Helicobacter Pylori Infection in Celiac Disease Patients
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The study was motivated by the following two hypotheses:
- Celiac patients with Helicobacter pylori might present different clinicopathological profiles from those celiacs without H.pylori.
- Celiac patients with Helicobacter pylori might show different histopathological responses to a gluten-free diet than those celiacs without H.pylori.
The research team compared the duodenal and gastric biopsies of 80 adults who had histologically and serologically confirmed CD. The biopsies were taken both before and after patients had adhered to a gluten-free diet for 12 to 18 months.
The team classified and scored gastritis using the Updated Sydney System. They classified duodenal biopsies using both the Marsh-Oberhuber and a simplified classification developed by the team.
Three test subjects who were positive for Helicobacter pylori, and 12 who were negative (a total of 15 test subjects), presented with lymphocytic gastritis.
Overall, a greater proportion of Helicobacter pylori-negative patients had severe villous atrophy (p < 0.01), while the Helicobacter pylori-positive patients more commonly showed milder forms (p < 0.01).
Regardless of their initial Helicobacter pylori status, all subjects showed marked improvement of duodenal aspects following a gluten-free diet (p < 0.001).
With the exception of the intraepithelial lymphocytes (IEL), which returned to normal in two Helicobacter pylori-positive patients, and in ten Helicobacter pylori-positive patients, gastric variables remained unchanged.
The study concludes that Helicobacter pylori gastritis is not related to the clinical features of celiac disease, and that a gluten-free diet is equally effective for both groups.
The study also notes that the inflammatory and structural changes to the mucosal architecture that are associated with celiac disease might eclipse some of the signs of lymphocytosis induced by Helicobacter pylori gastric infection.
The study also further documents the pathogenic connections between celiac disease and lymphocytic gastritis.
Am J Gastroenterol. 2006;101(8):1880-1885.
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