Skip to main content
SpringerLink
Log in

Beneficial effects of Helicobacter pylori eradication in systemic sclerosis patients

  • original article
  • Published:
Wiener klinische Wochenschrift Aims and scope Submit manuscript

Summary

Objective

Previous studies have shown that Helicobacter pylori (HP) infection is associated with increased activity and severity of systemic sclerosis (SSc), hence we aimed to evaluate the effect of HP eradication on various symptoms and inflammatory indices.

Methods

The SSc patients without dyspeptic symptoms were prospectively enrolled in this 18-month cross-sectional study. Patients were divided into two groups based on determination of HP infection. The infected group was treated in accordance with the current HP eradication protocol. Assessment of disease activity, severity and organ involvement was performed every 6 months.

Results

A total of 42 consecutive SSc patients without dyspepsia and variable disease activity and severity were recruited. Levels of modified Rodnan skin score, erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) significantly decreased following HP eradication (p < 0.001, p < 0.001 and p = 0.001, respectively), and in the HP-negative patient group ESR and CRP values increased (p = 0.03, p = 0.002). Eradication of HP in the group of infected patients induced progressive and significant improvement of disease activity and severity over time compared to baseline (p < 0.01, p < 0.001, respectively), whereas in the HP-negative patient group these scores remained unchanged. In our study, HP eradication was associated with an improvement of clinical symptoms and disease activity.

Conclusion

These findings suggest that HP detection and subsequent eradication could be beneficial in the management of SSc patients. Although, HP eradication seems to be advantageous in infected SSc patients, larger controlled studies are needed for a potential recommendation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Radić M, Kaliterna DM, Radić J. Helicobacter pylori infection and systemic sclerosis-is there a link? Joint Bone Spine. 2011;78:337–40. https://doi.org/10.1016/j.jbspin.2010.10.005.

    Article  PubMed  Google Scholar 

  2. Yong WC, Upala S, Sanguankeo A. Helicobacter pylori infection in systemic sclerosis: a systematic review and meta-analysis of observational studies. Clin Exp Rheumatol. 2018;36(Suppl 113):168–74.

    PubMed  Google Scholar 

  3. Radić M. Role of Helicobacter pylori infection in autoimmune systemic rheumatic diseases. World J Gastroenterol. 2014;20:12839–46. https://doi.org/10.3748/wjg.v20.i36.12839.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Radić M, Martinović Kaliterna D, Bonacin D, Morović Vergles J, Radić J. Correlation between Helicobacter pylori infection and systemic sclerosis activity. Rheumatology. 2010;49:1784–5. https://doi.org/10.1093/rheumatology/keq137.

    Article  PubMed  Google Scholar 

  5. Radić M, Kaliterna DM, Bonacin D, Vergles JM, Radić J, Fabijanić D, Kovačić V. Is Helicobacter pylori infection a risk factor for disease severity in systemic sclerosis? Rheumatol Int. 2013;33:2943–8. https://doi.org/10.1007/s00296-012-2585-z.

    Article  CAS  PubMed  Google Scholar 

  6. van den Hoogen F, Khanna D, Fransen J, Johnson SR, Baron M, Tyndall A, Matucci-Cerinic M, Naden RP, Medsger TA Jr, Carreira PE, Riemekasten G, Clements PJ, Denton CP, Distler O, Allanore Y, Furst DE, Gabrielli A, Mayes MD, van Laar JM, Seibold JR, Czirjak L, Steen VD, Inanc M, Kowal-Bielecka O, Müller-Ladner U, Valentini G, Veale DJ, Vonk MC, Walker UA, Chung L, Collier DH, Csuka ME, Fessler BJ, Guiducci S, Herrick A, Hsu VM, Jimenez S, Kahaleh B, Merkel PA, Sierakowski S, Silver RM, Simms RW, Varga J, Pope JE. 2013 classification criteria for systemic sclerosis: an American College of Rheumatology/European League against Rheumatism collaborative initiative. Arthritis Rheum. 2013;65:2737–47. https://doi.org/10.1002/art.38098.

    Article  PubMed  PubMed Central  Google Scholar 

  7. LeRoy EC, Black C, Fleischmajer R, Jablonska S, Krieg T, Medsger TA Jr, Rowell N, Wollheim F. Scleroderma (systemic sclerosis): classification, subsets and pathogenesis. J Rheumatol. 1988;15:202–5.

    CAS  PubMed  Google Scholar 

  8. Medsger TA Jr, Bombardieri S, Czirjak L, Scorza R, Della Rossa A, Bencivelli W. Assessment of disease severity and prognosis. Clin Exp Rheumatol. 2003;21(3 Suppl 29):S42–S6.

    PubMed  Google Scholar 

  9. Valentini G, Rossa DA, Bombardieri S, Bencivelli W, Silman AJ, D’Angelo S, Cerinic MM, Belch JF, Black CM, Bruhlmann P, Czirják L, De Luca A, Drosos AA, Ferri C, Gabrielli A, Giacomelli R, Hayem G, Inanc M, McHugh NJ, Nielsen H, Rosada M, Scorza R, Stork J, Sysa A, van den Hoogen FH, Vlachoyiannopoulos PJ. European multicentre study to define disease activity for systemic sclerosis. Identification of disease activity variables and development of preliminary activity indexes. Ann Rheum Dis. 2001;60:592–8. https://doi.org/10.1136/ard.60.6.592.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Savarino V, Mela GS, Zentilin P, Bisso G, Pivari M, Mansi C, Mele MR, Bilardi C, Vigneri S, Celle G. Comparison of isotope ratio mass spectrometry and nondispersive isotope-selective infrared spectroscopy for 13C-urea breath test. Am J Gastroenterol. 1999;94:1203–8. https://doi.org/10.1111/j.1572-0241.1999.01067.x.

    Article  CAS  PubMed  Google Scholar 

  11. Malfertheiner P, Megraud F, O’Morain CA, Atherton J, Axon AT, Bazzoli F, Gensini GF, Gisbert JP, Graham DY, Rokkas T, El-Omar EM, Kuipers EJ, European Helicobacter Study Group. Management of Helicobacter pylori infection—the Maastricht IV/ Florence Consensus Report. Gut. 2012;61:646–64. https://doi.org/10.1136/gutjnl-2012-302084.

    Article  CAS  PubMed  Google Scholar 

  12. Steen VD. Treatment of systemic sclerosis. Am J Clin Dermatol. 2001;2:315–25. https://doi.org/10.2165/00128071-200102050-00006.

    Article  CAS  PubMed  Google Scholar 

  13. Richard N, Hudson M, Gyger G, Baron M, Sutton E, Khalidi N, Pope JE, Carrier N, Larché M, Albert A, Fortin PR, Thorne C, Masetto A, on the behalf of Canadian Scleroderma Research Group. Clinical correlates of faecal incontinence in systemic sclerosis: identifying therapeutic avenues. Rheumatology. 2017;56:581–8. https://doi.org/10.1093/rheumatology/kew441.

    Article  CAS  PubMed  Google Scholar 

  14. Grossman C, Dovrish Z, Shoenfeld Y, Amital H. Do infections facilitate the emergence of systemic sclerosis? Autoimmun Rev. 2011;10:244–7. https://doi.org/10.1016/j.autrev.2010.09.010.

    Article  PubMed  Google Scholar 

  15. Bilgin H, Kocabaş H, Keşli R. The prevalence of infectious agents in patients with systemic sclerosis. Turk J Med Sci. 2015;45:1192–7.

    Article  CAS  PubMed  Google Scholar 

  16. Royle JG, Lanyon PC, Grainge MJ, Abhishek A, Pearce FA. The incidence, prevalence, and survival of systemic sclerosis in the UK Clinical Practice Research Datalink. Clin Rheumatol. 2018;37:2103–11. https://doi.org/10.1007/s10067-018-4182-3.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Efthymiou G, Dardiotis E, Liaskos C, Marou E, Tsimourtou V, Scheper T, Meyer W, Daponte A, Sakkas LI, Hadjigeorgiou G, Bogdanos DP. Anti-hsp60 antibody responses based on Helicobacter pylori in patients with multiple sclerosis: (ir)Relevance to disease pathogenesis. J Neuroimmunol. 2016;298:19–23. https://doi.org/10.1016/j.jneuroim.2016.06.009.

    Article  CAS  PubMed  Google Scholar 

  18. Narang M, Puri AS, Sachdeva S, Singh J, Kumar A, Saran RK. Celiac disease and Helicobacter pylori infection in children: is there any Association? J Gastroenterol Hepatol. 2017;32:1178–82. https://doi.org/10.1111/jgh.13654.

    Article  CAS  PubMed  Google Scholar 

  19. Thia KT, Loftus EV Jr, Sandborn WJ, Yang SK. An update on the epidemiology of inflammatory bowel disease in Asia. Am J Gastroenterol. 2008;103:3167–82. https://doi.org/10.1111/j.1572-0241.2008.02158.x.

    Article  PubMed  Google Scholar 

  20. Bravo D, Hoare A, Soto C, Valenzuela MA, Quest AF. Helicobacter pylori in human health and disease: mechanisms for local gastric and systemic effects. World J Gastroenterol. 2018;24:3071–89. https://doi.org/10.3748/wjg.v24.i28.3071.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Andréasson K, Alrawi Z, Persson A, Jönsson G, Marsal J. Intestinal dysbiosis is common in systemic sclerosis and associated with gastrointestinal and extraintestinal features of disease. Arthritis Res Ther. 2016;18:278. https://doi.org/10.1186/s13075-016-1182-z.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Volkmann ER, Chang YL, Barroso N, Furst DE, Clements PJ, Gorn AH, Roth BE, Conklin JL, Getzug T, Borneman J, McGovern DP, Tong M, Jacobs JP, Braun J. Association of systemic sclerosis with a unique colonic microbial consortium. Arthritis Rheumatol. 2016;68:1483–92. https://doi.org/10.1002/art.39572.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Rheumatology and Clinical Immunology, Center of excellence for Systemic Sclerosis Ministry of Health Republic of Croatia, School of Medicine in Split, University Hospital Center Split, Šižgorićeva 20/II, 21 000, Split, Croatia

    Mislav Radić MD PhD & Dušanka Martinović Kaliterna

  2. Division of Gastroenterology, School of Medicine in Split, University Hospital Center Split, Split, Croatia

    Damir Bonacin

  3. Division of Rheumatology and Clinical Immunology, School of Medicine in Zagreb, Dubrava University Hospital, Zagreb, Croatia

    Jadranka Morović Vergles

  4. Division of Nephrology, School of Medicine in Split, University Hospital Center Split, Split, Croatia

    Josipa Radić

  5. Clinic for Heart and Cardiovascular Diseases, School of Medicine in Split, University Hospital Center Split, Split, Croatia

    Damir Fabijanić

  6. Intensive Care Unit of the Department of Internal Medicine, School of Medicine in Split, University Hospital Center Split, Split, Croatia

    Vedran Kovačić

Authors
  1. Mislav Radić MD PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Dušanka Martinović Kaliterna
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Damir Bonacin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jadranka Morović Vergles
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Josipa Radić
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Damir Fabijanić
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Vedran Kovačić
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mislav Radić MD PhD.

Ethics declarations

Conflict of interest

M. Radić, D.M. Kaliterna, D. Bonacin, J.M. Vergles, J. Radić, D. Fabijanić and V. Kovačić declare that they have no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Radić, M., Kaliterna, D.M., Bonacin, D. et al. Beneficial effects of Helicobacter pylori eradication in systemic sclerosis patients. Wien Klin Wochenschr 135, 414–419 (2023). https://doi.org/10.1007/s00508-022-02142-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00508-022-02142-8

Keywords

Search

Navigation