Changes in the severity of gastric mucosal inflammation associated with Helicobacter pylori in humans coinfected with intestinal helminths

Indian J Gastroenterol. 2020 Apr;39(2):186-195. doi: 10.1007/s12664-020-01023-0. Epub 2020 May 20.


Background: Though a few studies in animal models suggest that intestinal helminths (IH) favorably affect evolution of gastritis associated with Helicobacter pylori (H. pylori) the studies supporting this concept in humans are only a few and are based on serological data.

Methods: To evaluate the possible influence of IH on the human gastric mucosa, three groups of Venezuelan adults with gastropathy (endoscopically diagnosed) were studied: H. pylori-/IH- (n = 17), H. pylori+/IH- (n = 18), and H. pylori+/IH+ (n = 11). Histological analysis (hematoxylin-eosin) and immunohistochemical staining (peroxidase) for cytokines interleukin-1beta (IL-1β), tumor necrosis factor alpha (TNF-α), gamma interferon (IFN-γ), and interleukin 4 (IL-4) were undertaken in gastric antral biopsies.

Results: Expression of the four cytokines was detected in all individuals in varying degrees, but proinflammatory cytokines were expressed in a higher degree in the H. pylori+/IH- group, mainly IL-1β (Th1-dominant immune response), associated with a higher degree of both histological inflammation and gastric cancer risk index (GCRI), as compared to the H. pylori-/IH- group. In contrast, an increased expression of IL-4 and a reduced expression of proinflammatory cytokines (Th2-dominant response), plus the tendency to a lower degree of mononuclear infiltration, mucosal atrophy in gastric corpus, and GCRI, were evidenced in the coinfected group.

Conclusions: The findings of the present study is perhaps the first histological evidence of a possible modulatory effect of IH on the gastric mucosal inflammatory response due to H. pylori infection in humans.

Keywords: Cytokine; Gastric cancer; Gastropathy; Immune response; Immunohistochemical staining; Interleukins.

MeSH terms

  • Adolescent
  • Adult
  • Atrophy
  • Coinfection / immunology
  • Coinfection / metabolism*
  • Coinfection / pathology*
  • Cytokines / metabolism*
  • Female
  • Gastric Mucosa / immunology
  • Gastric Mucosa / metabolism*
  • Gastric Mucosa / pathology*
  • Gastritis / immunology
  • Gastritis / metabolism
  • Gastritis / microbiology*
  • Gastritis / pathology*
  • Helicobacter Infections*
  • Helicobacter pylori*
  • Humans
  • Immunohistochemistry
  • Inflammation Mediators / metabolism*
  • Intestinal Diseases, Parasitic / immunology
  • Intestinal Diseases, Parasitic / metabolism*
  • Intestinal Diseases, Parasitic / pathology*
  • Leukocytes, Mononuclear / pathology
  • Male
  • Middle Aged
  • Young Adult


  • Cytokines
  • Inflammation Mediators