title: Protective effects of Helicobacter pylori against gastroesophageal reflux disease may be due to a neuroimmunological anti-inflammatory mechanism.
abstract: There is some evidence that Helicobacter pylori infection has a protective effect against gastroesophageal reflux disease (GORD) and its complications such as Barrett's oesophagus and oesophageal adenocarcinoma. In this paper, we propose that a neuroimmunological mechanism is responsible for the protective effect of H. pylori on GORD. H. pylori infection of the gastric mucosa induces a T helper1-like immune response and production of pro-inflammatory cytokines. These cytokines can inhibit local sympathetic tone, whereas they increase systemic sympathetic tone. Increased sympathetic tone can induce an anti-inflammatory milieu, which in turn can inhibit inflammation in the oesophagus and lower oesophageal sphincter (LOS). Furthermore, H. pylori infection may stimulate the cholinergic anti-inflammatory pathway. It has been suggested that reflux-induced oesophageal inflammation plays an important role in the pathogenesis of reflux oesophagitis. Reduction of oesophageal inflammation by increased systemic sympathetic tone and vagal activity may lead to a decrease in reflux-induced oesophageal injury and LOS dysfunction in GORD.
authors.affiliation: Department of Microbiology, Immunology and Genetics, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran. s_shahabi@umsu.ac.ir
authors.forename: Shahram
authors.initials: S
authors.lastname: Shahabi
authors.forename: Yousef
authors.initials: Y
authors.lastname: Rasmi
authors.forename: Nima Hosseini
authors.initials: NH
authors.lastname: Jazani
authors.forename: Zuhair Muhammad
authors.initials: ZM
authors.lastname: Hassan
mesh_terms: D000942:Antigens, Bacterial / Q000276:immunology; D016207:Cytokines / Q000276:immunology*; D004942:Esophagitis, Peptic / Q000276:immunology / Q000382:microbiology; D005764:Gastroesophageal Reflux / Q000276:immunology* / Q000382:microbiology / Q000517:prevention & control; D016481:Helicobacter Infections / Q000276:immunology* / Q000382:microbiology; D016480:Helicobacter pylori / Q000276:immunology*; D006801:Humans; D018836:Inflammation Mediators / Q000276:immunology*; D013564:Sympathetic Nervous System / Q000276:immunology* / Q000382:microbiology
chemical_list: D000942:Antigens, Bacterial; D016207:Cytokines; D018836:Inflammation Mediators