This Article Full Text Full Text (PDF) All Versions of this Article: 91/1/176    most recent Author Manuscript (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Larizza, D. Articles by Solcia, E. Search for Related Content PubMed PubMed Citation Articles by Larizza, D. Articles by Solcia, E. Related Collections Thyroid

Helicobacter pylori Infection and Autoimmune Thyroid Disease in Young Patients: The Disadvantage of Carrying the Human Leukocyte Antigen-DRB1*0301 Allele

Departments of Pediatric Sciences (D.L., V.C., M.C.) and Pathology (E.S.), University of Pavia and Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, 27100 Pavia, Italy; Immunohematology and Transfusion Center (M.M., A.M.I.) and Clinical Epidemiology and Biometry Unit (A.D.S.), Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, 27100 Pavia, Italy; and Institute of Internal Medicine (R.N.), Spedali Civili, 25125 Brescia, Italy

Address all correspondence and requests for reprints to: Professor Larizza Daniela, Department of Pediatric Sciences, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, P.le Golgi n. 2, 27100 Pavia, Italy. E-mail: d.larizza{at}smatteo.pv.it.

Context and Objective: Pathogenesis of autoimmune thyroid disease (ATD) is multifactorial. Helicobacter pylori (Hp) infection has been proposed to be involved in nongastrointestinal conditions and reported more frequently in ATD adult patients. We evaluated the prevalence of Hp antibodies in young ATD patients and investigated the possibility that a susceptible immunogenetic profile could influence the development of ATD in subjects with Hp infection.

Subjects and Methods: We retrospectively studied 90 children with ATD (median age 11.2 yr), 70 age- and sex-matched healthy subjects as controls, and 65 patients with Turner syndrome (median age 18.8 yr). Antibodies to Hp were determined at diagnosis in ATD patients and, in Turner patients, at the last control in cases without ATD and before the appearance of thyroid autoantibodies in the others. Serological and molecular human leukocyte antigen (HLA) typing for classes I and II polymorphisms was performed.

Results: Prevalence of positive Hp serology resulted significantly higher in ATD patients than controls (P = 0.032). No association was found between individual HLA alleles and Hp serology. HLA-A1, B8, and DRB1*0301 were found significantly associated with ATD. A significant interaction between HLA-DRB1*0301 and Hp infection was present in ATD patients and not controls (P = 0.007), suggesting that the copresence of these two factors might favor ATD development. A similar phenomenon was observed in Turner syndrome patients (P = 0.02; cumulative Mantel test, P = 0.0001).

Conclusions: Another target of Hp-elicited immune inflammatory response might be the thyroid gland in subjects with a peculiar immunogenetic profile so that ATD may be a consequence. Our findings suggest the opportunity of eradicating Hp infection in children with ATD and/or susceptible HLA alleles.