What are the diseases associated with Helicobacter infection?

  Helicobacter pylori (HP) was first isolated from gastric mucosal specimens of patients with chronic gastritis by Australians Warren and Warshall et al. in 1983. It is now believed that it settles on the epithelial cell surface of the gastric mucosa, has good dynamics and adhesion function, can produce a variety of enzymes and a variety of pathogenic factors and through these pathogenic factors induce inflammation, immune response, release of inflammatory mediators leading to destruction of the gastric mucosal barrier, causing changes in gastric acid secretion and producing different clinically relevant diseases. Numerous studies have shown that HP is the cause of chronic gastritis and peptic ulcer, and is also closely related to gastric cancer. With the depth of research, scholars at home and abroad also found that HP is closely related to the occurrence and development of some other diseases.  1, iron deficiency anemia: IDA is anemia that occurs when the body’s iron stores are exhausted and cannot meet the needs of normal erythropoiesis. HP has a certain correlation with IDA. Firstly, HP infection causes peptic ulcer combined with long-term bleeding in the digestive tract is the most direct cause; secondly, HP infection causes damage to the epithelium of the gastric mucosa, which directly leads to a decrease in gastric acid secretion, which in turn causes a decrease in the conversion of high-valent iron to low-valent iron in food and affects iron absorption.  2, mucosa-associated lymphoid tissue lymphoma: gastric MALT lymphoma is the main type of primary gastric malignant lymphoma gradually recognized in recent years, from the gastric mucosa-associated lymphoid tissue (MALT) so named. MALT lymphoma is a lymphoma of B-cell lineage occurring in extracellular tissues, with high and low malignancy. Gastric MALT lymphoma is a lymphoma of the B-cell lineage. Gastric MALT lymphoma accounts for approximately 40% of extra-nodal non-Hodgkin’s lymphomas. It has been widely studied because it is the most common and easy to detect. In recent years, it has been found that the development and progression of the disease is closely related to Helicobacter pylori (HP) infection, and the evidence comes mainly from epidemiological and clinical therapeutic data.  Hp positivity in the gastric mucosa of gastric MALT lymphoma can reach 90%; case-control studies have shown that prior Hp infection is associated with later occurrence of gastric lymphoma; therapeutic eradication of Hp causes varying degrees of regression in 75% of gastric MALT lymphomas and complete cure of early stage hypermalignant lymphoma, leading to the recommendation of eradication of Hp as the first option for treatment of the disease. There are reports of HP reinfection, recurrence of MALT lymphoma, and regression by eradication, suggesting a special relationship between infection and the development of this tumor. The achievements in pathogenesis, early diagnosis and treatment are considered to be the most advanced areas of research in gastrointestinal diseases in recent years.  3. Dermatological diseases: Chronic urticaria (CU) is a common disease in dermatology, which is a kind of limited edema produced by the dilation and increased permeability of small blood vessels in the skin mucosa, with a rather complex etiology and difficult to eradicate. In recent years, it has been found that eradication of HP can help in the treatment of CU.  4. Idiopathic thrombocytopenic purpura: The etiology of idiopathic thrombocytopenic purpura (ITP) as an autoimmune disease is still unclear. Recently, H. pylori infection has been found to be a possible causative factor in the development of some ITPs. Recently, many literature reported that ITP can be treated by HP eradication. comprehensive literature reported that the current use of HP eradication therapy for ITP has an efficiency of about 50%.  5. Cerebral infarction: The relationship between Helicobacter pylori (HP) infection and recurrence of cerebral infarction was observed. It was concluded that the recurrence rate of cerebral infarction was higher in HP-positive patients than in HP-negative patients, and the recurrence rate of cerebral infarction was reduced after HP eradication.  6, hepatic encephalopathy: hepatic encephalopathy (hepaticencephalopathy, HE) is mainly caused by increased blood ammonia, the stomach of the Helicobacter pylori (HP) can produce urease, resulting in increased ammonia concentration in gastric juice, and therefore has an important role in the occurrence of hepatic encephalopathy.  7.Gastric cancer: In the past 20 years, many scholars have devoted themselves to the epidemiological study of gastric cancer and found that the occurrence of gastric cancer is related to environmental factors. Many studies have considered HP infection as one of the environmental factors related to the occurrence of gastric cancer. Although it is not certain that there is a causal relationship between the two, more and more data show that Helicobacter pylori (HP) infection is a risk factor for gastric cancer, which first causes gastritis, then leads to gastric mucosal atrophy and evolves into gastric cancer gradually. Therefore, systematic antibacterial treatment for Hp-infected people to remove HP can not only prevent and treat chronic active gastritis and peptic ulcer, but also may reduce the incidence of gastric cancer.  8, Coronary heart disease: The pathogenesis of coronary heart disease is the abnormalities of blood lipids and platelet aggregation, adhesion, fibrin deposition, activation of platelet activation factor to form micro-thrombus, leukocyte collapse in the thrombus to explain the lipids, forming atherosclerotic plaque, platelets release thromboxane to further aggravate platelet aggregation and vasoconstriction, platelet pro-growth factor stimulates smooth muscle cell proliferation, forming coronary artery narrowing, causing coronary heart disease. There is a correlation between HP infection and coronary heart disease, and HP-infected patients with coronary heart disease may act through mechanisms such as immune response or altered lipid metabolism.  In addition to the various related diseases described above, some literature has reported that HP is associated with glaucoma, rheumatoid arthritis, functional dyspepsia, diabetes mellitus, and cirrhosis of the liver, and other studies have found that HP’s own protein can promote the formation of gallbladder stones. Some pediatricians also believe that HP is associated with growth retardation and sudden death in infants. As people’s understanding of various diseases deepens, more diseases related to HP will be discovered and need to be further studied and explored.