title: Screening for Helicobacter pylori in Idiopathic Pulmonary Fibrosis Lung Biopsies.
abstract: BACKGROUND
  Increasing evidence suggests a role of gastro-oesophageal reflux (GER) in idiopathic pulmonary fibrosis (IPF) pathogenesis. Recently, an association between serum Helicobacter pylori (HP) antibody positivity and more severe disease was described, but HP has not been directly analysed in lung tissue so far.
  
  
  OBJECTIVE
  To investigate the presence of HP in the lung tissue of IPF patients.
  
  
  METHODS
  Two tertiary interstitial lung disease care centre databases were screened for available lung biopsy material from IPF patients. Clinical and radiological data, including presence of GER and antiacid medication, were evaluated. HP-specific PCR was carried out on the IPF lung biopsy specimens.
  
  
  RESULTS
  A total of 39 IPF patients were included, of whom 85% were male. The patients' median age was 66 years, their vital capacity was 79% predicted, and their diffusing capacity for carbon monoxide was 53% predicted. In all, 82% of the lung biopsies were surgical and 18% transbronchial. Comorbidities were GER disease in 23% (n = 9), sleep apnoea in 13% (n = 5) and hiatal hernia in 38% of the cases (n = 15). Proton pump inhibitors were prescribed at the time of biopsy in 21% of the cases (n = 9). After a median follow-up of 25 months (range 6-69), there were 1 death, 1 lung transplantation and 8 acute exacerbations without relevant differences between the GER and non-GER subgroups. HP DNA was not detected in any of the lung tissue samples.
  
  
  CONCLUSIONS
  The fact that no HP DNA was detected in the lung tissues calls into question the proposed relevance of HP to the direct pathogenesis of IPF.
authors.affiliation: Centre for Interstitial and Rare Lung Diseases, Department of Pneumology and Respiratory Critical Care Medicine, Thoraxklinik, University of Heidelberg, Heidelberg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Kreuter
authors.forename: Detlef
authors.initials: D
authors.lastname: Kirsten
authors.forename: Thomas
authors.initials: T
authors.lastname: Bahmer
authors.forename: Roland
authors.initials: R
authors.lastname: Penzel
authors.forename: Martin
authors.initials: M
authors.lastname: Claussen
authors.forename: Svenja
authors.initials: S
authors.lastname: Ehlers-Tenenbaum
authors.forename: Thomas
authors.initials: T
authors.lastname: Muley
authors.forename: Karin
authors.initials: K
authors.lastname: Palmowski
authors.forename: Monika
authors.initials: M
authors.lastname: Eichinger
authors.forename: Marta
authors.initials: M
authors.lastname: Leider
authors.forename: Felix J F
authors.initials: FJ
authors.lastname: Herth
authors.forename: Klaus F
authors.initials: KF
authors.lastname: Rabe
authors.forename: Iris
authors.initials: I
authors.lastname: Bittmann
authors.forename: Arne
authors.initials: A
authors.lastname: Warth
mesh_terms: D000368:Aged; D001706:Biopsy; D016022:Case-Control Studies; D015897:Comorbidity; D004269:DNA, Bacterial / Q000302:isolation & purification*; D016208:Databases, Factual; D018450:Disease Progression; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy / Q000453:epidemiology*; D005858:Germany / Q000453:epidemiology; D016481:Helicobacter Infections / Q000175:diagnosis / Q000453:epidemiology*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006551:Hernia, Hiatal / Q000453:epidemiology*; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000453:epidemiology* / Q000382:microbiology / Q000503:physiopathology; D008168:Lung / Q000737:chemistry* / Q000473:pathology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D011653:Pulmonary Diffusing Capacity; D012336:RNA, Ribosomal, 16S; D012189:Retrospective Studies; D012891:Sleep Apnea Syndromes / Q000453:epidemiology; D014797:Vital Capacity
chemical_list: D004269:DNA, Bacterial; D054328:Proton Pump Inhibitors; D012336:RNA, Ribosomal, 16S