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    Home > Active Ingredient News > Immunology News > Eradicating Helicobacter pylori, actually has this effect on the white plug disease?

    Eradicating Helicobacter pylori, actually has this effect on the white plug disease?

    • Last Update: 2020-07-21
    • Source: Internet
    • Author: User
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    A week of wind and cloud, waiting for you to see! What's the relationship between BS and HP?! Beh ó et syndrome (BS) is a chronic, recurrent, systemic systemic disease with vasculitis as its basic pathological manifestation. Its main clinical features are recurrent oral and genital ulcers, eye and skin damage, and can involve multiple systemic systems such as joints, blood vessels, digestive tract and nerves.

    the disease is mainly called "Silk Road disease", because Behcet disease has a strong regional distribution, which is mainly found in Greece and other Mediterranean coastal countries, Turkey and other Middle East countries, as well as China, North Korea, Japan and other East Asian countries, which is roughly consistent with the ancient Silk Road.

    chart 1 the prevalence of Behcet's disease: the incidence rate in China is higher than that in Japan, about 14/10 million.

    Helicobacter pylori (HP) is a gram-negative Helicobacter, which is mainly transmitted from person to person through oral route.

    after HP enters the human body from the oral cavity, it is specially colonized in the gastric epithelium, which is difficult for the body to remove spontaneously after colonization, resulting in persistent or lifelong infection.

    HP infection can almost cause active inflammation of gastric mucosa. On the basis of chronic inflammatory activity, some patients can also develop a series of diseases such as peptic ulcer and gastric cancer.

    studies have shown that Streptococcus, HP, herpes simplex virus, EB virus or parvovirus B19 DNA may play a role in triggering and / or prolonging BS.

    some scholars have pointed out that the oral ulcer of patients with HP infection is more serious than that of BS patients without HP infection, and the oral ulcer of patients with HP eradication is significantly improved. Therefore, it is speculated that HP is a microorganism that can trigger and aggravate BS.

    however, previous studies have different opinions and disputes.

    Chinese scholars published a related article in the international journal Helicobacter, which was the first meta-analysis on the relationship between HP and BS.

    eradication of HP can improve BS oral ulcer! After searching the English literature published in PubMed, MEDLINE and EMBASE databases before July 1, 2019, the researchers finally analyzed six of them.

    in the final six studies, there were 1119 participants, including 449 patients with BS and 670 healthy controls.

    the main characteristics of participants are shown in Table 1: the basic characteristics of participants in the six studies included in Table 1 note: BS, Behcet's syndrome; H pylori, Helicobacter pylori; rut, rapid urease test; UBT, urea breath test. According to statistics, the total HP infection rate of participants was 40.04%, including 50.78% in BS group and 32.84% in control group.

    the results show that the susceptibility of BS individuals to HP is 1.39 times higher than that of the general population.

    as shown in Figure 2: the sensitivity of BS individuals to Helicobacter pylori infection is 1.39 times higher (or = 1.39, 95% CI = 1.03, 1.87). According to the 1990 international BS classification diagnostic standard: recurrent oral ulcer + at least 2 of the other 4 clinical manifestations, BS can be diagnosed (pay attention to exclude other diseases for each clinical manifestation), see Table 2.

    after Hp eradication, which symptoms of BS will be affected? Table 2 what is the relationship between Hp eradication and BS symptoms? The results showed that oral ulcer, genital ulcer and skin lesions of BS patients were relieved after Hp eradication, but the results of acupuncture test, eye related lesions and vascular involvement did not change significantly after Hp eradication.

    it is recommended to eradicate BS patients infected with HP! In this study, the researchers comprehensively analyzed the correlation between HP and BS through meta-analysis, and discussed the impact of HP eradication on the symptoms of BS, that is, the HP infection rate of BS patients was higher than that of healthy people.

    after Hp eradication, the clinical manifestations of BS including oral ulcer, genital ulcer and skin lesions can be improved.

    at present, it is suggested that most of the people infected with HP should be eradicated. Seven bismuth quadruple therapy [2 antibiotics + proton pump inhibitor (PPI) + bismuth agent] is recommended as the main empirical eradication program, and the eradication rate of these programs can reach 85% - 94%.

    the recommended course of treatment is 10 days or 14 days.

    studies have confirmed that HP may be the etiological factor of BS.

    HP infection can almost cause active inflammation of gastric mucosa. On the basis of chronic inflammatory activity, some patients can also develop a series of diseases such as peptic ulcer and gastric cancer.

    however, if BS involves gastrointestinal tract (i.e. enterobehcet's disease), the common symptoms include abdominal pain, diarrhea and bloody stool, which can involve the whole digestive tract, presenting as single or multiple ulcers and secondary intestinal bleeding or perforation.

    it is difficult to differentiate from inflammatory bowel disease.

    therefore, the correlation between the two is worth further exploration.

    this study still has some limitations. Although it provides higher quality evidence to prove the relationship between HP and BS, more prospective studies are needed to further verify.

    reference sources: [1] Yazici h, Seyahi e, hatemi g, et al. Nature Reviews, rheumatology, 2018, 14 (2): 107. [2] he Tingyan, Yang Jun, et al. Progress in diagnosis and treatment of Behcet's disease [J]. Chinese Journal of Practical Pediatrics 2020 Vol.35 (4): 284-288 [3] Osman, ersoy, reyhan, [4] Yu y, Yao x, Liang J, Lu C, Yan T, Lin Helicobacter pylori associated with Beh à et's syndrome? A meta ‐ analysis. Helicobacter. 2019; 24: e12663. HTTPS:// .1111/hel.12663. 
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