Original Article

Correlation Analysis of Helicobacter pylori Infection and Digestive Tract Symptoms in Children and Related Factors of Infection


Background: To analyze the correlation between Helicobacter pylori infection and digestive tract symptoms in children and other related factors, and to explore the risk factors of H. pylori infection in children and the expression of inflammatory factors in H. pylori-positive and H. pylori-negative children.

Methods: Overall, 234 children with H. pylori test in Xuzhou Children's Hospital, Xuzhou Medical University (Xuzhou, China) were enrolled. Among them, 73 children were H. pylori-positive and 161 were H. pylori-negative. The expression levels of cytokines interleukin-8 (IL-8), interleukin-18 (IL-18) and interferon-γ (IFN-γ) in H. pylori-positive and H. pylori-negative children were determined by ELISA. The correlation between H. pylori-positive and general data, digestive tract symptoms, other clinical symptoms, living habits, eating habits, family history and other related factors was statistically analyzed. Multivariate Logistic regression analysis was used to analyze the independent risk factors of H. pylori infection in children.

Results: Family monthly income, inattentive eating, sharing toothbrushes and cups, gnawing fingers, eating fried food, drinking raw water, eating smoked and pickled food, father suffering from gastropathy and mother suffering from gastropathy were independent risk factors for H. pylori infection in children. The most common digestive tract symptoms of children with H. pylori infection were abdominal pain, accompanied by one or more clinical symptoms. The expression levels of IL-8, IL-18 and IFN-γ in H. pylori-positive children were significantly higher than those in H. pylori-negative children.

Conclusion: Prevention of H. pylori infection in children is helpful for healthy growth of children, and cytokines IL-8, IL-18, IFN-γ have the potential to be used as biomarkers for diagnosis of H. pylori-positive children.

1. Mimica-Dukić N, Simin N, Orčić D, et al (2018). Therapeutic efficiency of essential oils against Helicobacter pylori infections. Facta Universitatis, Series Physics, Chemistry and Technology, 16: 29.
2. Thung I, Aramin H, Vavinskaya V, Gupta S, Park JY, Crowe SE, Valasek MA (2016). The global emergence of Helicobacter pylori antibiotic resistance. Aliment Pharmacol Ther, 43: 514-533.
3. Chey WD, Leontiadis GI, Howden CW, et al (2017). ACG clinical guideline: treatment of Helicobacter pylori infection. Am J Gastroenterol, 112(2): 212-239.
4. Hooi JKY, Lai WY, Ng WK, et al (2017). Global prevalence of Helicobacter pylori infection: systematic review and meta-analysis. Gastroenterology, 153(2): 420-429.
5. Plummer M, Franceschi S, Vignat J, et al (2015). Global burden of gastric cancer attributable to Helicobacter pylori. Int J Cancer, 136(2): 487-490.
6. Castro-Muñoz LJ, González-Díaz CA, Muñoz-Escobar A, et al (2017). Prevalence of Helicobacter pylori from the oral cavity of Mexican asymptomatic children under 5 years of age through PCR. Arch Oral Biol, 73: 55-59.
7. Shinozaki S, Nomoto H, Kondo Y, et al (2016). Comparison of vonoprazan and proton pump inhibitors for eradication of Helicobacter pylori. Kaohsiung J Med Sci, 32(5): 255-260.
8. Rizvanov AA, Haertlé T, Bogomolnaya L, et al (2019). Helicobacter pylori and its antibiotic heteroresistance: A neglected issue in published guidelines. Front Microbiol, 10: 1796.
9. David JM, Dominguez C, Hamilton DH, et al (2016). The IL-8/IL-8R Axis: a double agent in tumor immune resistance. Vaccines(Basel), 4(3): 22.
10. Wiedemann T, Hofbaur S, Loell E, et al (2016). A C-terminal coiled-coil region of CagL is responsible for Helicobacter pylori-induced IL-8 expression. Eur J Microbiol Immunol (Bp), 6(3): 186-196.
11. Ramis IB, Vianna JS, Gonçalves CV, et al (2017). Polymorphisms of the IL-6, IL-8 and IL-10 genes and the risk of gastric pathology in patients infected with Helicobacter pylori. J Microbiol Immunol Infect, 50(2): 153-159.
12. Wynn JL, Wilson CS, Hawiger J, et al (2016). Targeting IL-17A attenuates neonatal sepsis mortality induced by IL-18. Proc Natl Acad Sci U S A, 113(19): E2627-E2635.
13. Jorgensen I, Lopez JP, Laufer SA, et al (2016). IL‐1β, IL‐18, and eicosanoids promote neutrophil recruitment to pore‐induced intracellular traps following pyroptosis. Eur J Immunol, 46(12): 2761-2766.
14. Pachathundikandi SK, Müller A, Backert S (2016). Inflammasome activation by Helicobacter pylori and its implications for persistence and immunity. Inflammasome Signaling and Bacterial Infections. Curr Top Microbiol Immunol, 397: 117-131.
15. Puren AJ, Fantuzzi G, Gu Y, et al (1998). Interleukin-18 (IFNgamma-inducing factor) induces IL-8 and IL-1beta via TNFalpha production from non-CD14+ human blood mononuclear cells. J Clin Invest, 101(3): 711-721.
16. Slaats J, Ten Oever J, van de Veerdonk FL, et al (2016). IL-1β/IL-6/CRP and IL-18/ferritin: distinct inflammatory programs in infections. PLoS Pathog, 12(12): e1005973.
17. Shen J, Xiao Z, Zhao Q, et al (2018). Anti‐cancer therapy with TNF α and IFN γ: A comprehensive review. Cell Prolif, 51(4): e12441.
18. Krummel MF, Mahale JN, Uhl LFK, et al (2018). Paracrine costimulation of IFN-γ signaling by integrins modulates CD8 T cell differentiation. Proc Natl Acad Sci U S A, 115(45): 11585-11590.
19. Davinelli S, Melvang HM, Andersen LP, et al (2019). Astaxanthin from Shrimp Cephalothorax Stimulates the Immune Response by Enhancing IFN-γ, IL-10, and IL-2 Secretion in Splenocytes of Helicobacter Pylori-Infected Mice. Mar Drugs, 17(7): 382.
20. Hornbeck PV (2001). Enzyme‐linked immunosorbent assays. Curr Protoc Immunol, 110: 2.1.1-2.1.23.
21. Suzuki H, Ataka K, Asakawa A, et al (2019). Helicobacter pylori Vacuolating Cytotoxin A Causes Anorexia and Anxiety via Hypothalamic Urocortin 1 in Mice. Sci Rep, 9(1): 6011.
22. HajiFattahi F, Hesari M, Zojaji H, et al (2015). Relationship of halitosis with gastric Helicobacter pylori infection. J Dent (Tehran), 12(3): 200-205.
23. Erdemir G, Ozkan TB, Ozgur T, et al (2016). Helicobacter pylori infection in children: nutritional status and associations with serum leptin, ghrelin, and IGF‐1 levels. Helicobacter, 21(4): 317-324.
24. Hasosah M, Satti M, Shehzad A, et al (2015). Prevalence and Risk Factors of Helicobacter pylori Infection in Saudi Children: A Three‐Year Prospective Controlled Study. Helicobacter, 20(1): 56-63.
25. Shiferaw G, Abera D (2019). Magnitude of Helicobacter pylori and associated risk factors among symptomatic patients attending at Jasmin internal medicine and pediatrics specialized private clinic in Addis Ababa city, Ethiopia. BMC Infect Dis, 19(1): 118.
26. Ding Z, Zhao S, Gong S, et al (2015). Prevalence and risk factors of Helicobacter pylori infection in asymptomatic Chinese children: a prospective, cross‐sectional, population‐based study. Aliment Pharmacol Ther, 42(8): 1019-1026.
27. Choi YJ, Kim N (2016). Gastric cancer and family history. Korean J Intern Med, 31(6): 1042-1053.
28. Sanjun DU, Lyu Q, Duo LI (2017). Changes of serum IL-6 and IL-8 levels in patients with gastric cancer and the clinical relationships with Helicobacter pylori infection. Journal of Chinese Physician, 19: 250-252, 256.
29. Mohamed AA, Mina H, Tosson AMS (2016). Correlation of Helicobacter Pylori Infection With IL-8 and Recurrence of Abdominal Pain: Our Experience from an Endemic Area. J Gastroenterol Hepatol Res, 5: 2248-2253.
30. Day AS, Su B, Ceponis PJ, et al (2004). Helicobacter pylori infection induces interleukin-18 production in gastric epithelial (AGS) cells. Dig Dis Sci, 49(11-12): 1830-1835.
31. Lopes AI, Quiding-Jarbrink M, Palha A, et al (2005). Cytokine expression in pediatric Helicobacter pylori infection. Clin Diagn Lab Immunol, 12(8): 994-1002.
IssueVol 49 No 10 (2020) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijph.v49i10.4694
Helicobacter pylori Infection Digestive tract symptoms Risk factors Cytokines

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How to Cite
YU X, FENG D, WANG G, DONG Z, ZHOU Q, ZHANG Y. Correlation Analysis of Helicobacter pylori Infection and Digestive Tract Symptoms in Children and Related Factors of Infection. Iran J Public Health. 2020;49(10):1912-1920.