Helicobacter pylori serology in autoimmune diseases - fact or fiction?
BACKGROUND
The pathogenesis of autoimmunity is presumed to be a complex process including genetic predisposition, hormonal balance and environmental factors such as infectious agents. Helicobacter pylori, a common bacterial infectious agent has been associated with a variety of autoimmune disorders. However, this bacteria is also thought to play a protective role in the development of multiple sclerosis (MS), systemic lupus erythematosus (SLE) and inflammatory bowel disease (IBD). We tested various links between anti-H. pylori (anti-HP) antibodies and a wide profile of autoimmune diseases and autoantibodies.


METHODS
A total of 1290 patients diagnosed with 14 different autoimmune diseases from two geographical areas (Europe and Latin America) and two groups of healthy matching controls (n=385) were screened for the presence of H. pylori IgG antibodies by "pylori detect" kit. In parallel, a large profile belonging to three groups of autoantibodies was tested in all sera (anti-nuclear antibodies, autoantibodies associated with thrombophilia and gastrointestinal diseases).


RESULTS
Our data demonstrate associations between anti-HP antibodies and anti-phospholipid syndrome, giant cell arteritis, systemic sclerosis and primary biliary cirrhosis. Our data also support a previously known negative association between the prevalence of anti-HP antibodies and IBD. Additionally, links were made between seropositivity to H. pylori and the presence of anti-nuclear antibodies, dsDNA, anti-Ro and some thrombophilia-associated antibodies, as well as negative associations with gastrointestinal-associated antibodies.


CONCLUSIONS
Whether these links are epiphenomenal or H. pylori does play a causative role in the autoimmune diseases remains uncertain. The negative associations could possibly support the notion that in susceptible individuals infections may protect from the development of autoimmune diseases.
The Zabludowicz Center for Autoimmune Disease, Sheba Medical Center, Tel Hashomer, Israel.
Maya
M
Ram
Ori
O
Barzilai
Yinon
Y
Shapira
Juan-Manuel
JM
Anaya
Angela
A
Tincani
Ljudmila
L
Stojanovich
Stefano
S
Bombardieri
Nicola
N
Bizzaro
Shaye
S
Kivity
Nancy
N
Agmon Levin
Yehuda
Y
Shoenfeld
D000907:Antibodies, Bacterial / Q000097:blood; D000937:Antigen-Antibody Reactions; D001327:Autoimmune Diseases / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D001774:Blood Chemical Analysis; D016481:Helicobacter Infections / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D016480:Helicobacter pylori / Q000276:immunology* / Q000302:isolation & purification; D006801:Humans
D000907:Antibodies, Bacterial