Department of Gastroenterology, University Hospital of Salamanca, Salamanca, Spain.
Biol Blood Marrow Transplant. 2011 May;17(5):765-9. doi: 10.1016/j.bbmt.2010.11.014. Epub 2010 Nov 18.
The gastrointestinal (GI) tract is the main target site of graft-versus-host disease (GVHD). Diagnosis is based on endoscopic and histological findings. Helicobacter pylori (HP) is a Gram-negative spiral bacterium linked to gastritis, peptic ulcer disease, gastric mucosa-associated lymphoid tissue lymphoma, and adenocarcinoma and is frequently observed on endoscopy in patients who have undergone transplantation. The role, if any, played by HP infection in the development of acute GVHD is unknown. We conducted a retrospective study between January 1, 1990, and December 31, 2008, of 338 upper GI endoscopies (gastroscopies) performed on patients who underwent allogeneic stem cell transplantation with clinical suspicion of GVHD (198 patients). Acute and chronic GVHD were confirmed from histological features in 97 patients (51.3%) and 68 patients (36%), respectively. HP infection was detected in 69 patients (35%) and had a negative modulating effect on the development of acute GVHD (relative risk [RR], 0.60; 95% confidence interval, 0.46-0.79; P = .001) and chronic GVHD (RR, 0.75; 95% confidence interval, 0.61-0.92; P = .016). Furthermore, the presence of HP was inversely correlated with the histological severity of GVHD (P = .003). Our findings suggest that infection with HP may have a negative modulating effect on GVHD.
胃肠道（GI）是移植物抗宿主病（GVHD）的主要靶位。诊断基于内镜和组织学发现。幽门螺杆菌（HP）是一种革兰氏阴性螺旋菌，与胃炎、消化性溃疡病、胃黏膜相关淋巴组织淋巴瘤和腺癌有关，在移植后患者的内镜检查中经常观察到。HP 感染在急性 GVHD 发展中的作用尚不清楚。我们对 1990 年 1 月 1 日至 2008 年 12 月 31 日期间进行的 338 例接受同种异体干细胞移植并有 GVHD 临床怀疑的患者进行了回顾性研究（198 例）。97 例（51.3%）和 68 例（36%）患者分别从组织学特征中证实为急性和慢性 GVHD。在 69 例患者（35%）中检测到 HP 感染，其对急性 GVHD（相对风险 [RR]，0.60；95%置信区间，0.46-0.79；P =.001）和慢性 GVHD（RR，0.75；95%置信区间，0.61-0.92；P =.016）的发展有负调节作用。此外，HP 的存在与 GVHD 的组织学严重程度呈负相关（P =.003）。我们的发现表明，HP 感染可能对 GVHD 有负调节作用。
