scholarly journals Helicobacter pylori Infection and Autoimmune Disease Such as Immune Thrombocytopenic Purpura

2010 ◽  
Vol 84 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Michio OHTA
Keyword(s):  
Helicobacter Pylori ◽  
Autoimmune Disease ◽  
Immune Thrombocytopenic Purpura ◽  
Thrombocytopenic Purpura

Helicobacter pylori infection and chronic immune thrombocytopenic purpura: long-term results of bacterium eradication and association with bacterium virulence profiles

Blood ◽  
2007 ◽  
Vol 110 (12) ◽  
pp. 3833-3841 ◽  
Author(s):  
Giovanni Emilia ◽  
Mario Luppi ◽  
Patrizia Zucchini ◽  
Monica Morselli ◽  
Leonardo Potenza ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Chronic Gastritis ◽  
Immune Thrombocytopenic Purpura ◽  
Long Term Results ◽  
Platelet Response ◽  
Related Factors ◽  
Thrombocytopenic Purpura ◽  
Platelet Recovery ◽  
Chronic Immune Thrombocytopenic Purpura ◽  
H Pylori

AbstractEradication of Helicobacter pylori may lead to improvement of chronic immune thrombocytopenic purpura (ITP), although its efficacy over time is uncertain. We report the results of H pylori screening and eradication in 75 consecutive adult patients with ITP. We also used molecular methods to investigate lymphocyte clonality and H pylori genotypes in the gastric biopsies from 10 H pylori–positive patients with ITP and 19 H pylori–positive patients without ITP with chronic gastritis. Active H pylori infection was documented in 38 (51%) patients and successfully eradicated in 34 (89%) patients. After a median follow-up of 60 months, a persistent platelet response in 23 (68%) of patients with eradicated infection was observed; 1 relapse occurred. No differences in mucosal B- or T-cell clonalities were observed between patients with ITP and control participants. Of note, the frequency of the H pylori cagA gene (P = .02) and the frequency of concomitant H pylori cagA, vacAs1, and iceA genes (triple-positive strains; P = .015) resulted statistically higher in patients with ITP than in control participants. All asymptomatic H pylori–positive patients with ITP were suffering from chronic gastritis. Our data suggest a sustained platelet recovery in a proportion of patients with ITP by H pylori eradication alone. Overrepresentation of specific H pylori genotypes in ITP suggests a possible role for bacterium-related factors in the disease pathogenesis.

scholarly journals Efficacy of Helicobacter pylori Eradication Therapy on Platelet Recovery in Pediatric Immune Thrombocytopenic Purpura-Case Series and a Systematic Review

2020 ◽  
Vol 8 (10) ◽  
pp. 1457
Author(s):  
Tamaki Ikuse ◽  
Masanori Toda ◽  
Kosuke Kashiwagi ◽  
Kimiko Maruyama ◽  
Masumi Nagata ◽  
...  
Keyword(s):  
Systematic Review ◽  
Helicobacter Pylori ◽  
Immune Thrombocytopenic Purpura ◽  
Pediatric Patients ◽  
Eradication Therapy ◽  
Platelet Response ◽  
Thrombocytopenic Purpura ◽  
Helicobacter Pylori Eradication ◽  
H Pylori ◽  
Helicobacter Pylori Eradication Therapy

Evidence relating to the efficacy of Helicobacter pylori eradication therapy for chronic immune thrombocytopenic purpura (cITP) in childhood is inadequate. The aim of this retrospective study was to determine the efficacy of H. pylori eradication therapy for platelet response in pediatric patients with cITP in our hospital, and to perform a systematic review of previous reports about pediatric patients with cITP who were positive for H. pylori infection and were treated with H. pylori eradication therapy. Analysis of the data of pediatric patients with cITP in our hospital and a systematic review of digital literature databases of studies in pediatric patients with cITP were performed. Data of 33 pediatric patients with cITP from our hospital records showed that the prevalence of H. pylori infection and the rate of response to platelet therapy were 15% and 33.3%, respectively. Data of 706 pediatric patients from 18 previous reports showed that the prevalence of H. pylori infection and rate of platelet response were 23% and 43.8%, respectively. Eradication therapy for H. pylori infection in pediatric cITP patients can be expected to result in a response equivalent to that in the adult population, with fewer adverse effects than other treatments for cITP.

Immune Thrombocytopenic Purpura and Helicobacter pylori Infection

2003 ◽  
Vol 163 (1) ◽  
pp. 120 ◽  
Author(s):  
Monica Morselli ◽  
Leonardo Potenza ◽  
Mario Luppi ◽  
Giuseppe Torelli ◽  
Giovanni Emilia
Keyword(s):  
Helicobacter Pylori ◽  
Immune Thrombocytopenic Purpura ◽  
Helicobacter Pylori Infection ◽  
Thrombocytopenic Purpura

scholarly journals Successful treatment with rituximab of refractory immune thrombocytopenic purpura

2009 ◽  
Vol 3 (4) ◽  
pp. 171-179
Author(s):  
Daniela Tirotta ◽  
Vittorio Durante
Keyword(s):  
Helicobacter Pylori ◽  
Intravenous Immunoglobulin ◽  
Idiopathic Thrombocytopenic Purpura ◽  
Successful Treatment ◽  
Immune Thrombocytopenic Purpura ◽  
Standard Treatment ◽  
Thrombocytopenic Purpura ◽  
Fourth Dose ◽  
Refractory Itp

Idiopathic thrombocytopenic purpura (ITP) is a disorder characterized by accelerated destruction of platelets. About 25 to 30% of patients with ITP are resistant to standard treatment. Recent reports suggest that rituximab may be useful in treating chronic refractory ITP. We report a case of a 72-year-old woman with ITP resistant to standard treatment with steroids (prednisone 2 mg/kg for 2 weeks, followed by prednisone 1 mg/kg) and intravenous immunoglobulin (0,5 mg/kg for 5 days). An infection by Helicobacter pylori was eradicated; afterwards she was treated with rituximab 375 mg/m2, once weekly for four weeks, resulting in a complete long-lasting response. Rituximab could represent a satisfactory alternative to the splenectomia in the adults with ITP; in our case the remission is complete (stable platelets > 200 x 109 after 8 months), early (before the fourth dose) and sustained (follow-up 18 months).

Alteration of Circulating Regulatory T Cells in Japanese Adult Patients with Immune Thrombocytopenic Purpura after Eradication of Helicobacter Pylori.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 3410-3410
Author(s):  
Koji Miyazaki ◽  
Mikio Danbara ◽  
Manabu Ohsaka ◽  
Yuhko Suzuki ◽  
Ryouichi Horie ◽  
...  
Keyword(s):  
T Cells ◽  
Helicobacter Pylori ◽  
Regulatory T Cells ◽  
Immune Thrombocytopenic Purpura ◽  
Mononuclear Cells ◽  
Eradication Therapy ◽  
Autoimmune Disorder ◽  
Japanese Adult ◽  
Thrombocytopenic Purpura ◽  
Platelet Counts

Abstract Immune thrombocytopenic purpura (ITP) is an autoimmune disorder, and eradication of Helicobacter pylori (HP) has been demonstrated to be an effective and tolerable firstline treatment for the patients infected with HP in Japan. However the mechanism has still remained to be uncovered. Recently CD4+CD25high+Foxp3+ regulatory T cells (Tregs), which regulate autoreactive T cells, have been identified, and suggested to play an important role in pathogenesis of ITP, as well as other autoimmune disorders. It has been shown that Tregs are reduced and suppressed in the ITP patients. And a recent report has demonstrated that the defective Tregs are restored upon the rituximab treatment. However, the effects of HP eradication therapy on Tregs have not been determined. The aim of this study is to investigate the circulating Tregs in ITP patients treated with HP eradication. And we also attempted to elucidate the mechanisms of the treatment. The peripheral blood CD4+CD25high+ Tregs were measured by flow cytometry before and after the treatment in 21 Japanese adults with HP-positive chronic ITP. We also confirmed the expression of Foxp3 in this cellular population with the permeabilized mononuclear cells. Among 21 patients, the platelet counts increased in 13 cases (responders), but not in 9 cases (non-responders). In responders the numbers of Tregs have been restored, but not in non-responders after the treatment. It is interesting here that the amounts of Tregs were still transiently elevated in an early phase (2–3weeks) after the treatment in some non-responders without recovery of the platelet counts. Furthermore, in three cases, who failed in pylorus elimination, Tregs were also transiently increased in number associated with brief recovery of the platelet counts, and reduced to the initial level in about two months. After the successful re-eradication, the numbers of Tregs and platelets have been restored. From these results it is shown that HP eradication can modulate Tregs to increase the platelet counts for ITP patients. We also demonstrate that the increase of Tregs by HP eradication was more rapid than that by rituximab, which required about three months. Further, it might be suggested that there are two phases of the therapy with HP eradication for ITP. In an initial stage, the therapy itself could have an effect modulating the immune systems to potentiate Tregs. Some drugs, such as macrolide antibiotics including clarithromycin have been demonstrated to be a potent immunomodulator. However, this phase is not sufficient for the successful treatment, as shown in the cases of failure in HP elimination. In a retentive stage, extermination of HP is also necessary for sustainment of restored Tregs.

scholarly journals Helicobacter pylori: An Underrated Cause of Immune Thrombocytopenic Purpura. A Comprehensive Review

Cureus ◽  
2019 ◽  
Author(s):  
Muhammad A Zain ◽  
Fahad Zafar ◽  
Ammar A Ashfaq ◽  
Abdur R Jamil ◽  
Asrar Ahmad
Keyword(s):  
Helicobacter Pylori ◽  
Immune Thrombocytopenic Purpura ◽  
Thrombocytopenic Purpura ◽  
Comprehensive Review
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