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Infection with Helicobacter pylori is associated with protection against tuberculosis

Perry, S and De Jong, BC and Solnick, JV and De La Luz Sanchez, M and Yang, S and Lin, PL and Hansen, LM and Talat, N and Hill, PC and Hussain, R and Adegbola, RA and Flynn, JA and Canfield, D and Parsonnet, J (2010) Infection with Helicobacter pylori is associated with protection against tuberculosis. PLoS ONE, 5 (1).

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Background: Helicobacter pylori, a lifelong and typically asymptomatic infection of the stomach, profoundly alters gastric immune responses, and may benefit the host in protection against other pathogens. We explored the hypothesis that H. pylori contributes to the control of infection with Mycobacterium tuberculosis. Methodology/Principal Findings: We first examined M. tuberculosis-specific IFN-c and H. pylori antibody responses in 339 healthy Northern Californians undergoing routine tuberculin skin testing. Of 97 subjects (29%) meeting criteria for latent tuberculosis (TB) infection (LTBI), 45 (46%) were H. pylori seropositive. Subjects with LTBI who were H. pylori-seropositive had 1.5-fold higher TB antigen-induced IFN-c responses (p = 0.04, ANOVA), and a more Th-1 like cytokine profile in peripheral blood mononuclear cells, compared to those who were H. pylori seronegative. To explore an association between H. pylori infection and clinical outcome of TB exposure, we evaluated H. pylori seroprevalence in baseline samples from two high risk TB case-contact cohorts, and from cynomolgus macaques experimentally challenged with M. tuberculosis. Compared to 513 household contacts who did not progress to active disease during a median 24 months follow-up, 120 prevalent TB cases were significantly less likely to be H. pylori infected (AOR: 0.55, 95% CI 0.0.36-0.83, p = 0.005), though seroprevalence was not significantly different from non-progressors in 37 incident TB cases (AOR: 1.35 [95% CI 0.63-2.9] p = 0.44). Cynomolgus macaques with natural H. pylori infection were significantly less likely to progress to TB 6 to 8 months after M. tuberculosis challenge (RR: 0.31 [95% CI 0.12-0.80], p = 0.04). Conclusions/Significance: H. pylori infection may induce bystander effects that modify the risk of active TB in humans and non-human primates. That immunity to TB may be enhanced by exposure to other microbial agents may have important implications for vaccine development and disease control. © 2010 Perry et al.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Perry, S
De Jong, BC
Solnick, JV
De La Luz Sanchez, M
Yang, S
Lin, PLpll7@pitt.eduPLL7
Hansen, LM
Talat, N
Hill, PC
Hussain, R
Adegbola, RA
Flynn, JA
Canfield, D
Parsonnet, J
ContributionContributors NameEmailPitt UsernameORCID
Date: 20 January 2010
Date Type: Publication
Journal or Publication Title: PLoS ONE
Volume: 5
Number: 1
DOI or Unique Handle: 10.1371/journal.pone.0008804
Schools and Programs: School of Medicine > Immunology
Refereed: Yes
MeSH Headings: Adolescent; Adult; Aged; Aged, 80 and over; Analysis of Variance; Animals; Antibodies, Bacterial--biosynthesis; Case-Control Studies; Child; Child, Preschool; Cohort Studies; Female; Helicobacter Infections--complications; Helicobacter Infections--immunology; Helicobacter Infections--microbiology; Helicobacter pylori--isolation & purification; Humans; Interferon-gamma--biosynthesis; Macaca fascicularis; Male; Middle Aged; Tuberculin Test; Tuberculosis--complications; Young Adult
Other ID: NLM PMC2808360
PubMed Central ID: PMC2808360
PubMed ID: 20098711
Date Deposited: 31 Jul 2012 20:48
Last Modified: 02 Feb 2019 14:55


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