TY - JOUR
T1 - Helicobacter pylori cagA+ Is associated with milder duodenal histological changes in chilean celiac patients
AU - Lucero, Yalda
AU - Oyarzún, Amaya
AU - O'Ryan, Miguel
AU - Quera, Rodrigo
AU - Espinosa, Nelly
AU - Valenzuela, Romina
AU - Simian, Daniela
AU - Alcalde, Elisa
AU - Arce, Claudio
AU - Farfán, Mauricio J.
AU - Vergara, Alejandra F.
AU - Gajardo, Iván
AU - Mendez, Jocelyn
AU - Carrasco, Jorge
AU - Errázuriz, Germán
AU - Gonzalez, Mónica
AU - Ossa, Juan C.
AU - Maiza, Eduardo
AU - Perez-Bravo, Francisco
AU - Castro, Magdalena
AU - Araya, Magdalena
N1 - Publisher Copyright:
© 2017 Lucero, Oyarzún, O'Ryan, Quera, Espinosa, Valenzuela, Simian, Alcalde, Arce, Farfán, Vergara, Gajardo, Mendez, Carrasco, Errázuriz, Gonzalez, Ossa, Maiza, Perez-Bravo, Castro and Araya.
PY - 2017/8/23
Y1 - 2017/8/23
N2 - 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 non-celiac individuals. Clinical presentation, HLA genotype, Hp/cagA gene detection in gastric mucosa, duodenal histology, Foxp3 positive cells and TGF-ß 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-ß expression in duodenum was similar in active-CD 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.
AB - 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 non-celiac individuals. Clinical presentation, HLA genotype, Hp/cagA gene detection in gastric mucosa, duodenal histology, Foxp3 positive cells and TGF-ß 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-ß expression in duodenum was similar in active-CD 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.
KW - CagA gene
KW - Celiac disease
KW - Duodenal atrophy
KW - Helicobacter pylori
KW - Potential celiac disease
UR - http://www.scopus.com/inward/record.url?scp=85031505720&partnerID=8YFLogxK
U2 - 10.3389/fcimb.2017.00376
DO - 10.3389/fcimb.2017.00376
M3 - Article
C2 - 28879170
AN - SCOPUS:85031505720
SN - 2235-2988
VL - 7
JO - Frontiers in Cellular and Infection Microbiology
JF - Frontiers in Cellular and Infection Microbiology
IS - AUG
M1 - 376
ER -