Delitala A P, Pes G M, Errigo A, Maioli M, Delitala G, Dore M P
Azienda Ospedaliero-Universitaria di Sassari, Sassari, Italy.
Eur Rev Med Pharmacol Sci. 2016 Oct;20(19):4041-4047.
H. pylori infection is reportedly associated with autoimmune diseases such as chronic thyroiditis and autoimmune diabetes. The aim of this study is to determine the association between H. pylori infection and its virulent strain CagA with antibodies against thyroperoxidase (TPO Ab) and thyrotropin (TSH) in a cohort of latent autoimmune diabetes in adult (LADA) patients.
We included 234 LADA patients (53.8% women). Antibodies against H. pylori whole antigens and CagA, TPO Ab and TSH were assessed in all patients.
Prevalence of IgG against H. pylori and GagA was 52.1% and 20.9% respectively. Antibodies against H. pylori were not associated with TPO Ab and TSH (rho = 0.067, p = 0.620 and rho = 0.156, p = 0.099, respectively). Antibodies against CagA showed a positive association with TSH and TPO Ab (respectively rho = 0.309, p = 0.036 and rho = 0.419, p = 0.037). Subjects with hypothyroidism (TSH ≥ 3.5 μU/ml) had an increased frequency of Ab anti CagA (p = 0.059).
The infection by H. pylori strains expressing CagA is associated with increased TPO Ab and TSH levels in LADA patients, suggesting a possible mechanism involved in thyroid autoimmunity and dysfunction of the gland. Further research is needed to test this hypothesis.
据报道，幽门螺杆菌感染与自身免疫性疾病如慢性甲状腺炎和自身免疫性糖尿病有关。本研究的目的是确定在一组成年隐匿性自身免疫性糖尿病（LADA）患者中，幽门螺杆菌感染及其毒力菌株CagA与抗甲状腺过氧化物酶抗体（TPO Ab）和促甲状腺激素（TSH）之间的关联。
我们纳入了234例LADA患者（53.8%为女性）。对所有患者检测了抗幽门螺杆菌全抗原抗体、抗CagA抗体、TPO Ab和TSH。
抗幽门螺杆菌IgG和抗GagA的患病率分别为52.1%和20.9%。抗幽门螺杆菌抗体与TPO Ab和TSH无关（相关系数分别为0.067，p = 0.620和0.156，p = 0.099）。抗CagA抗体与TSH和TPO Ab呈正相关（相关系数分别为0.309，p = 0.036和0.419，p = 0.037）。甲状腺功能减退（TSH≥3.5 μU/ml）的患者抗CagA抗体频率增加（p = 0.059）。
表达CagA的幽门螺杆菌感染与LADA患者TPO Ab和TSH水平升高有关，提示可能存在参与甲状腺自身免疫和腺体功能障碍的机制。需要进一步研究来验证这一假设。
