DOI QR코드

DOI QR Code

알레르기 질환: 천식, 아토피, 특발성 두드러기

Extra-Intestinal Manifestation of Helicobacter pylori Infection: Allergic Diseases Including Asthma, Atopy and Idiopathic Urticaria

  • 신철민 (서울대학교 의과대학 내과학교실)
  • Shin, Cheol Min (Department of Internal Medicine, Seoul National University College of Medicine)
  • 발행 : 2013.06.01

초록

Helicobacter pylori (H. pylori) infection is known to be negatively associated with allergic diseases including asthma in epidemiologic studies, mainly from the western countries. Bronchial asthma and allergic diseases are initiated by T-cells producing T-helper type 2 (Th2) cytokines (e.g. interleukin-4 (IL-4) and IL-5), which is inhibited by Th1 responses. H. pylori infection appears to inhibit Th2 responses, as well as to drive Th1 inflammation, and recent studies using experimental models of allergic airway disease elucidated a direct link between H. pylori infection and suppression of allergic airway disease through the induction of regulatory T cells. H. pylori has been implicated as a factor in idiopathic urticaria. Its eradication, however, has been shown conflicting results only. Therefore, routine H. pylori eradication for patients with chronic urticaria is not recommended. In Korea, prevalence of H. pylori infection shows a decreasing trend, and studies on association of H. pylori infection with asthma is warranting in the population.

키워드

참고문헌

  1. Yim JY, Kim N, Choi SH, et al. Seroprevalence of Helicobacter pylori in South Korea. Helicobacter 2007;12:333-340. https://doi.org/10.1111/j.1523-5378.2007.00504.x
  2. Thomas JE, Dale A, Harding M, Coward WA, Cole TJ, Weaver LT. Helicobacter pylori colonization in early life. Pediatr Res 1999;45:218-223. https://doi.org/10.1203/00006450-199902000-00010
  3. Rothenbacher D, Inceoglu J, Bode G, Brenner H. Acquisition of Helicobacter pylori infection in a high-risk population occurs within the first 2 years of life. J Pediatr 2000;136: 744-748.
  4. Eder W, Ege MJ, von Mutius E. The asthma epidemic. N Engl J Med 2006;355:2226-2235. https://doi.org/10.1056/NEJMra054308
  5. Blaser MJ, Chen Y, Reibman J. Does Helicobacter pylori protect against asthma and allergy? Gut 2008;57:561-567. https://doi.org/10.1136/gut.2007.133462
  6. Taube C, Müller A. The role of Helicobacter pylori infection in the development of allergic asthma. Expert Rev Respir Med 2012;6:441-449. https://doi.org/10.1586/ers.12.40
  7. Thjodleifsson B, Asbjornsdottir H, Sigurjonsdottir RB, et al. Seroprevalence of Helicobacter pylori and cagA antibodies in Iceland, Estonia and Sweden. Scand J Infect Dis 2007;39: 683-689. https://doi.org/10.1080/00365540701225736
  8. Chen Y, Blaser MJ. Inverse associations of Helicobacter pylori with asthma and allergy. Arch Intern Med 2007;167: 821-827. https://doi.org/10.1001/archinte.167.8.821
  9. Matricardi PM, Rosmini F, Riondino S, et al. Exposure to foodborne and orofecal microbes versus airborne viruses in relation to atopy and allergic asthma: epidemiological study. BMJ 2000;320:412-417. https://doi.org/10.1136/bmj.320.7232.412
  10. Tsang KW, Lam WK, Chan KN, et al. Helicobacter pylori sero-prevalence in asthma. Respir Med 2000;94:756-759. https://doi.org/10.1053/rmed.2000.0817
  11. Jarvis D, Luczynska C, Chinn S, Burney P. The association of hepatitis A and Helicobacter pylori with sensitization to common allergens, asthma and hay fever in a population of young British adults. Allergy 2004;59:1063-1067. https://doi.org/10.1111/j.1398-9995.2004.00539.x
  12. Jun ZJ, Lei Y, Shimizu Y, Dobashi K, Mori M. Helicobacter pylori seroprevalence in patients with mild asthma. Tohoku J Exp Med 2005;207:287-291. https://doi.org/10.1620/tjem.207.287
  13. Pessi T, Virta M, Adjers K, et al. Genetic and environmental factors in the immunopathogenesis of atopy: interaction of Helicobacter pylori infection and IL4 genetics. Int Arch Allergy Immunol 2005;137:282-288. https://doi.org/10.1159/000086421
  14. Chen Y, Blaser MJ. Helicobacter pylori colonization is inversely associated with childhood asthma. J Infect Dis 2008;198:553-560. https://doi.org/10.1086/590158
  15. Amberbir A, Medhin G, Erku W, et al. Effects of Helicobacter pylori, geohelminth infection and selected commensal bacteria on the risk of allergic disease and sensitization in 3-year-old Ethiopian children. Clin Exp Allergy 2011;41: 1422-1430. https://doi.org/10.1111/j.1365-2222.2011.03831.x
  16. Zevit N, Balicer RD, Cohen HA, Karsh D, Niv Y, Shamir R. Inverse association between Helicobacter pylori and pediatric asthma in a high-prevalence population. Helicobacter 2012; 17:30-35.
  17. Zhou X, Wu J, Zhang G. Association between Helicobacter pylori and asthma: a meta-analysis. Eur J Gastroenterol Hepatol 2013;25:460-468. https://doi.org/10.1097/MEG.0b013e32835c280a
  18. Wang Q, Yu C, Sun Y. The association between asthma and Helicobacter pylori: a meta-analysis. Helicobacter 2013;18: 41-53. https://doi.org/10.1111/hel.12012
  19. Martinez FD, Wright AL, Taussig LM, Holberg CJ, Halonen M, Morgan WJ. Asthma and wheezing in the first six years of life: the Group Health Medical Associates. N Engl J Med 1995;332:133-138. https://doi.org/10.1056/NEJM199501193320301
  20. Lee JH, Kim N, Chung JI, et al. Long-term follow up of Helicobacter pylori IgG serology after eradication and reinfection rate of H. pylori in South Korea. Helicobacter 2008;13:288-294. https://doi.org/10.1111/j.1523-5378.2008.00616.x
  21. Haldar P, Pavord ID. Noneosinophilic asthma: a distinct clinical and pathologic phenotype. J Allergy Clin Immunol 2007;119:1043-1052. https://doi.org/10.1016/j.jaci.2007.02.042
  22. Woodruff PG, Modrek B, Choy DF, et al. T-helper type 2-driven inflammation defines major subphenotypes of asthma. Am J Respir Crit Care Med 2009;180:388-395. https://doi.org/10.1164/rccm.200903-0392OC
  23. Kudo M, Melton AC, Chen C, et al. IL-17A produced by ${\alpha}$ ${\beta}$ T cells drives airway hyper-responsiveness in mice and enhances mouse and human airway smooth muscle contraction. Nat Med 2012;18:547-554. https://doi.org/10.1038/nm.2684
  24. Lambrecht BN, Hammad H. The role of dendritic and epithelial cells as master regulators of allergic airway inflammation. Lancet 2010;376:835-843. https://doi.org/10.1016/S0140-6736(10)61226-3
  25. Taube C, Duez C, Cui ZH, et al. The role of IL-13 in established allergic airway disease. J Immunol 2002;169:6482-6489. https://doi.org/10.4049/jimmunol.169.11.6482
  26. Locksley RM. Asthma and allergic inflammation. Cell 2010; 140:777-783. https://doi.org/10.1016/j.cell.2010.03.004
  27. Blaser MJ, Falkow S. What are the consequences of the disappearing human microbiota? Nat Rev Microbiol 2009; 7:887-894. https://doi.org/10.1038/nrmicro2245
  28. Matricardi PM, Rosmini F, Panetta V, Ferrigno L, Bonini S. Hay fever and asthma in relation to markers of infection in the United States. J Allergy Clin Immunol 2002;110:381-387. https://doi.org/10.1067/mai.2002.126658
  29. Braun-Fahrlander C, Riedler J, Herz U, et al. Environmental exposure to endotoxin and its relation to asthma in schoolage children. N Engl J Med 2002;347:869-877. https://doi.org/10.1056/NEJMoa020057
  30. McLoughlin RM, Mills KH. Influence of gastrointestinal commensal bacteria on the immune responses that mediate allergy and asthma. J Allergy Clin Immunol 2011;127:1097- 1107. https://doi.org/10.1016/j.jaci.2011.02.012
  31. Ly NP, Litonjua A, Gold DR, Celedon JC. Gut microbiota, probiotics, and vitamin D: interrelated exposures influencing allergy, asthma, and obesity? J Allergy Clin Immunol 2011; 127:1087-1094. https://doi.org/10.1016/j.jaci.2011.02.015
  32. Prescott SL, Macaubas C, Holt BJ, et al. Transplacental priming of the human immune system to environmental allergens: universal skewing of initial T cell responses toward the Th2 cytokine profile. J Immunol 1998;160:4730- 4737.
  33. Denning TL, Wang YC, Patel SR, Williams IR, Pulendran B. Lamina propria macrophages and dendritic cells differentially induce regulatory and interleukin 17-producing T cell responses. Nat Immunol 2007;8:1086-1094. https://doi.org/10.1038/ni1511
  34. Olszak T, An D, Zeissig S, et al. Microbial exposure during early life has persistent effects on natural killer T cell function. Science 2012;336:489-493. https://doi.org/10.1126/science.1219328
  35. Hill DA, Siracusa MC, Abt MC, et al. Commensal bacteriaderived signals regulate basophil hematopoiesis and allergic inflammation. Nat Med 2012;18:538-546. https://doi.org/10.1038/nm.2657
  36. Codolo G, Mazzi P, Amedei A, et al. The neutrophil-activating protein of Helicobacter pylori down-modulates Th2 inflammation in ovalbumin-induced allergic asthma. Cell Microbiol 2008;10:2355-2363. https://doi.org/10.1111/j.1462-5822.2008.01217.x
  37. D'Elios MM, Codolo G, Amedei A, et al. Helicobacter pylori, asthma and allergy. FEMS Immunol Med Microbiol 2009;56:1-8. https://doi.org/10.1111/j.1574-695X.2009.00537.x
  38. Arnold IC, Dehzad N, Reuter S, et al. Helicobacter pylori infection prevents allergic asthma in mouse models through the induction of regulatory T cells. J Clin Invest 2011;121: 3088-3093. https://doi.org/10.1172/JCI45041
  39. Oertli M, Sundquist M, Hitzler I, et al. DC-derived IL-18 drives Treg differentiation, murine Helicobacter pylori-specific immune tolerance, and asthma protection. J Clin Invest 2012;122:1082-1096. https://doi.org/10.1172/JCI61029
  40. Arnold IC, Hitzler I, Muller A. The immunomodulatory properties of Helicobacter pylori confer protection against allergic and chronic inflammatory disorders. Front Cell Infect Microbiol 2012;2:10.
  41. Kao JY, Zhang M, Miller MJ, et al. Helicobacter pylori immune escape is mediated by dendritic cell-induced Treg skewing and Th17 suppression in mice. Gastroenterology 2010;138:1046-1054. https://doi.org/10.1053/j.gastro.2009.11.043
  42. Zuberbier T, Asero R, Bindslev-Jensen C, et al. EAACI/ GA(2)LEN/EDF/WAO guideline: definition, classification and diagnosis of urticaria. Allergy 2009;64:1417-1426. https://doi.org/10.1111/j.1398-9995.2009.02179.x
  43. Zuberbier T, Asero R, Bindslev-Jensen C, et al. EAACI/ GA(2)LEN/EDF/WAO guideline: management of urticaria. Allergy 2009;64:1427-1443. https://doi.org/10.1111/j.1398-9995.2009.02178.x
  44. Staevska M, Popov TA, Kralimarkova T, et al. The effectiveness of levocetirizine and desloratadine in up to 4 times conventional doses in difficult-to-treat urticaria. J Allergy Clin Immunol 2010;125:676-682. https://doi.org/10.1016/j.jaci.2009.11.047
  45. Shakouri A, Compalati E, Lang DM, Khan DA. Effectiveness of Helicobacter pylori eradication in chronic urticaria: evidence-based analysis using the Grading of Recommendations Assessment, Development, and Evaluation system. Curr Opin Allergy Clin Immunol 2010;10:362-369. https://doi.org/10.1097/ACI.0b013e32833c79d7
  46. Ye YM, Kim JE, Nahm DI, et al. Comparison of Clinical Characteristics and Prognosis of Chronic Urticaria according to the Aspirin Sensitivity. Korean J Asthma Allergy Clin Immunol 2005;25:194-199.
  47. Magen E, Mishal J. Possible benefit from treatment of Helicobacter pylori in antihistamine-resistant chronic urticaria. Clin Exp Dermatol 2013;38:7-12. https://doi.org/10.1111/j.1365-2230.2012.04467.x