Eradication of Helicobacter pylori may lead to improvement of chronic immune thrombocytopenic purpura (ITP), although its efficacy over time is uncertain. We report the results of H pylori screening and eradication in 75 consecutive adult patients with ITP. We also used molecular methods to investigate lymphocyte clonality and H pylori genotypes in the gastric biopsies from 10 H pylori-positive patients with ITP and 19 H pylori-positive patients without ITP with chronic gastritis. Active H pylori infection was documented in 38 (51%) patients and successfully eradicated in 34 (89%) patients. After a median follow-up of 60 months, a persistent platelet response in 23 (68%) of patients with eradicated infection was observed; 1 relapse occurred. No differences in mucosal B- or T-cell clonalities were observed between patients with ITP and control participants. Of note, the frequency of the H pylori cagA gene (P = .02) and the frequency of concomitant H pylori cagA, vacAs1, and iceA genes (triple-positive strains; P = .015) resulted statistically higher in patients with ITP than in control participants. All asymptomatic H pylori-positive patients with ITP were suffering from chronic gastritis. Our data suggest a sustained platelet recovery in a proportion of patients with ITP by H pylori eradication alone. Overrepresentation of specific H pylori genotypes in ITP suggests a possible role for bacterium-related factors in the disease pathogenesis.
|Data di pubblicazione:||2007|
|Titolo:||Helicobacter pylori infection andchronic immune thrombocytopenic purpura: long-term results of bacteriumeradication and association with bacterium virulence profiles|
|Autore/i:||Emilia, Giovanni; Luppi, Mario; Zucchini, Patrizia; Morselli, M; Potenza, Leonardo; Forghieri, Fabio; Volzone, F; Jovic, Gordana; Leonardi, G; Donelli, A; Torelli, Giuseppe|
|Digital Object Identifier (DOI):||10.1182/blood-2006-12-063222|
|Codice identificativo ISI:||WOS:000251272200012|
|Codice identificativo Scopus:||2-s2.0-37049004014|
|Citazione:||Helicobacter pylori infection andchronic immune thrombocytopenic purpura: long-term results of bacteriumeradication and association with bacterium virulence profiles / Emilia, Giovanni; Luppi, Mario; Zucchini, Patrizia; Morselli, M; Potenza, Leonardo; Forghieri, Fabio; Volzone, F; Jovic, Gordana; Leonardi, G; Donelli, A; Torelli, Giuseppe. - In: BLOOD. - ISSN 0006-4971. - STAMPA. - 110(12)(2007), pp. 3833-3841.|
|Tipologia||Articolo su rivista|
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