosinophilic oesophagitis

• Published in: Alimentary pharmacology & therapeutics 2016-04, Vol.43 (7), p.825-830
• Main Authors: von Arnim, U., Wex, T., Link, A., Messerschmidt, M., Venerito, M., Miehlke, S., Malfertheiner, P.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antibodies, Bacterial - blood; Case-Control Studies; Enzyme-Linked Immunosorbent Assay; Eosinophilic Esophagitis - blood; Eosinophilic Esophagitis - diagnosis; Eosinophilic Esophagitis - epidemiology; Female; Helicobacter Infections - blood; Helicobacter Infections - diagnosis; Helicobacter Infections - epidemiology; Helicobacter pylori - isolation & purification; Humans; Male; Middle Aged; Risk Factors; Seroepidemiologic Studies; Young Adult
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1111/apt.13560

Summary Background Eosinophilic oesophagitis (EoE) represents a chronic immune‐antigen‐mediated allergic disease of the oesophagus of still unknown aetiology. Environmental exposure has been postulated to play a pathogenetic role. Helicobacter pylori (H. pylori) infection has been inversely associated with allergic diseases including atopic dermatitis, asthma and allergic rhinitis and H. pylori may play a protective role in these conditions. Little is known about the relationship between EoE and H. pylori. Aim To investigate in a case–control study whether H. pylori infection is associated with a reduced risk of developing EoE. Methods H. pylori infection was evaluated by serology in 58 [11(19%) female, 47 (81%) male, median age: 36.5 years, range 20–72 years] patients with a clinical and histologically proven diagnosis of EoE and 116 age and sex‐matched controls (1 case: 2 controls). Antibodies against H. pylori were identified by enzyme‐linked immunosorbent assay. Patients with H. pylori‐specific IgG ≥30 enzyme immunounits were classified as H. pylori‐positive. Results 3/58 (5.2%) patients with EoE had serological evidence of H. pylori infection (EoE – H. pylori current infection) and 5/58 (8.6%) reported prior eradication therapy for H. pylori infection (EoE – H. pylori former infection). The control group demonstrated significantly higher seroprevalence of H. pylori (37.9%, P < 0.0001) when compared to patients with EoE. EoE was inversely associated with H. pylori infection [odds ratio (OR) 0.24, 95% confidence interval (CI) 0.11–0.50]. Conclusion Helicobacter pylori infection is inversely associated with EoE. Our results may contribute to further understanding the pathogenesis and evolving aetiology of EoE.