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. 2019 Dec 2;9(4):182-187.
doi: 10.18683/germs.2019.1174. eCollection 2019 Dec.

Inverse Association Between Helicobacter pylori Infection and Childhood Asthma in Greece: A Case-Control Study

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Inverse Association Between Helicobacter pylori Infection and Childhood Asthma in Greece: A Case-Control Study

Christina Tsigalou et al. Germs. .
Free PMC article


Introduction: Helicobacter pylori infection is a well-established etiological factor for a variety of diseases such as peptic ulcer and gastric cancer. On the other hand, there is ongoing research suggesting that H. pylori might have a beneficial effect through a pivotal influence in the immunological response especially in asthma. The aim of the current case-control study was to evaluate the prevalence of H. pylori infection in asthmatic children.

Methods: Twenty-seven children with exacerbation of persistent asthma, aged 8.6±4.5 years (18 males, 9 females) and 54 age-sex-matched non-asthmatic controls were enrolled. Clinical examination and laboratory investigations were performed. Detection of H. pylori antigen (HpSA) in stool samples was performed by a commercial kit (bioNexia® kit, BioMérieux). Serum specific IgG antibodies were detected by a rapid chromatographic immunoassay (DIAsourceImmunoAssays). Serum IgE concentration was determined by electrochemiluminescence (ECL) (Roche Elecsys) and IgE levels ≥ 90 IU/mL were considered significantly elevated.

Results: In 3 (11.1%) of the 27 asthmatic children H. pylori infection (based on both detection of HpSA and specific IgG-Abs) was established, whereas as many as 16 of the 54 (29.6%) non-asthmatic ones were found infected (odds ratio 0.1; 95%CI, 0.039-0.305, p=0.026).

Conclusions: Our findings reveal an inverse relationship between H. pylori infection and children's persistent asthma in Greece.

Keywords: Asthma; Helicobacter pylori; children; persistent.

Conflict of interest statement

Conflicts of interest: All authors – none to declare.


Figure 1
Figure 1. Level of total IgE in study group
Figure 2
Figure 2. Hypothesis of possible immune mechanism related to Helicobacter pylori infection and asthma
Gastric colonization by H. pylori, through dendritic cells (DC) mediated T cell expression, affects the Th1/Th2 response. The rise of gastric mucosal T regulatory cells (T regs) in H. pylori infection subsequently can provoke increase in the levels of interleukin (IL)-10 release, that inhibits a Th2 response and the activation of Th17. Thus H. pylori infection is favoring a Th1 response and not a Th2, that is related with allergic manifestations and asthma.

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