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Helicobacter Pylori’s Destructive Role

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From Alzheimer's to Heart Disease and Beyond

By Nieske Zabriskie, ND

Helicobacter pylori (H. pylori) is a spiral-shaped bacterium that has the ability to withstand the highly acidic environment of the stomach. It can adhere to the lining of the stomach and cause damage, although it may not always cause symptoms in affected individuals. Approximately two-thirds of the world’s population is infected with H. pylori. In the United States, it is estimated that 20 percent of people under 40 years old and half of those over 60 years are infected.1 Additionally, research has found that many children are infected. Approximately 8 percent of children age one to three years old test positive for antibodies to H. pylori. They also found that by age 18-23 years, 24.5 percent of individuals were infected.2

It is well established that H. pylori causes gastrointestinal disease. In fact, H. pylori causes more than 90 percent of duodenal ulcers and more than 80 percent of stomach ulcers.3 H. pylori also causes gastritis, an inflammation of the stomach lining, which can lead to chronic inflammation or loss of function of the cells (atrophic gastritis). Furthermore, individuals with this infection have a 2-6-fold increased risk of developing mucosa-associated lymphoid tissue lymphoma and stomach cancer compared to uninfected individuals.4

Although H. pylori infects the stomach, it has been shown to play a role in the development of numerous non-gastrointestinal diseases. Researchers suggest that H. pylori induces systemic inflammation as well as decreases the absorption of nutrients, thereby increasing the risk of several diseases. Some of the conditions associated with H. pylori infection include cardiovascular disease, stroke, anemia, glaucoma, Alzheimer’s disease, rosacea, eczema, chronic hives, diabetes, thyroid disease and idiopathic thrombocytopenic purpura.

Alzheimer’s Disease

One of the most interesting associations with H. pylori infection is the increased risk of Alzheimer’s disease. One study found that H. pylori antibodies were significantly higher in both the serum and cerebral spinal fluid in patients with Alzheimer’s disease compared to age-matched subjects with normal cognition. Additionally, this study showed that increasing severity of cognitive dysfunction correlated to increasing levels of H. pylori antibodies in the cerebral spinal fluid.5 In another study, researchers found H. pylori antibodies in 88 percent of Alzheimer’s patients compared to only 46.7 percent of the control subjects. Furthermore, this study found that successful eradication treatment of H. pylori in Alzheimer’s patients resulted in improvement in cognitive and functional ability over the two-year follow-up period.6

Cardiovascular Disease

Several cardiovascular diseases are associated with H. pylori infections. One study found that eradication treatment of H. pylori increased high-density lipoprotein (HDL) cholesterol (“good” cholesterol), and decreased the inflammatory markers C-reactive protein (CRP) and fibrinogen, which are associated with atherosclerosis and cardiovascular disease risk.7 Research has shown that the presence of H. pylori antibodies were significantly more frequent in individuals with coronary artery disease (CAD) compared to healthy control subjects. In fact, the presence of antibodies was nearly double in the subjects with CAD compared to the control group, which also correlated to increased CRP levels.8 Similarly, another study showed that H. pylori infection was related to increased arterial stiffness and increased systolic blood pressure in diabetic subjects.9

Skin Disorders

Rosacea is a chronic inflammatory skin disease characterized by recurrent episodes of facial flushing, redness, small red bumps or pimples, and dilated blood vessels. One study showed that 88 percent of subjects with rosacea had evidence of H. pylori infection. The researchers also demonstrated that H. pylori eradication resulted in the disappearance or significant reduction in rosacea in 51 of 60 subjects within 2-4 weeks.10 Other skin conditions associated with H. pylori infection include psoriasis,11 chronic urticaria (hives), prurigo chronica multiformis, pruritus cutaneus and eczema nummulare. Eradication treatment in subjects with these skin conditions showed significant improvement in skin symptoms.12

Glaucoma

Glaucoma is the second leading cause of blindness in the world. One study showed that Helicobacter pylori was present in 88 percent of glaucoma cases compared to 47 percent of age-matched control subjects. In the subjects with successful H. pylori eradication, mean intraocular pressure and mean visual field parameters significantly improved.13 Similarly, another study found that H. pylori antibodies were significantly elevated in the serum and aqueous humor (the thick fluid within the eye) in subjects with glaucoma compared to subjects with cataracts. Additionally, the researchers found that the levels of H. pylori antibodies in the aqueous humor correlate to the severity of glaucoma-related damage in individuals with primary open-angle glaucoma.14

Blood Disorders

Studies suggest that H. pylori infection is associated with blood disorders such as iron-deficiency anemia and idiopathic thrombocytopenic purpura (ITP). Research has shown that in patients with unexplained iron-deficiency anemia, the most common type of anemia, approximately 50 percent have evidence of active H. pylori infection.15 Other research has shown that H. pylori positive cases were associated with a decrease in ferritin, a measurement of iron storage, and were 2.7 times more likely to develop anemia than those testing negative for infection.16 Substantial research also indicates that H. pylori infection is associated with ITP, which is a disease of low platelet levels with no known cause. H. pylori infection was found in 63.3 percent of patients with ITP, and the presence of H. pylori increased the risk of developing ITP by 2.25 times.17 Furthermore, research has shown that platelet counts improve in ITP patients that undergo successful H. pylori eradication treatment.18

Endocrine Disorders

Some researchers suggest that H. pylori infection plays a role in several endocrine disorders such as autoimmune thyroid diseases, diabetes, obesity, osteoporosis and primary hyperparathyroidism.19 One study found that 75.6 percent of subjects with type 2 diabetes had H. pylori infections, compared to only 46 percent of control subjects.20 A similar study showed that there was a higher prevalence of H. pylori infection both in obese and in diabetic patients compared to control subjects, and prevalence became still higher in obese patients with impaired glucose tolerance.21 Another study showed that patients with autoimmune thyroid disease had significantly increased prevalence of H. pylori compared to healthy controls.22

Natural Solutions for H. Pylori Infections

Eradication of H. pylori can improve numerous conditions, and natural strategies exist to help eradicate this harmful organism. The resin of Pistacia lentiscus, known as mastic gum (found in CeaseFire®), has been studied in patients with gastritis, ulcers, and H. pylori infection. Studies indicate that mastic gum kills 50-90 percent of H. pylori, depending on concentration.23 Additional research has demonstrated that mastic gum reduces H. pylori colonization by 30-fold.24 One recently published clinical trial tested the efficacy of mastic gum supplementation in patients with dyspepsia (indigestion and stomach pain). Subjects received mastic gum at a dose of 350 mg three times daily or placebo for 3 weeks. The results showed that in the subjects receiving mastic gum, 77 percent reported significant improvement in symptoms, including stomach pain and heartburn, compared to 40 percent in the placebo group.25 Other clinical trials have shown that mastic gum supplementation induced symptomatic relief in 80 percent of patients with duodenal ulcers, and 70 percent of subjects had confirmed healing using endoscopy.26

Conclusion

Infection with H. pylori is associated with increased risk of numerous diseases, likely through the induction of systemic inflammation. Eradication of H. pylori is an important step in reducing symptoms related to these diseases. Mastic gum is a natural product that has shown efficacy against H. pylori and related symptoms.

References

1. National Institutes of Health: National Digestive Diseases Information Clearinghouse. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/hpylori/index.htm. Accessed on: 02-13-10.

2. Malaty HM, El-Kasabany A, Graham DY, et al. Age at acquisition of Helicobacter pylori infection: a follow-up study from infancy to adulthood. Lancet. 2002 Mar 16;359(9310):931-5.

3. Centers for Disease Control and Prevention (CDC). Helicobacter pylori. Available at: http://www.cdc.gov/ncidod/aip/research/hp.html. Accessed on: 02-13-10.

4. Centers for Disease Control and Prevention (CDC). Helicobacter pylori and Peptic Ulcer Disease. Available at: http://www.cdc.gov/ulcer/keytocure.htm#illnesses. Accessed on: 02-13-10.

5. Kountouras J, Boziki M, Gavalas E, et al. Increased cerebrospinal fluid Helicobacter pylori antibody in Alzheimer’s disease. Int J Neurosci. 2009;119(6):765-77.

6. Kountouras J, Boziki M, Gavalas E, et al. Eradication of Helicobacter pylori may be beneficial in the management of Alzheimer’s disease. J Neurol. 2009 May;256(5):758-67.

7. Pellicano R, Oliaro E, Fagoonee S, et al. Clinical and biochemical parameters related to cardiovascular disease after Helicobacter pylori eradication. Int Angiol. 2009 Dec;28(6):469-73.

8. Jha HC, Prasad J, Mittal A. High immunoglobulin A seropositivity for combined Chlamydia pneumoniae, Helicobacter pylori infection, and high-sensitivity C-reactive protein in coronary artery disease patients in India can serve as atherosclerotic marker. Heart Vessels. 2008 Nov;23(6):390-6.

9. Ohnishi M, Fukui M, Ishikawa T, et al. Helicobacter pylori infection and arterial stiffness in patients with type 2 diabetes mellitus. Metabolism. 2008 Dec;57(12):1760-4.

10. Szlachcic A. The link between Helicobacter pylori infection and rosacea. J Eur Acad Dermatol Venereol. 2002 Jul;16(4):328-33.

11. Qayoom S, Ahmad QM. Psoriasis and Helicobacter pylori. Indian J Dermatol Venereol Leprol. 2003 Mar-Apr;69(2):133-4.

12. Shiotani A, Okada K, Yanaoka K, et al. Beneficial effect of Helicobacter pylori eradication in dermatologic diseases. Helicobacter. 2001 Mar;6(1):60-5.

13. Kountouras J, Mylopoulos N, Chatzopoulos D, et al. Eradication of Helicobacter pylori may be beneficial in the management of chronic open-angle glaucoma. Arch Intern Med. 2002 Jun 10;162(11):1237-44.

14. Kountouras J, Mylopoulos N, Konstas AG, et al. Increased levels of Helicobacter pylori IgG antibodies in aqueous humor of patients with primary open-angle and exfoliation glaucoma. Graefes Arch Clin Exp Ophthalmol. 2003 Nov;241(11):884-90.

15. Hershko C, Ronson A. Iron deficiency, Helicobacter infection and gastritis. Acta Haematol. 2009;122(2-3):97-102.

16. Zakaria NH, Ahmed EA. Investigation of a Possible Association Between Refractory Iron Deficiency Anaemia to an Underlying Remote Helicobacter pylori Infection. J Egypt Public Health Assoc. 2009;84(1-2):141-68.

17. Shaikh KH, Ahmed S, Ayyub M, et al. Association of Helicobacter pylori infection with idiopathic thrombocytopenic purpura. J Pak Med Assoc. 2009 Oct;59(10):660-3.

18. Wu S, Li Y, Jian Z, et al. Anti-Helicobacter pylori treatment in patients with idiopathic thrombocytopenic purpura. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2009 Dec;34(12):1251-4.

19. Papamichael KX, Papaioannou G, Karga H, et al. Helicobacter pylori infection and endocrine disorders: is there a link? World J Gastroenterol. 2009 Jun 14;15(22):2701-7.

20. Gulcelik NE, Kaya E, Demirbas B, et al. Helicobacter pylori prevalence in diabetic patients and its relationship with dyspepsia and autonomic neuropathy. J Endocrinol Invest. 2005 Mar;28(3):214-7.

21. Perdichizzi G, Bottari M, Pallio S, et al. Gastric infection by Helicobacter pylori and antral gastritis in hyperglycemic obese and in diabetic subjects. New Microbiol. 1996 Apr;19(2):149-54.

22. Larizza D, Calcaterra V, Martinetti M, et al. Helicobacter pylori infection and autoimmune thyroid disease in young patients: the disadvantage of carrying the human leukocyte antigen-DRB1*0301 allele. J Clin Endocrinol Metab. 2006 Jan;91(1):176-9.

23. Marone P, Bono L, Leone E, et al. Bactericidal activity of Pistacia lentiscus mastic gum against Helicobacter pylori. J Chemother. 2001 Dec;13(6):611-4.

24. Paraschos S, Magiatis P, Mitakou S, et al. In vitro and in vivo activities of Chios mastic gum extracts and constituents against Helicobacter pylori. Antimicrob Agents Chemother. 2007 Feb;51(2):551-9.

25. Dabos KJ, Sfika E, Vlatta LJ, et al. Is Chios mastic gum effective in the treatment of functional dyspepsia? A prospective randomised double-blind placebo controlled trial. J Ethnopharmacol. 2010 Feb 3;127(2):205-9.

26. Al-Habbal MJ, Al-Habbal Z, Huwez FU. A double-blind controlled clinical trial of mastic and placebo in the treatment of duodenal ulcer. Clin Exp Pharmacol Physiol. 1984 Sep-Oct;11(5):541-4.