Abstract
Behçet’s disease is a systemic vasculitic syndrome with unknown etiology. The aim of the present study was to compare the Helicobacter pylori seropositivity and cytotoxin associated gene-A status in patients with Behçet’s disease. Ninety-one patients with Behçet’s disease and 83 age- and sex-matched persons with or without any gastrointestinal complaints were included in the study. Demographic characteristics and H. pylori IgG, IgM, and cytotoxin-associated gene-A IgG status of the Behçet’s disease and the control groups were analyzed. The influence of eradication therapy on clinical findings was also determined. The prevalence of H. pylori IgG seropositivity was slightly but not significantly higher in patients with Behçet’s disease compared to the controls [72 (79.1%) vs 56 (67.5%), (p = 0.082)]. The prevalence of cytotoxin-associated gene A positivity was significantly higher in Behçet’s disease compared to the controls [59 (64.8.%) vs 32 (38.5%), respectively, (p = 0.002)]. Eradication of H. pylori has significantly decreased clinical manifestations such as oral and genital ulceration, arthritis/arthralgia, and cutaneous findings of Bahçet’s disease. Our study indicates that H. pylori may be involved in the pathogenesis of Behçet’s disease or disease activity might be enhanced due to induced inflammation or altered immunity.
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References
Kurokawa SM, Suzuki N (2004) Behcet’s disease. Clin Exp Med 3:10–20
Gül A (2005) Behçet’s disease as an autoinflammatory disorder. Curr Drug Targets Inflamm Allergy 4:81–83
Graham DY (1997) Helicobacter pylori infection in the pathogenesis of duodenal ulcer and gastric cancer: a model. Gastroenterology 113:1983–1991
Dunn BE, Cohen H, Blaser MJ (1997) Helicobacter pylori. Clin Microbiol Rev 10:720–741
Holtmann G, Talley NJ, Mitchell H, Hazell S (1998) Antibody response to specific H. pylori antigens in functional dyspepsia, duodenal ulcer disease, and health. Am J Gastroenterol 93:1222–1227
Blaser MJ, Perez-Perez GI, Kleanthous H, Cover TL, Peek RM, Chyou PH, Stemmermann GN, Nomura A (1995) Infection with Helicobacter pylori strains possessing cagA is associated with an increased risk of developing adenocarcinoma of stomach. Cancer Res 55:2111–2115
International Study Group for Behçet’s Disease (1990) Criteria for diagnosis of Behçet’s disease. Lancet 335:1078–1080
Lehner T, Lavery E, Smith R, van der Zee R, Mizushima Y, Shinnick T (1991) Association between the 65-kilodalton heat shock protein, Streptococcus sanguis and the corresponding antibodies in Behçet’s syndrome. Infect Immun 59:1434–1441
Pervin K, Childerstone A, Shinnick T, Mizushima Y, van der Zee R, Hasan A, Vaughan R, Lehner T (1993) T cell epitope expression of mycobacterial and homologous human 65-kilodalton heat shock protein peptides in short term cell lines from patients with Behçet’s disease. J Immunol 151:2273–2282
Direskeneli H, Direskeneli GS (2003) The role of heat shock proteins in Behçet’s disease. Clin Exp Rheumatol 21:S44–S48
Kibaroglu A, Eksioglu-Demiralp E, Akoglu T, Direskeneli H (2004) T and NK (2004) cell subset changes with microbial extracts and human HSP60-derived peptides in Behçet’s disease. Clin Exp Rheumatol 22:59–63
Imamura Y, Kurokawa MS, Yoshikawa H, Nara K, Takada E, Masuda C, Tsukikawa S, Ozaki S, Matsuda T, Suzuki N (2005) Involvement of Th1 cells and heat shock protein 60 in the pathogenesis of intestinal Behçet’s disease. Clin Exp Immunol 139:371–378
Mayr M, Kiechl S, Willeit J, Wick G, Xu Q (2000) Infections, immunity, and atherosclerosis: associations of antibodies to Chlamydia pneumoniae, Helicobacter pylori, and Cytomegalovirus with immune reactions to heat shock protein 60 and carotid or femoral atherosclerosis. Circulation 22:833–839
Goodwin CS, Mendal NM, Northfield TC (1997) Helicobacter pylori infection. Lancet 349:265–269
Figura N, Giordano N, Burroni D, Macchia G, Vindigni G, Gennari C, Bayeli PF (1994) Sjögren’s syndrome and Helicobacter pylori infection. Eur J Gastroenterol Hepatol 6:321–322
Showi Y, Nozawa R, Sato K, Suzuki H (1996) Seroprevalence of Helicobacter pylori infection in patients with connective tissue diseases. Microbiol Immunol 40:409–503
Presotto F, Sabini, B, Cecchetto A, Plebani M, De Lazzari F, Pedini B, Betterle C (2003) Helicobacter pylori infection and gastric autoimmune diseases: is there a link? Helicobacter 8:578–584
Censini S, Lange C, Xiang Z, Crabtree JE, Ghiara P, Borodovsky M, Rappuoli R, Covacci A (1996) Cag, a pathogenicity island of Helicobacter pylori, encodes type I-specific and disease-associated factors. Proc Natl Acad Sci USA 93:14648–14653
Akopyants NS, Clifton SW, Kersulyte D, Crabtree JE, Youree BE, Reece CA, Bukanov NO, Drazek ES, Roe BA, Berg DE (1998) Analysis of the cag pathogenicity island of Helicobacter pylori. Mol Microbiol 28:37–53
Krause I, Molad Y, Mitrani M, Weinberger A (2000) Pathergy reaction in Behcet’s disease: lack of correlation with mucocutaneous manifestations and systemic disease expression. Clin Exp Rheumatol 18:71–74
Sicinschi LA, Correa P, Schneider BG (2003) Comparison off genotyping of Helicobacter pyori cagA and vacA virulence genes from gastric biopsies and stool specimens. Helicobacter 8:601–607
Rudi J, Kolb C, Maiwald M, Kuck D, Sieg A, Galle PR, Stremmel W (1998) Diversity of Helicobacter pylori vacA and cagA genes and relationship to VacA and CagA protein expression, cytotoxin production, and associated diseases. J Clin Microbiol 36:944–948
Mahachai V, Tangkijvanich P, Wannachai N, Sumpathanukul P, Kullavanijaya P (1999) CagA and VacA: virulence factors of Helicobacter pylori in Thai patients with gastroduodenal diseases. Helicobacter 4:143–147
Weel JFL, van der Hulst RWM, Gerrits Y, Roorda P, Feller M, Dankert J, Tytgat GNJ, van der Ende A (1996) The interrelationship between cytotoxin-associated gene A, vacuolating cytotoxin, and Helicobacter pylori-related diseases. J Infect Dis 173:1171–1175
Avcı O, Ellidokuz E, Simsek I, Buyukgebiz B, Gunes AT (1999) Helicobacter pylori and Behcet’s disease. Dermatology 199:140–143
Segal ED, Cha J, Lo J, Falkow S, Tompkins LS (1999) Altered states: involvement of phosphorylated Cag A in the induction of host cellular growth changes by Helicobacter pylori. Proc Natl Acad Sci USA 96:14559–14564
Ning-Sheng L, Ruay-Sheng L, Kuo-Chih T (2005) High frequency of unusual gastric/duodenal ulcers in patients with Behçet’s disease in Taiwan: a possible correlation of MHC molecules with the development of gastric/duodenal ulcers. Clin Rheumatol 24:516–520
Takada Y, Saigenji K (2003) Is intestinal Behçet’s disease in fact an enterocolitis or an ulcer disease, and is steroid treatment useful or harmful? J Gastroenterol 38:1015–1016
Tzourmakliotis D, Economou M, Manolakopoulos S, Bethanis S, Bergele C, Lakoumentas J, Sclavos P, Milionis H, Margeli A, Vogiatzakis E, Avgerinos A (2004) Clinical significance of cytotoxin-associated gene A status of Helicobacter pylori among non-steroidal anti-inflammatory drug users with peptic ulcer bleeding: a multicenter case-control study. Scand J Gastroenterol 39:1180–1185
Chan FKL, To KF, Wu JCY, Yung MY, Leung WK, Kwok T, Hui y, Chan HLY, Chan CSY, Hui E, Woo J, Sung JJY (2002) Eradication of Helicobacter pylori and risk of peptic ulcers in patients starting long-term treatment with non-steroidal anti-inflammatory drugs: a randomized trial. Lancet 359:9–13
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Apan, T.Z., Gürsel, R. & Dolgun, A. Increased seropositivity of Helicobacter pylori cytotoxin-associated gene-A in Behçet’s disease. Clin Rheumatol 26, 885–889 (2007). https://doi.org/10.1007/s10067-006-0416-x
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DOI: https://doi.org/10.1007/s10067-006-0416-x