The relationship of Cag-A in patients with HP positive alopecia areata and vitiligo

Year 2015, , 366 - 370, 01.11.2015

Gamze Erfan Mustafa Oran Rafet Mete Hayati Güneş Mehmet Emin Yanık Hulya Albayrak Mustafa Kaan Taşolar Murat Aydın Birol Topçu Mustafa Kulaç

https://doi.org/10.5505/abantmedj.2015.77598

Abstract

INTRODUCTION: Even though some dermatological diseases have been related to Helicobacter pylori HP , in alopecia areata there are conflicting data. The reason of this conflict might be Cag-A cytotoxin-associated gene A which is one of the factors responsible from virulance of HP. According to the search of medical literature in vitiligo there is only one study which reports possible role of HP and Cag-A.METHODS: HP stool antigen and Cag-A seroprevalence in serum with ELISA investigated in 60 healthy subjects, 60 AA and 52 vitiligo patients without history, symptom, diagnosis and treatment of dyspepsia, autoimmun disorders and other infections. The severity of diseases were assessed by severity of alopecia tool/SALT and rule of nine and relationship between HP, Cag-A positivity and severity of diseases were investigated.RESULTS: Fourthy-three %71.7 of AA, 26 %50 of vitiligo patients were HP + . Also Cag-A positivity was in 26 %60,4 of AA, 17 %65,3 of vitiligo patients. In comparison of healthy subjects and AA patients HP and Cag-A positivity were significantly higher in AA patients p

Keywords

Alopecia areata, autoimmunity, Cag-A protein, helicobacter pylori, virulance, vitiligo

Helicobacter Pylori pozitif Alopesi areata ve Vitiligo hastalarında Cag-A ilişkisi

Abstract

GİRİŞ ve AMAÇ: Helicobacter Pylori HP ile bazı dermatolojik hastalıklar arasında ilişki kurulurken, alopesi areata AA ve HP arasında çelişkili veriler mevcuttur. Bu çelişkili sonuçların nedeni, HP’nin virulansından sorumlu faktörlerden biri olan Cag-A sitotoksin ilişkili gen ürünü A olabilir. Vitiligoda ise HP’nin muhtemel rolü hakkında tıbbı literatürde çok az sayıda çalışma bulunmaktadır. Literatürde tespit edilebildiği kadarıyla Cag-A + suşlarının rolünün saptandığı sadece bir çalışma bulunmaktadır. YÖNTEM ve GEREÇLER: Altmış AA ve 52 vitiligo tanısı almış, dispepsi, eşlik eden otoimmün hastalıklar ve diğer enfeksiyonlar açısından hikâye, belirti, tanı ve tedavileri olmayan hastalar ve 60 sağlıklı bireyde HP stool antijeni ve serumlarında Cag-A seroprevelansı ELİSA kullanılarak incelendi. Hastalık şiddetleri AA grubunda alopesi şiddet ölçeği SALT skoru ve vitiligo grubunda ise “dokuzlar kuralı” ile ölçüldü ve HP, Cag-A pozitifliği ile ilişkisi karşılaştırıldı.BULGULAR: AA grubunda 43 %71,7 , vitiligo grubunda 26 %50 hastada HP + ’liği saptandı. Bu hastalardan AA hastalarında Cag-A + ’liği 26 %60,4 , vitiligo hastalarında 17 %65,3 kişide saptandı. AA hastaları ile kontrol grubu karşılaştırıldığında, HP + ’liği ve Cag-A + ’liği AA hastalarında belirgin olarak yüksek sayıda saptanırken p

Keywords

Alopesi areata, Cag-A, helicobacter pylori, otoimmunite, virulans, vitiligo

References

• 1- Hasni SA. Role of Helicobacter pylori infection in autoimmune diseases. Curr Opin Rheumatol 2012;24:429-34.
• 2- Akashi R, Ishiguro N, Shimizu S, Kawashima M. Clinical study of the relationship between Helicobacter pylori and chronic urticaria and prurigo chronica multiformis: effectiveness of eradication therapy for Helicobacter pylori. J Dermatol 2011;38:761-6.
• 3- Sagi L, Baum S, Agmon-Levin N, Sherer Y, Katz BS, Barzilai O, Ram M, Bizzaro N, SanMarco M, Trau H, Shoenfeld Y. Autoimmune bullous diseases the spectrum of infectious agent antibodies and review of the literature. Autoimmun Rev 2011;10:527-35.
• 4- Szlachcic A. The link between Helicobacter pylori infection and rosacea. J Eur Acad Dermatol Venereol 2002;16: 328-33.
• 5- Daudén E, Cabrera MM, Oñate MJ, Pajares JM, García-Díez A..CagA seropositivity in Helicobacter pylori positive patients with psoriasis. J Eur Acad Dermatol Venereol 2004;18: 116-7.
• 6- Ersoy O, Ersoy R, Yayar O, Demirci H, Tatlican S. H pylori infection in patients with Behcet’s disease. World J Gastroenterol 2007;13: 2983-5.
• 7- Erfan G, Mete R, Oran M,Yanık M.E, Güneş H, Kaya Ş, Topçu B. CagA strain of Helicobacter Pylori in recurrent aphtous stomatitis patients without dyspeptic symptoms:response to eradication therapy. Acta Medica Mediterranea 2014;30:285-9
• 8- Doğan Z1, Özdemir P, Ekşioğlu M, Filik L..Relationship between Helicobacter pylori infection and vitiligo: a prospective study. Am J Clin Dermatol 2014;15:457-62.
• 9- Rifaioglu EN, Aydogan F, Bulbul Sen B, Sen T, Ekiz O. Investigation into the frequency of Helicobacter pylori infection with carbon 14 urea breath test in patients with vitiligo. Turk J Med. Sci. 2014;44: 1051-4
• 10-Olsen EA, Hordinsky MK, Price VH, Roberts JL, Shapiro J, Canfield D, Duvic M, King LE Jr, McMichael AJ, Randall VA, Turner ML, Sperling L, Whiting DA, Norris D. Alopecia areata investigational assessment guidelines-Part II. National alopecia areata foundation. J Am Acad Dermatol 2004;51: 440–7.
• 11-Alghamdi KM1, Kumar A, Taïeb A, Ezzedine K. Assessment methods for the evaluation of vitiligo. J Eur Acad Dermatol Venereol 2012;26: 1463–71.
• 12-Covacci A, Telford JL, Del Giudice G G, Parsonnet J, Rappuoli R. Helicobacter pylori virulence and genetic geography. Science 1999;284: 1328-33.
• 13-Suzuki R, Shiota S, Yamaoka Y. Molecular epidemiology, population genetics, and pathogenic role of helicobacter pylori. Infect Genet Evol 2012;12:203-13.
• 14-Islam N, Leung PS, Huntley AC, Gershwin ME.The Autoimmune Basis of Alopecia Areata: A Comprehensive Review. Autoimmun Rev. 2015;14:81-9
• 15-Argenziano G, Donnarumma G, Iovene MR, Arnese P, Baldassarre MA, Baroni A. Incidence of antiHelicobacter pylori and anti-CagA antibodies in rosacea patients. International Journal of Dermatology 2003;42:601–4.
• 16-Galeone M, Colucci R, D'Erme AM, Moretti S, Lotti T. Potential infectious etiology of behcet's disease. Patholog Res Int 2012;2012:595380.
• 17-Hernando-Harder AC, Booken N, Goerdt S Sınger MV, Harder H. Helicobacter pylori infection and dermatologic diseases. Eur J Dermatol 2009; 19:431-44.
• 18-Rigopoulos D, Katsambas A, Karalexis A, Papatheodorou G, Rokkas T.No increased prevalence of Helicobacter pylori in patients with alopecia areata. J Am Acad Dermatol 2002; 46:141.
• 19-Abdel-Hafez HZ, Mahran AM, Hofny ER, Attallah DA, Sayed DS, Rashed HA.. Is Helicobacter pylori infection associated with alopecia areata? J Cosmet Dermatol 2009;8:52-5.
• 20-Campuzano-Maya G. Cure of alopecia areata after eradication of Helicobacter pylori: a new association? World J Gastroenterol. 2011;17:3165-70.
• 21-Ertugrul DT, Karadag AS, Takci Z, Bilgili SG, Ozkol HU, Tutal E, Akin KO. Serum holotranscobalamine, vitamin B12, folic acid and homocysteine levels in alopecia areata patients. Cutan Ocul Toxicol. 2013; 32:1-3.
• 22-Gonul M, Cakmak SK, Soylu S, Kilic A, Gul U. Serum vitamin B12, folate, ferritin and iron levels in Turkish patients with vitiligo. Indian J Dermatol Venereol Leprol. 2010;76.448
• 23-Tuzun Y, Keskin S, Kote E. The role of Helicobacter pylori infection in skin disease: facts and controversies. Clinics in Dermatology 2010;28:478-82
• 24-Fan XG, Chua A, Fan XJ, Keeling PW. Increased gastric production of interleukin-8 and tumour necrosis factor in patients with Helicobacter pylori infection. J Clin Pathol 1995;48:133–6.
• 25-Teraki Y1, Imanishi K, Shiohara T. Cytokines in alopecia areata:contrasting cytokine profiles in localized form and extensive form (alopecia universalis). Acta Derm Venereol 1996;76:421-3.