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Protective effects of Helicobacter pylori against gastroesophageal reflux disease may be due to a neuroimmunological anti‐inflammatory mechanism
Author(s) -
Shahabi Shahram,
Rasmi Yousef,
Jazani Nima Hosseini,
Hassan Zuhair Muhammad
Publication year - 2008
Publication title -
immunology and cell biology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.999
H-Index - 104
eISSN - 1440-1711
pISSN - 0818-9641
DOI - 10.1038/sj.icb.7100119
Subject(s) - helicobacter pylori , inflammation , medicine , pathogenesis , reflux , gastroenterology , immune system , mechanism (biology) , disease , cholinergic , immunology , philosophy , epistemology
There is some evidence that Helicobacter pylori infection has a protective effect against gastroesophageal reflux disease (GORD) and its complications such as Barrett's oesophagus and oesophageal adenocarcinoma. In this paper, we propose that a neuroimmunological mechanism is responsible for the protective effect of H. pylori on GORD. H. pylori infection of the gastric mucosa induces a T helper1‐like immune response and production of pro‐inflammatory cytokines. These cytokines can inhibit local sympathetic tone, whereas they increase systemic sympathetic tone. Increased sympathetic tone can induce an anti‐inflammatory milieu, which in turn can inhibit inflammation in the oesophagus and lower oesophageal sphincter (LOS). Furthermore, H. pylori infection may stimulate the cholinergic anti‐inflammatory pathway. It has been suggested that reflux‐induced oesophageal inflammation plays an important role in the pathogenesis of reflux oesophagitis. Reduction of oesophageal inflammation by increased systemic sympathetic tone and vagal activity may lead to a decrease in reflux‐induced oesophageal injury and LOS dysfunction in GORD.