Associations of Helicobacter pylori seropositivity and gastric inflammation with pediatric asthma

Nael Elias, Elias Nasrallah, Camelia Khoury, Bshara Mansour, Layaly Abu Zuher, Valeria Asato, Khitam Muhsen

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Objective: Controversy exists regarding an association between Helicobacter pylori infection and asthma in children. We examined the hypotheses of inverse associations of H. pylori seroprevalence and pepsinogen (PG) levels, as markers of gastric inflammation, with asthma in children. Methods: A hospital-based case-control study was conducted among children aged 4.8 to 17.3 years in Israel. Confirmed asthma cases (n = 75) were recruited through a pulmonary clinic, and controls (n = 160) without asthma were enrolled. Using enzyme-linked immunosorbent assays we measured the presence of H. pylori immunoglobulin G (IgG) antibodies, IgG antibodies to cytotoxin-associated gene A antigen (CagA) (virulent factor), serum PG levels and exposure to other enteric pathogens (Shigella flexneri). Multivariable logistic regression models were applied. Results: H. pylori IgG seropositivity was 25% and 40% among cases and controls, respectively (P =.03). H. pylori CagA IgG seropositivity was associated with reduced risk of asthma (adjusted odds ratio [OR], 0.33 [95% CI, 0.11-0.95] but not for the CagA negative serology (adjusted OR, 0.70 [95% CI, 0.32-1.54]). Children who were H. pylori seropositive with a PGI:PGII of ≤6.78 (severe gastric inflammation) had a lower likelihood of asthma (adjusted OR, 0.31 [95% CI, 0.10-0.89]) than did seronegative children. Exposure to Shigella flexneri did not differ between cases and controls, nor according to H. pylori seropositivity. Among the asthmatic children, pulmonary function did not differ according to H. pylori seropositivity. Conclusions: H. pylori infection and its related gastric inflammation may have a protective role in the risk of pediatric asthma and further research into a potential causal pathway is required.

Original languageEnglish
Pages (from-to)2236-2245
Number of pages10
JournalPediatric Pulmonology
Volume55
Issue number9
DOIs
StatePublished - 1 Sep 2020
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2020 Wiley Periodicals LLC

Funding

This study was undertaken in partial fulfillment of the requirements for an MPH degree of Dr. Nael Elias, Sackler Faculty of Medicine, Tel Aviv University. We are very thankful to Prof. Guillermo I Perez‐Perez and Prof. Martin J Blaser from New York University School of Medicine, New York, NY, USA for providing the recombinant CagA antigen. Funding for this study was partially provided by the MAOF scholarship awarded to Prof. K.M. by the Council of High Education: Maof scholarship (Alon 2013‐2014) and internal funding from Tel Aviv University: the vice president funds (590879). This study was undertaken in partial fulfillment of the requirements for an MPH degree of Dr. Nael Elias, Sackler Faculty of Medicine, Tel Aviv University. We are very thankful to Prof. Guillermo I Perez-Perez and Prof. Martin J Blaser from New York University School of Medicine, New York, NY, USA for providing the recombinant CagA antigen. Funding for this study was partially provided by the MAOF scholarship awarded to Prof. K.M. by the Council of High Education: Maof scholarship (Alon 2013-2014) and internal funding from Tel Aviv University: the vice president funds (590879).

FundersFunder number
Council of High Education
MAOF
Sackler Faculty of Medicine, Tel Aviv University
Tel Aviv University590879

    Keywords

    • Helicobacter pylori
    • asthma
    • cytotoxin-associated gene A antigen
    • pulmonary function
    • serum pepsinogen

    Fingerprint

    Dive into the research topics of 'Associations of Helicobacter pylori seropositivity and gastric inflammation with pediatric asthma'. Together they form a unique fingerprint.

    Cite this