Tuesday, 28 July 2015

The concomitant role of Helicobacter pylori in Sjogren's syndrome (IL-8, TNF-alpha and HCl)

The diagram I wish to build that will ultimately help design a bridge to understanding the concomitant role of H. pylori in Sjogren's syndrome knows today an enhancement. But let me summarise a bit of what was revealed on my last post:

  • Chronic gastric inflammation with high prevalence of serum titers of H. pylori causing mucosal atrophy is seen in ~ 80% of patients with Sjogren's syndrome;
  • Patients with other connective tissue diseases do not reveal this anti-H. pylori antibodies relationship;
  • However, biopsy results do not present an etiological link between H. pylori and Sjogren's patients; nevertheless, there might be genetic/infection differences from country to country;
  • Correlation between H. pylori infection of the gastric mucosa and anti-H. pylori IgG serum titers has been revealed;
  • Infection by H. pylori and disturbance of immunological mechanisms in Sjogren's syndrome patients may trigger a network of local and systemic reactions.
What else is there available in the literature that can support the concomitant role of H. pylori in the perturbed chain of responses typical of Sjogren's syndrome? 

The quite old discovery by Freimark et al (1989) that shows high serum levels of IL-8 (small signalling protein secreted by epithelial cells, macrophages, smooth muscle cells or even endothelial cells) [1] responding to alterations in the body system. The same pattern is also seen with increased levels of TNF-alpha, another signalling protein present in systemic inflammation and secreted by, for example, activated macrophages [1]. The elevated serum levels of both IL-8 and TNF-alpha reported by Freimark et al (1989) takes place in asymptomatic H. pylori patients who also show signs of increased gastrin (a peptide hormone that stimulates production of HCl in the stomach, duodenum and pancreas. 

As Miedany et al (2005) so well states, this direct relationship can help explain, in the future, if this bacteria is responsible for inducing Sjogren's or maintaining typical Sjogren's responses in the autoimmune scenario of the disease.

On the other hand we have a very interesting link between H. pylori infection and how long the disease actually lasts. The really curious fact is that presented by Fiocca et al (1994) disclosing that H. pylori antigens might be acting as antigen presenting cells recognised by lymphocytes [2]. Hence and in very simple terms, if H. pylori is still present, the organism still maintains an immunological response and the systemic inflammation is pursued. A vicious cycle indeed!

Most importantly, what I take from all this is that eradication of H. pylori might be adequate to alleviate Sjogren's or simply reduce the inflammatory response levels. Especially in avoiding lymphomas [3], a trait somewhat common in Sjogren's patients. 

See you soon in another interesting building of my diagram up there on the concomitant role of H. pylori in sjogren's syndrome. Please contribute with your findings, comments and own experiences.

[1] Freimark, B., Fantozzi, R., Bone, R., Bordin, G., Fox, R. (1989). "Detection of clonally expanded salivary gland lymphocytes in Sjogren's syndrome". Arthritis Rheumatology, 32(7), pp. 859-869.

[2] Fiocca, R., Luinetti, O, Villani, L., Chiaravalli, A., Capella, C., Solcia, E. (1994). "Epithelial cytotoxicity, immune response and inflammatory components of H. pylori gastritis". Scandinavian Journal of Gastroenterology, 205, pp. 11-16.

[3] Nardone, G (2000). "Risk Factor of Cancer Development in Helicobacter pylori". Digestive Liver Diseases, 32(suppl 3), pp. S190-S192.


  1. I think that you might be right. For almost one year I have problems with dry eyes and contact lenses intolerance. I am also ANA positive - just a little bit and the doctors say that maybe I have it and maybe I don't. I am trying some natural approach and my ANA levels are almost normal now, but I still have problems with my eyes. I've discovered that I have Helicobacter pylori and tomorrow I will start with antibiotics. I hope that this might solve the problems with my eyes.

  2. Dear Anonymous,

    thank you so much for your comment. Unfortunately I don't know if the antibiotics will sort it out straight away, the pylori I mean; it is a resilient bacteria, very capable of 'hiding and surviving'. Sometimes a second course of antibiotics is prescribed I have read. In terms of dry eyes, and in case you are suffering of Sjogren's syndrome, I'm almost positive getting rid of the bacteria won't cure you. One thing I realised was that changes in diet by adding more natural anti-inflammatory foods and reducing triggering agents like hydrogenated oils, less sugar, less dairy products, no eating after 9.30 pm and no junk food help tremendously. As anti-inflammatory food I can advise garlic, green peas, green tea, turmeric (one coffee spoon of turmeric with lukewarm water in the morning before breakfast has been doing wonders for me), red cabbage, onions, cherries, oregano oil, walnuts (super important for vegetarians who consequently do not eat fish - due to omega-3), purslane, low protein diet and high carbohydrate diet, avocado, olive oil and raw nuts and seeds. I have been a bit taken by work to do, but I will try my best to proceed writing about the concomitant role of pylori in Sjogren's, as I am sure I will get somewhere positive with sharing this idea of mine based on scientific articles. Thanks again for your visit.