title: Helicobacter pylori infection contributes to placental impairment in preeclampsia: basic and clinical evidences.
abstract: BACKGROUND
  Preeclampsia (PE) is a major cause of maternal and neonatal morbidity and mortality. Epidemiological association between Helicobacter pylori (Hp) infection and PE onset has been widely shown. The aim of this study was to analyze a possible correlation between Hp infection and the severity of clinical presentation of PE and to identify an immunologic mechanism triggered by Hp infection potentially contributing to the pathogenesis of PE.
  
  
  METHODS
  Sera from 93 preeclamptic women and 87 healthy pregnant women were tested for Hp infection by immunoassay and for anti-CagA antibodies by Western blot assay. The serologic results were correlated with the clinical features of PE. The functional effect of serum IgG fractions, positive or negative for Hp, from preeclamptic women or controls were tested on trophoblast and endothelial cell cultures and in a murine model of angiogenesis.
  
  
  RESULTS
  Preeclamptic women showed higher seroprevalence of Hp infection (57.0%) compared to controls (33.3%) (P<.001). The seropositivity for CagA-positive strains of Hp was 45.2% in preeclamptic women vs 13.7% in controls (P<.001). In PE women, Hp infection was associated with abnormality of uterine arteries Doppler (P<.001). Hp+ IgG fractions from preeclamptic women bound to trophoblast and endometrial endothelial cell cultures, reducing in vitro invasiveness and angiogenesis, respectively, and inhibited angiogenesis in mice.
  
  
  CONCLUSIONS
  Our data show, for the first time, an association between Hp infection and PE with abnormal uterine arteries Doppler velocimetry, suggesting a role for Hp infection in impairing placental development and increasing the risk to develop PE. This study opens the new perspective of a potential screening and treatment for Hp infection in pregnancy.
authors.affiliation: Department of Obstetrics and Gynecology, Università Cattolica Del Sacro Cuore, Policlinico A. Gemelli, Rome, Italy.
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Di Simone
authors.affiliation: Department of Obstetrics and Gynecology, Università Cattolica Del Sacro Cuore, Policlinico A. Gemelli, Rome, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Tersigni
authors.affiliation: Department of Surgical Sciences, Università degli Studi di Torino, Turin, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Cardaropoli
authors.affiliation: Emergency Department, Università Cattolica Del Sacro Cuore, Policlinico A. Gemelli, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Franceschi
authors.affiliation: Department of Obstetrics and Gynecology, Università Cattolica Del Sacro Cuore, Policlinico A. Gemelli, Rome, Italy.
authors.forename: Fiorella
authors.initials: F
authors.lastname: Di Nicuolo
authors.affiliation: Department of Obstetrics and Gynecology, Università Cattolica Del Sacro Cuore, Policlinico A. Gemelli, Rome, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Castellani
authors.affiliation: Institute of Microbiology, Università Cattolica Del Sacro Cuore, Policlinico A. Gemelli, Rome, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Bugli
authors.affiliation: Institute of Public Health, Università Cattolica Del Sacro Cuore, Rome, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: de Waure
authors.affiliation: Department of Obstetrics and Gynecology, Università Cattolica Del Sacro Cuore, Policlinico A. Gemelli, Rome, Italy.
authors.forename: Anna Franca
authors.initials: AF
authors.lastname: Cavaliere
authors.affiliation: Department of Internal Medicine, Università Cattolica Del Sacro Cuore, Policlinico A. Gemelli, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Gasbarrini
authors.affiliation: Institute of Microbiology, Università Cattolica Del Sacro Cuore, Policlinico A. Gemelli, Rome, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Sanguinetti
authors.affiliation: Department of Obstetrics and Gynecology, Università Cattolica Del Sacro Cuore, Policlinico A. Gemelli, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Scambia
authors.affiliation: Department of Surgical Sciences, Università degli Studi di Torino, Turin, Italy.
authors.forename: Tullia
authors.initials: T
authors.lastname: Todros
mesh_terms: D000328:Adult; D000818:Animals; D000907:Antibodies, Bacterial / Q000097:blood; D015153:Blotting, Western; D042783:Endothelial Cells / Q000187:drug effects / Q000502:physiology; D005260:Female; D016481:Helicobacter Infections / Q000150:complications*; D006801:Humans; D008819:Mice, Nude; D018919:Neovascularization, Physiologic / Q000187:drug effects; D010920:Placenta / Q000473:pathology*; D011225:Pre-Eclampsia / Q000473:pathology*; D011247:Pregnancy; D014327:Trophoblasts / Q000187:drug effects / Q000502:physiology; D018608:Ultrasonography, Doppler; D055988:Uterine Artery / Q000000981:diagnostic imaging / Q000473:pathology; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial
keywords: 
  Helicobacter pylori
  ; CagA; angiogenesis; placenta; preeclampsia; trophoblast