Helicobacter pylori cagA + is associated with milder duodenal histological changes in chilean celiac patients
Author
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Lucero Álvarez, Yalda
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Oyarzún, Amaya
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O'Ryan Gallardo, Miguel
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Valenzuela, Romina
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Alcalde Ruíz, Elisa
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Arce Fricke, Claudio
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Farfán Urzúa, Mauricio
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Vergara, Alejandra F.
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Sandoval Gajardo, Iván Elías
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Méndez, Jocelyn
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Carrasco, Jorge
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Ossa Alemparte, Juan
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Pérez Bravo, Francisco
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Castro Lebrero, Magdalena
Author
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Araya, Magdalena
Admission date
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2018-07-06T14:33:20Z
Available date
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2018-07-06T14:33:20Z
Publication date
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2017
Cita de ítem
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Front. Cell. Infect. Microbiol. 7: 376
es_ES
Identifier
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10.3389/fcimb.2017.00376
Identifier
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https://repositorio.uchile.cl/handle/2250/149589
Abstract
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Background: Mechanisms underlying the high clinical and histological diversity of celiac disease (CD) remain elusive. Helicobacter pylori (Hp) chronically infects gastric and duodenal mucosa and has been associated with protection against some immune-mediated conditions, but its role (specifically of cagA+ strains) in CD is unclear. Objective: To assess the relationship between gastric Hp infection (cagA+ strains) and duodenal histological damage in patients with CD. Design: Case-control study including patients with active-CD, potential-CD and nonceliac individuals. Clinical presentation, HLA genotype, Hp/cagA gene detection in gastric mucosa, duodenal histology, Foxp3 positive cells and TGF-β expression in duodenal lamina propria were analyzed. Results: We recruited 116 patients, 29 active-CD, 37 potential-CD, and 50 non-CD controls. Hp detection was similar in the three groups (∼30–40%), but cagA+ strains were more common in infected potential-CD than in active-CD (10/11 vs. 4/10; p = 0.020) and non-CD (10/20; p = 0.025). Among active-CD patients, Foxp3 positivity was significantly higher in subjects with cagA+ Hp+ compared to cagA- Hp+ (p < 0.01) and Hp- (p < 0.01). In cagA+ Hp+ individuals, Foxp3 positivity was also higher comparing active- to potential-CD (p < 0.01). TGF-β expression in duodenum was similar in activeCD with cagA+ Hp+ compared to Hp- and was significantly downregulated in cagA+ potential-CD subjects compared to other groups. Conclusion: Hp infection rates were similar among individuals with/without CD, but infection with cagA+ strains was associated with milder histological damage in celiac patients infected by Hp, and in active-CD cases with higher expression of T-reg markers. Results suggest that infection by cagA+ Hp may be protective for CD progression, or conversely, that these strains are prone to colonize intestinal mucosa with less severe damage.
Patrocinador
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Comision Nacional de Investigacion Cientifica y Tecnologica (CONICYT) CONICYT FONDECYT 11121671