SEARCHNARRATIVE_REVIEWcardiology, infectious disease

narrative_review·cardiology, infectious disease, gastroenterology, epidemiology, public health·PMC10611526

Infection with Helicobacter pylori may predispose to atherosclerosis: role of inflammation and thickening of intima-media of carotid arteries

Frontiers in Pharmacology · 9 authors, 5 centres

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TL;DR

It concludes that while associations are plausible, contradictory findings exist and further evidence is needed.

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It notes that CagA-positive strains of H. pylori show a higher correlation with atherosclerosis. However, the review also highlights contradictory studies that found no role for H. pylori, attributing these discrepancies to confounding variables like diagnostic methods and strain differences. The central implication is that H. pylori may exacerbate atherosclerosis, but stronger evidence is required to establish it alongside traditional risk factors.

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narrative_review

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cardiology

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100% · A

ORIGINAL PAPER

PMC10611526

Infection with Helicobacter pylori may predispose to atherosclerosis: role of inflammation and thickening of intima-media of carotid arteries

Frontiers in Pharmacology

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ABSTRACT

Abstract Atherosclerosis is a major instigator of cardiovascular disease (CVD) and a main cause of global morbidity and mortality. The high prevalence of CVD calls for urgent attention to possible preventive measures in order to curb its incidence. Traditional risk factors of atherosclerosis, like age, smoking, diabetes mellitus, dyslipidemia, hypertension and chronic inflammation, are under extensive investigation. However, these only account for around 50% of the etiology of atherosclerosis, mandating a search for different or overlooked risk factors. In this regard, chronic infections, by Helicobacter pylori for instance, are a primary candidate. H. pylori colonizes the gut and contributes to several gastrointestinal diseases, but, recently, the potential involvement of this bacterium in extra-gastric diseases including CVD has been under the spotlight. Indeed, H. pylori infection appears to stimulate foam cell formation as well as chronic immune responses that could upregulate key inflammatory mediators including cytokines, C-reactive protein, and lipoproteins. These factors are involved in the thickening of intima-media of carotid arteries (CIMT), a hallmark of atherosclerosis. Interestingly, H. pylori infection was found to increase (CIMT), which along with other evidence, could implicate H. pylori in the pathogenesis of atherosclerosis. Nevertheless, the involvement of H. pylori in CVD and atherosclerosis remains controversial as several studies report no connection between H. pylori and atherosclerosis. This review examines and critically discusses the evidence that argues for a potential role of this bacterium in atherogenesis. However, additional basic and clinical research studies are warranted to convincingly establish the association between H. pylori and atherosclerosis. Keywords: cardiovascular disease, oxidative stress, extra-gastric disease, CagA, vitamin B12 deficiency

CITATION EXPORT

Karl Aramouni, Roland K Assaf, Maria Azar et al.. Infection with Helicobacter pylori may predispose to atherosclerosis: role of inflammation and thickening of intima-media of carotid arteries. Frontiers in Pharmacology. (2023). https://doi.org/10.3389/fphar.2023.1285754

AUTHORS

9 · 5 CENTRES

Karl Aramouni, Roland K Assaf, Maria Azar, Karen Jabbour, Abdullah Shaito, Amirhossein Sahebkar, Assaad A Eid, Manfredi Rizzo, Ali H Eid

1 Faculty of Medicine, American University of Beirut, Beirut, Lebanon
2 Biomedical Research Center, Department of Biomedical Sciences at College of Health Sciences, College of Medicine, Qatar University, Doha, Qatar
3 Biotechnology Research Center, Applied Biomedical Research Center, Department of Biotechnology, School of Pharmacy, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
4 Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
5 Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, Doha, Qatar