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FIBROMYALGIA A MANIFESTATION OF HELICOBACTER PYLORI INFECTION?
... As a consequence of acute or repetitive tissue injuries, cytokines cause central sensitization by long-term activation of the spinal cord glia and dorsal horn neurons [5]. Inflammation is an important mediator of increased sympathetic nervous system activity and may lead to pain, increased arousal, and emotional distress via mediating sympathetic nervous system activity in fibromyalgia patients [6]. ...
... Although there are several studies suggesting an association between various infections and FMS [29,30], there are only two studies about H. pylori infection and FMS, their results were controversial [6,31]. ...
... In the study of Akkaya et al. [31], they documented a significant HP seropositivity only of H. pylori IgG antibody in the FMS group compared with healthy controls. However, Malt et al. [6] did not find any difference for H. pylori-seropositivity between groups. ...
Helicobacter pylori infection has been associated with digestive and rheumatic diseases. Aim of the work: to investigate the prevalence of H. pylori in fibromyalgia syndrome (FMS), to determine the relationship between these two diseases.Patients and methodsThe present study was a cross-sectional descriptive study, 100 female patients with primary FMS, and 100 healthy females to serve as control group were included. Serum samples were tested for the presence of anti-H. pylori antibodies by using the enzyme-linked immunosorbent assay technique.ResultsThe prevalence of H. Pylori IgG antibody of the patients was significantly higher than the control group (68 PFMS, 32 controls p < 0.001). Also there were 50 PFMS cases and 24 controls of positive IgA antibody (p < 0.001). Patients who were H. pylori IgG antibody positive when compared to patients who were H. pylori negative, more frequently have post-exertion pain (p = 0.0307), morning stiffness (p = 0.0177), confusion (p = 0.0139), depression (p = 0.0015), mood disturbance (p = 0.0093), anxiety (p = 0.0388), tension headache (p = 0.0088), sleep disturbance (p = 0.0046), and changes in appetite (p = 0.0301). Duration of FMS in patients who were H. pylori positive was 9.8 ± 1.8 years while in patients who were H. pylori negative it was 8 ± 2 years (p < 0.001). Patients who were H. pylori positive when compared to patients who were H. pylori negative, had a higher visual analog scale (VAS) of fatigue (p < 0.001), VAS of global severity (p = 0.0017), VAS of anxiety (p < 0.001), higher fibromyalgia impact questionnaire (FIQ) (p < 0.001), and more tender points count (p < 0.001).Conclusion
Significant increase existing in IgG and IgA antibody titer against H. pylori in FMS compared to control groups.
... It is obvious that, in genetically susceptible subjects, a certain environmental factor (especially an infective agent) may induce or exacerbate many autoimmune diseases [11]. Although there are several studies suggesting association between various infections and FM121314151617181920212223, there is only one study about HP infection and FM [24]. This study was performed to determine the seroprevalence of HP in patients with FM and investigate the association between HP and clinical characteristics of FM. ...
... Neuroendocrine or immunologic abnormalities, physical trauma, genetic factors, psychological distress, sleep disturbances (non-REM sleep anomaly), peripheral mechanisms (i.e., diminutions in muscle ATP and phosphocreatinine, muscle tension, and microtrauma), or psychiatric morbidity are general etiopathogenetic causes of FM suggested in the studies [4, 29, 30]. However, there are some studies suggesting relation between different types of infection and FM; there is presently no proof that fibromyalgia is caused by an infection [24]. Infectious agents may contribute to the appearance of FM by activating cytokines and leading to neuroendocrine abnormalities [8]. ...
... As a consequence of acute or repetitive tissue injuries, cytokines cause central sensitization by long-term activation of spinal cord glia and dorsal horn neurons [31]. Inflammation may lead to pain, increased arousal, and emotional distress via mediating sympathetic nervous system activity in fibromyalgia patients [24]. Nash et al. [14] reported a case of coxsackievirus infection mimicking FM. ...
Although there are some studies suggesting relation between different types of infection and fibromyalgia syndrome (FM), there
is presently no proof that FM is caused by an infection. Helicobacter pylori (HP) infection may cause extragastric manifestations. Inflammation is an important mediator of increased sympathetic nervous
system activity and may lead to pain in fibromyalgia patients. In this study, we aimed to investigate the HP seropositivity
in fibromyalgia patients compared with controls for possible role of HP infection in FM. Sixty-seven patients with fibromyalgia
were evaluated. Two of them were excluded from the study because of high level of acute phase reactants. Sixty-five female
patients with fibromyalgia and 41 randomly selected age-matched female healthy controls were enrolled to study. Serum HP IgA
and IgG antibodies were measured by enzyme-linked immunosorbent assay technique. Fibromyalgia Impact Questionnaire was assessed
in patients and controls. Seropositivity of HP IgG antibody in the fibromyalgia patients was significantly higher than in
the control group. No statistically significant differences were found regarding the clinical features between fibromyalgia
patients with HP IgG antibody and patients without IgG antibody. Our study suggests that former HP infection may have a role
in the etiopathogenesis of fibromyalgia syndrome or may act as a triggering factor. However, high seroprevalence of HP in
general population and prevalent asymptomatic infection make it difficult to interpret these results for the definite role
of HP in FM. Highlighting the pathophysiologic mechanisms of FM will result in more effective treatment regimens.
... It is obvious that, in genetically susceptible subjects, a certain environmental factor (especially an infective agent) may induce or exacerbate many autoimmune diseases [11]. Although there are several studies suggesting association between various infections and FM [12][13][14][15][16][17][18][19][20][21][22][23], there is only one study about HP infection and FM [24]. This study was performed to determine the seroprevalence of HP in patients with FM and investigate the association between HP and clinical characteristics of FM. ...
... However, there are some studies suggesting relation between different types of infection and FM; there is presently no proof that fibromyalgia is caused by an infection [24]. Infectious agents may contribute to the appearance of FM by activating cytokines and leading to neuroendocrine abnormalities [8]. ...
... As a consequence of acute or repetitive tissue injuries, cytokines cause central sensitization by long-term activation of spinal cord glia and dorsal horn neurons [31]. Inflammation may lead to pain, increased arousal, and emotional distress via mediating sympathetic nervous system activity in fibromyalgia patients [24]. Nash et al. [14] reported a case of coxsackievirus infection mimicking FM. ...
Although there are some studies suggesting relation between different types of infection and fibromyalgia syndrome (FM), there is presently no proof that FM is caused by an infection. Helicobacter pylori (HP) infection may cause extragastric manifestations. Inflammation is an important mediator of increased sympathetic nervous system activity and may lead to pain in fibromyalgia patients. In this study, we aimed to investigate the HP seropositivity in fibromyalgia patients compared with controls for possible role of HP infection in FM. Sixty-seven patients with fibromyalgia were evaluated. Two of them were excluded from the study because of high level of acute phase reactants. Sixty-five female patients with fibromyalgia and 41 randomly selected age-matched female healthy controls were enrolled to study. Serum HP IgA and IgG antibodies were measured by enzyme-linked immunosorbent assay technique. Fibromyalgia Impact Questionnaire was assessed in patients and controls. Seropositivity of HP IgG antibody in the fibromyalgia patients was significantly higher than in the control group. No statistically significant differences were found regarding the clinical features between fibromyalgia patients with HP IgG antibody and patients without IgG antibody. Our study suggests that former HP infection may have a role in the etiopathogenesis of fibromyalgia syndrome or may act as a triggering factor. However, high seroprevalence of HP in general population and prevalent asymptomatic infection make it difficult to interpret these results for the definite role of HP in FM. Highlighting the pathophysiologic mechanisms of FM will result in more effective treatment regimens.
... Furthermore, elevated systemic inflammation burden due to microbial translocation improves trained myelopoiesis in the bone marrow with improved generation of monocyte lineage and, neutrophils which are employed to periodontal tissue and exacerbate periodontitis. Endocrine pathway: gut microbiota can regulate the hormone-like chemicals or production of human hormone, which further influence periodontitis and bone homeostasis [64] Visceral pain Gastrointestinal Microbiota Possible for employing gastrointestinal microbiota as a therapeutic target for visceral pain [89] Inflammatory pain Gastrointestinal Microbiota Alterations of the microbial environment as an importance of disorder, stress/injury, can lead to a wide range of physiological /behavioral effects, locally, as well as an altered gut motility, decline in gut barrier integrity, inflammatory mediator release equally nociceptive and distension receptor sensitization [89,90] Migranes (headache) Microbiota Gut permeability due to gut microbiota plays a key role in migraine patient [91,92] Fibromyalgia HP FM patients in common may be particularly vulnerable to CNS effects of HP [93] Fibromyalgia Microbiome Findings revealed that advance trainings are needed to measure potential microbiome alterations in other chronic pain conditions, and to discover potential causal relationships between the gut microbiome and FM [94] Chronic Pain-nociceptive, neuropathic and inflammatory [103] FGIDS ...
The relationship between gut microbiota and pain, such as visceral pain, headaches (migraine), itching, prosthetic joint infection (PJI), chronic abdominal pain (CAP), joint pain, etc., has received increasing attention. Several parts of the evidence suggest that microbiota is one of the most important pain modulators and they can regulate pain in the central and peripheral nervous systems. Any alteration in microbiota by diet or antibiotics mediation may characterize a novel therapeutic strategy for pain management. The present study includes the most up-to-date and influential scientific findings on the association of microbiota with pain, despite the fact that the underlying mechanism is not identified in most cases. According to recent research, identifying the molecular mechanisms of the microbiota-pain pathway can have a unique perspective in treating many diseases, even though there is a long way to reach the ideal point. This study will stress the influence of microbiota on the common diseases that can stimulate the pain with a focus on underlying mechanisms.
... 4 To date, only two studies investigated the possible association between H. pylori and FMS. In these studies, Malt et al. 13 reported similar rates of H. pylori seropositivity in patients with FMS (n=28) and controls (n=39), while Akkaya et al. 4 found that the prevalence of immunoglobulin (Ig) G anti-H. pylori antibodies was significantly higher in fibromyalgia patients (67.7%) compared to controls (43.9%). ...
Patients and methods: The study was performed on 32 fibromyalgia syndrome patients (28 females, 4 males; mean age 38.5±8.6 years) suffering from dyspeptic complaints. All participants were evaluated by gastric endoscopy and bacterial culture for the presence of H. pylori. Patients included in the study were all H. pylori positive. The patients were assessed by the number of tender points, the Pittsburgh Sleep Quality Index, the Beck Depression Inventory, and the Beck Anxiety Inventory pre- and post-treatment for eradication of H. pylori. Amoxicillin 1 g, clarithromycin 500 mg, and lansoprazole 30 mg were given twice daily for three weeks to all patients.
... Microorganisms might contribute to the development of FMG by activation of inflammatory cytokines leading towards neuroendocrine abnormalities [34] . A study by Malt et al [35] shows that about 33% of the ...
Helicobacter pylori (H. pylori) infection is widely prevalent throughout worldwide. H. pylori manage a long-term survival in hostile environment of human stomach leading to peptic ulcer diseases and gastric cancer. But mostly infected person remains asymptomatic. Its chronic interaction with immune system makes H. pylori as an attractive candidate for the researchers to study its association with autoimmune diseases. This article presents a review of the literature on the association of H. pylori infection in selective autoimmune rheumatic diseases (RD). The authors used MeSH terms " Helicobacter pylori " with " rheumatoid arthritis, " " systemic lupus erythematosus, " or " fibromyalgia " to search PubMed database. All relevant studies identified were included. Despite extensive medical advancement many questions on role of H. pylori infection in autoim-mune RD still remain unanswered. Further studies are therefore needed to address the role of H. pylori in pathogenesis of RD. Core tip: Helicobacter pylori (H. pylori) infection is widely prevalent throughout worldwide. Its chronic interaction with immune system makes H. pylori is an attractive candidate for the researchers to study its association with autoimmune disorders. This study presents a review of the literature on the H. pylori association with selective autoimmune rheumatic disorders. Despite extensive medical advancement many questions on the association of H. pylori infection with autoimmune rheumatic disorders still remain unanswered. More studies are therefore required to address the role of H. pylori infection in
... In contrast, an early case-control found no difference in serologic prevalence between fibromyalgia patients and age matched controls [158] . ...
Helicobacter pylori (H. pylori) infection has been clearly linked to peptic ulcer disease and some gastrointestinal malignancies. Increasing evidence demonstrates possible associations to disease states in other organ systems, known as the extraintestinal manifestations of H. pylori. Different conditions associated with H. pylori infection include those from hematologic, cardiopulmonary, metabolic, neurologic, and dermatologic systems. The aim of this article is to provide a concise review of the evidence that supports or refutes the associations of H. pylori and its proposed extraintestinal manifestations. Based on data from the literature, PUD, mucosal associated lymphoid tumors lymphoma, and gastric adenocarcinoma has well-established links. Current evidence most supports extraintestinal manifestations with H. pylori in immune thrombocytopenic purpura, iron deficiency anemia, urticaria, Parkinson's, migraines and rosacea; however, there is still plausible link with other diseases that requires further research.
... However, among these patients, there was no difference in clinical manifestations of FMG between H. pylori seropositive versus seronegative individuals. Another study of 28 female FMG patients reported similar rates of H. pylori seropositivity in patients and controls [49]. ...
The etiology of most autoimmune diseases remains elusive. Prevailing evidence suggests an environmental trigger in a genetically susceptible individual. Helicobacter pylori (H. pylori) have managed to survive in a hostile environment in their host for long period and have evaded eradication by the immune system. Its chronic interaction with the immune system and the ubiquitous presence worldwide makes H. pylori an ideal candidate to study as a trigger of autoimmune phenomena. In this review, we would present data regarding the interplay between H. pylori and various components of the immune system and its association with various autoimmune diseases.
Strong associations of H. pylori with some autoimmune diseases such as immune thrombocytopenia have been found; but most other autoimmune disease studies have revealed conflicting data. The chronic survival of H. pylori in humans is possible because of an overall downregulation of the body's immune response. In addition to this overall effect on the immune system, there are clinical and epidemiological data suggestive of H. pylori infection having a protective role in some autoimmune diseases.
Based on our review H. pylori status should be checked and treated only in certain autoimmune diseases such as ITP. For the majority of the autoimmune diseases, the role of H. pylori remains controversial signifying need for further research.
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