Article Text
Abstract
introduction: Helicobacter pylori is one of the most widespread bacterial infections worldwide, therefore nowadays its prevalence was decreasing, mostly in developed countries. There are some studies which support that H pylori could favour the development of food allergy.
Objectives To assess the relationship between H pylori infection and specific immunoglobulin E (Ig E) antibodies to food allergens in symptomatic children.
Methods We conducted a prospective study of 394 symptomatic children (249 girls, age range 6 months-18 years), mostly with uninvestigated dyspepsia requiring an endoscopic evaluation in our unit, from January to November 2016. All patients were evaluated for H pylori infection by at least two standard invasive tests and for specific immunoglobulin E antibodies to major food allergens ( R-biopharm, Germany). The nutritional status of patients was assessed in all cases by the new World Health Organisation (WHO, 2007) growth charts. EPI-INFO version 7 was used for statistical analysis.
Results Active H pylori infection was documented in 246 (62,3%) cases. The allergic sensitisation to at least one of the food allergens was identified in 134 of 394 patients (34%). The majority of Ig E positive children (109 of 134 cases; 81,3%) were positive for cow’s milk followed by egg (17,9%), wheat (7,46%), peanut (4,5%), soybean (3,73%). The allergic sensitisation to food allergens was associated with abnormal levels of specific Ig E antibodies to common inhalatory allergens in 55 of 134 cases (41,04%). Regarding the association of H pylori infection with an elevated serum Ig E level to at least one of the food allergens tested, there was no significant correlation (p=0,14). 77 of 134 (31,30%) patients positive for food specific Ig E antibodies were H pylori infected and 57 of them (38,55%) were H pylori negative (Fisher exact test=0,08). The assessment of the patients nutritional profile in relationship with H pylori infection and food allergy not revealed a statistically significant effect on the two ends of the poor nutritional status (undernutrition and overnutrition).
Conclusions This endoscopic series revealed that the recent decline of H pylori infection observed in developed countries is not evident in our symptomatic children. There was no association between H pylori infection and Ig E mediated food allergy. Undernutrition and overnutrition were not associated with the H pylori infection and food allergy in our patients.