title: Helicobacter pylori and autoimmune disease: cause or bystander.
abstract: Helicobacter pylori (H. pylori) is the main cause of chronic gastritis and a major risk factor for gastric cancer. This pathogen has also been considered a potential trigger of gastric autoimmunity, and in particular of autoimmune gastritis. However, a considerable number of reports have attempted to link H. pylori infection with the development of extra-gastrointestinal autoimmune disorders, affecting organs not immediately relevant to the stomach. This review discusses the current evidence in support or against the role of H. pylori as a potential trigger of autoimmune rheumatic and skin diseases, as well as organ specific autoimmune diseases. We discuss epidemiological, serological, immunological and experimental evidence associating this pathogen with autoimmune diseases. Although over one hundred autoimmune diseases have been investigated in relation to H. pylori, we discuss a select number of papers with a larger literature base, and include Sjögrens syndrome, rheumatoid arthritis, systemic lupus erythematosus, vasculitides, autoimmune skin conditions, idiopathic thrombocytopenic purpura, autoimmune thyroid disease, multiple sclerosis, neuromyelitis optica and autoimmune liver diseases. Specific mention is given to those studies reporting an association of anti-H. pylori antibodies with the presence of autoimmune disease-specific clinical parameters, as well as those failing to find such associations. We also provide helpful hints for future research.
authors.affiliation: Daniel S Smyk, Andreas L Koutsoumpas, Maria G Mytilinaiou, Dimitrios P Bogdanos, Institute of Liver Studies, Division of Transplantation Immunology and Mucosal Biology, King's College Hospital, School of Medicine, King's College London, London SE5 9RS, United Kingdom.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Smyk
authors.affiliation: Daniel S Smyk, Andreas L Koutsoumpas, Maria G Mytilinaiou, Dimitrios P Bogdanos, Institute of Liver Studies, Division of Transplantation Immunology and Mucosal Biology, King's College Hospital, School of Medicine, King's College London, London SE5 9RS, United Kingdom.
authors.forename: Andreas L
authors.initials: AL
authors.lastname: Koutsoumpas
authors.affiliation: Daniel S Smyk, Andreas L Koutsoumpas, Maria G Mytilinaiou, Dimitrios P Bogdanos, Institute of Liver Studies, Division of Transplantation Immunology and Mucosal Biology, King's College Hospital, School of Medicine, King's College London, London SE5 9RS, United Kingdom.
authors.forename: Maria G
authors.initials: MG
authors.lastname: Mytilinaiou
authors.affiliation: Daniel S Smyk, Andreas L Koutsoumpas, Maria G Mytilinaiou, Dimitrios P Bogdanos, Institute of Liver Studies, Division of Transplantation Immunology and Mucosal Biology, King's College Hospital, School of Medicine, King's College London, London SE5 9RS, United Kingdom.
authors.forename: Eirini I
authors.initials: EI
authors.lastname: Rigopoulou
authors.affiliation: Daniel S Smyk, Andreas L Koutsoumpas, Maria G Mytilinaiou, Dimitrios P Bogdanos, Institute of Liver Studies, Division of Transplantation Immunology and Mucosal Biology, King's College Hospital, School of Medicine, King's College London, London SE5 9RS, United Kingdom.
authors.forename: Lazaros I
authors.initials: LI
authors.lastname: Sakkas
authors.affiliation: Daniel S Smyk, Andreas L Koutsoumpas, Maria G Mytilinaiou, Dimitrios P Bogdanos, Institute of Liver Studies, Division of Transplantation Immunology and Mucosal Biology, King's College Hospital, School of Medicine, King's College London, London SE5 9RS, United Kingdom.
authors.forename: Dimitrios P
authors.initials: DP
authors.lastname: Bogdanos
mesh_terms: D000818:Animals; D000907:Antibodies, Bacterial / Q000097:blood; D001327:Autoimmune Diseases / Q000453:epidemiology / Q000276:immunology* / Q000382:microbiology; D015551:Autoimmunity; D016481:Helicobacter Infections / Q000453:epidemiology / Q000276:immunology* / Q000382:microbiology; D016480:Helicobacter pylori / Q000276:immunology* / Q000472:pathogenicity; D006801:Humans; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D000907:Antibodies, Bacterial
keywords: Autoimmunity; Gastritis; Helicobacter pylori; Infection; Mimicry; Rheumatology