You are here

Article Text

Article menu
Download PDFPDF
Inflammatory bowel disease
Original article
Dual role of Helicobacter and Campylobacter species in IBD: a systematic review and meta-analysis
  1. Natalia Castaño-Rodríguez1,
  2. Nadeem O Kaakoush1,
  3. Way Seah Lee2,3,
  4. Hazel M Mitchell1
  1. 1School of Biotechnology and Biomolecular Sciences, The University of New South Wales, Sydney, New South Wales, Australia
  2. 2Department of Paediatrics, University Malaya Medical Centre, Kuala Lumpur, Malaysia
  3. 3University Malaya Pediatrics and Child Health Research Group, University Malaya, Kuala Lumpur, Malaysia
  1. Correspondence to Professor Hazel M Mitchell, Lab301A, Biological Sciences Building (D26), School of Biotechnology and Biomolecular Sciences, The University of New South Wales, Sydney, NSW 2052, Australia; h.mitchell{at}unsw.edu.au

Abstract

Objective To conduct a comprehensive global systematic review and meta-analysis on the association between Helicobacter pylori infection and IBD. As bacterial antigen cross-reactivity has been postulated to be involved in this association, published data on enterohepatic Helicobacter spp (EHS) and Campylobacter spp and IBD was also analysed.

Design Electronic databases were searched up to July 2015 for all case-control studies on H. pylori infection/EHS/Campylobacter spp and IBD. Pooled ORs (P-OR) and 95% CIs were obtained using the random effects model. Heterogeneity, sensitivity and stratified analyses were performed.

Results Analyses comprising patients with Crohn's disease (CD), UC and IBD unclassified (IBDU), showed a consistent negative association between gastric H. pylori infection and IBD (P-OR: 0.43, p value <1e-10). This association appears to be stronger in patients with CD (P-OR: 0.38, p value <1e-10) and IBDU (P-OR: 0.43, p value=0.008) than UC (P-OR: 0.53, p value <1e-10). Stratification by age, ethnicity and medications showed significant results. In contrast to gastric H. pylori, non H. pylori-EHS (P-OR: 2.62, p value=0.001) and Campylobacter spp, in particular C. concisus (P-OR: 3.76, p value=0.006) and C. showae (P-OR: 2.39, p value=0.027), increase IBD risk.

Conclusions H. pylori infection is negatively associated with IBD regardless of ethnicity, age, H. pylori detection methods and previous use of aminosalicylates and corticosteroids. Antibiotics influenced the magnitude of this association. Closely related bacteria including EHS and Campylobacter spp increase the risk of IBD. These results infer that H. pylori might exert an immunomodulatory effect in IBD.

  • INFLAMMATORY BOWEL DISEASE
  • HELICOBACTER PYLORI
  • CAMPYLOBACTER
  • META-ANALYSIS

https://doi.org/10.1136/gutjnl-2015-310545

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Contributors NC-R, NOK, WSL and HMM contributed to conception and design of the study. NC-R and NOK contributed to data acquisition, analysis and interpretation of the data. NC-R drafted the initial version of the manuscript. NC-R, NOK, WSL and HMM commented on drafts of the paper and have approved the final draft of the manuscript.

    • Funding WSL receives funding from the Ministry of Higher Education, Malaysia (UM.C/625/HIR/MOHE/CHAN/13/1).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    Linked Articles