The concomitant role of Helicobacter pylori in Sjogren's syndrome - Evidence 1 to 5

                       

Sjogren's syndrome is a chronic inflammatory disorder [1], firstly observed by the Swedish ophthalmologist Henrik Sjogren in 1930. This syndrome is associated with autoimmune disturbance of the exocrine glands [2] by lymphocyte proliferation, mainly resulting in reduced glandular secretions and mucosal dryness, though it can cause a range of other symptoms such as pain and fatigue.

The reasons behind Sjogren's syndrome are still quite unknown and under intense scrutiny. Some clinical scientists relate Sjogren's to hormonal, genetic or environmental factors. However, there is a number of recent articles that support my personal belief that Sjogren's syndrome can result from the activity of the ubiquitous bacteria Helicobacter pylori after events of gastrointestinal stress.

Throughout the coming months I will be doing my own literature research to unveil what of pertinent is known today on the concomitant role of H. pylori in flaring up Sjogren's syndrome. In addition, I will be also looking a little deeper into the fragilities of H. pylori as an organism and presenting you with the latest research breakthrough on antimicrobial agents triggering this gram negative bacteria.

For reasons that have to do with time availability I won't be able to offer all the references consulted, but the most prominent pieces of research. I honestly hope that we can make this ride together and I wish you can contribute with any information you might find pertinent. The link between Sjogren's and H. pylori can be more than a mere coincidence as stated by many authors. 

The information collected from your peers, relatives or observations you have made on your own self (if you suffer of Sjogren's). Even indirect evidences will be taken into account for the building of my diagram/puzzle (see figure above). Evidence by evidence, step-by-step we might build a nice overview that can help us understand the aforementioned underlying role of H. pylori in primary (syndrome developed by itself) and secondary Sjogren's syndrome (in combination with another autoimmune disease) a lot better.

Evidence 1 -  H. pylori is worldwide spread and the commonest bacterial infection colonising the acid secreting part of the stomach where it can live for long periods of time.

Evidence 2 -  H. pylori has been identified as antigenic (stimulating the production of antibodies) for local accumulation of lymphoid tissue.

Evidence 3 -  H. pylori infection triggers either or both local and systemic immune response against bacterial antigens like, for example, the heat shock protein 60 (HSP60).

Evidence 4 - Prevalence of pylori infections and the average quantity of anti-pylori antibodies in sera from patients suffering with Sjogren's were significantly higher [2] than in control groups (even a control group suffering from connective tissue disease).

Evidence 5 - There is a significant correlation between presence of H. pylori Immunoglobulin G and Immunoglobulin M antibodies in patients with Sjogren's.

To be continued...

[1] Sjogren's syndrome, Arhritis Research UK, [http://www.arthritisresearchuk.org/arthritis-information/conditions/sjogrens-syndrome.aspx], last visited on the 20th of July 2015, last update unknown.

[2] Miedany, Y. M., Baddour, M., Ahmed, I., Fahmy, H. (2005). "Sjogren's syndrome: concomitant H. pylori infection  and possible correlation with clinical parameters". Joint Bone Spine, 72(2), pp. 135-141.