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Review
. 2020 Jul 28;26(28):4076-4093.
doi: 10.3748/wjg.v26.i28.4076.

Helicobacter pylori infection: Beyond gastric manifestations

Maria Luísa Cordeiro Santos  1 , Breno Bittencourt de Brito  1 , Filipe Antônio França da Silva  1 , Mariana Miranda Sampaio  1 , Hanna Santos Marques  2 , Natália Oliveira E Silva  1 , Dulciene Maria de Magalhães Queiroz  3 , Fabrício Freire de Melo  4
Affiliations
Review

Helicobacter pylori infection: Beyond gastric manifestations

Maria Luísa Cordeiro Santos et al. World J Gastroenterol. .

Abstract

Helicobacter pylori (H. pylori) is a bacterium that infects more than a half of world's population. Although it is mainly related to the development of gastroduodenal diseases, several studies have shown that such infection may also influence the development and severity of various extragastric diseases. According to the current evidence, whereas this bacterium is a risk factor for some of these manifestations, it might play a protective role in other pathological conditions. In that context, when considered the gastrointestinal tract, H. pylori positivity have been related to Inflammatory Bowel Disease, Gastroesophageal Reflux Disease, Non-Alcoholic Fatty Liver Disease, Hepatic Carcinoma, Cholelithiasis, and Cholecystitis. Moreover, lower serum levels of iron and vitamin B12 have been found in patients with H. pylori infection, leading to the emergence of anemias in a portion of them. With regards to neurological manifestations, a growing number of studies have associated that bacterium with multiple sclerosis, Alzheimer's disease, Parkinson's disease, and Guillain-Barré syndrome. Interestingly, the risk of developing cardiovascular disorders, such as atherosclerosis, is also influenced by the infection. Besides that, the H. pylori-associated inflammation may also lead to increased insulin resistance, leading to a higher risk of diabetes mellitus among infected individuals. Finally, the occurrence of dermatological and ophthalmic disorders have also been related to that microorganism. In this sense, this minireview aims to gather the main studies associating H. pylori infection with extragastric conditions, and also to explore the main mechanisms that may explain the role of H. pylori in those diseases.

Keywords: Autoimmune; Cardiovascular; Diabetes; Extragastric; Helicobacter pylori; Neurological; Ophthalmic; Timeline; Treatment.

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Conflict of interest statement

Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.

Figures

Figure 1
Figure 1
First studies on the association between Helicobacter pylori infection and extragastric manifestations over time. CV: Cardiovascular; IBD: Intestinal bowel disease; ITP: Idiopathic thrombocytopenic purpura; GBS: Guillain-Barré Syndrome; IDA: Iron deficiency anemia; RGE: Gastroesophageal reflux disease; PD: Parkinson’s disease; MS: Multiple sclerosis; AD: Alzheimer’s disease; NAFLD: Non-alcoholic fatty liver disease.
Figure 2
Figure 2
Summary scheme of non-gastric manifestations of Helicobacter pylori infection. In orange, the manifestations for which Helicobacter pylori (H. pylori) infection represents a risk association. In green, the manifestations for which H. pylori infection represents a protective association. In gray, the manifestations for which studies show a dichotomous association.
See this image and copyright information in PMC

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