title: Helicobacter pylori infection is associated with a reduced risk of developing eosinophilic oesophagitis.
abstract: 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.
  
  
  OBJECTIVE
  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].
  
  
  CONCLUSIONS
  Helicobacter pylori infection is inversely associated with EoE. Our results may contribute to further understanding the pathogenesis and evolving aetiology of EoE.
authors.affiliation: Department of Gastroenterology, Hepatology and Infectious diseases, Otto-von-Guericke University of Magdeburg, Magdeburg, Germany.
authors.forename: U
authors.initials: U
authors.lastname: von Arnim
authors.affiliation: Department of Gastroenterology, Hepatology and Infectious diseases, Otto-von-Guericke University of Magdeburg, Magdeburg, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Wex
authors.affiliation: Department of Gastroenterology, Hepatology and Infectious diseases, Otto-von-Guericke University of Magdeburg, Magdeburg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Link
authors.affiliation: Department of Gastroenterology, Hepatology and Infectious diseases, Otto-von-Guericke University of Magdeburg, Magdeburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Messerschmidt
authors.affiliation: Department of Gastroenterology, Hepatology and Infectious diseases, Otto-von-Guericke University of Magdeburg, Magdeburg, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Venerito
authors.affiliation: Cooperation of Internal Medicine, Center for Digestive Diseases, Hamburg, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Miehlke
authors.affiliation: Department of Gastroenterology, Hepatology and Infectious diseases, Otto-von-Guericke University of Magdeburg, Magdeburg, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Malfertheiner
mesh_terms: D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000097:blood; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D057765:Eosinophilic Esophagitis / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D016481:Helicobacter Infections / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial