Antibiotics (Mar 2024)

<i>Helicobacter pylori</i> in Inflammatory Bowel Diseases: Active Protagonist or Innocent Bystander?

  • Elisabetta Bretto,
  • Simone Frara,
  • Angelo Armandi,
  • Gian Paolo Caviglia,
  • Giorgio Maria Saracco,
  • Elisabetta Bugianesi,
  • Demis Pitoni,
  • Davide Giuseppe Ribaldone

DOI
https://doi.org/10.3390/antibiotics13030267
Journal volume & issue
Vol. 13, no. 3
p. 267

Abstract

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Helicobacter pylori (H. pylori) infection is a prominent entity within human infectious diseases which cause chronic gastritis, peptic ulcers, gastric malignancies, and extragastric disorders. Its persistent colonization can lead to a systemic inflammatory cascade, potentially instigating autoimmune responses and contributing to the pathogenesis of autoimmune diseases. While the specific etiopathogenesis of inflammatory bowel diseases (IBDs) is still unknown, it is widely recognized that immunological, genetic, and environmental factors are implicated. Various bacterial and viral pathogens have been implicated in the pathogenesis of IBDs. Numerous studies suggest a correlation between H. pylori infection and IBDs. While subject to debate, this link suggests that the bacterium’s presence somehow impacts the progression of IBDs by modifying the diversity of the gut microbiota, consequently altering local chemical profiles and disrupting the pattern of gut immune response. However, epidemiological evidence indicates a protective role of H. pylori infection against the onset of autoimmune diseases. Additionally, laboratory findings demonstrate H. pylori’s capacity to promote immune tolerance and restrict inflammatory reactions. The aim of this review is to elucidate the proposed mechanisms and confounding factors that underlie the potential association between H. pylori infection and IBDs.

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