Eradication of Helicobacter pylori is reported to increase the platelet count in some H pylori-positive patients with chronic idiopathic thrombocytopenic purpura.
However, the efficacy of the eradication was quite different according to the previous reports.
To determine whether H pylori infection can contribute to chronic idiopathic thrombocytopenic purpura, Dr Suzuki and colleagues performed a randomized controlled trial.
In addition, the researchers investigated the possible pathogenic mechanisms and predicted the platelet response after eradication of H pylori.
|H pylori eradication was achieved in 85% of patients|
|American Journal of Gastroenterology|
The team analyzed several H pylori virulence factors, and the urease activities of the infected H pylori strains.
The research team also analyzed the titers of anti-CagA IgG antibodies in each patient.
The research team reported that patients with chronic idiopathic thrombocytopenic purpura underwent gastroscopy and that gastric H pylori infection was confirmed by culture.
The team randomized H pylori-positive chronic idiopathic thrombocytopenic purpura patients to either the eradication or the non-eradication group.
The eradication group received a standard antibiotic therapy for H pylori.
The researchers defined response to treatment as complete if the platelet count was above 150 to 103/μl.
Partial response to treatment was defined as the platelet count increasing by more than 50 to 103/μl above the pretreatment count.
The team investigated virulence factors by PCR and PCR-based direct sequencing.
The researchers measured anti-CagA IgG antibody titer of each patient's serum by ELISA.
The researchers found that of the 36 patients, 25 were positive for H pylori and eradication was achieved in 85% of these patients.
The platelet response was significantly different between the eradication group and the non-eradication group.
The research team identified no significant differences in clinical factors between the responders and the nonresponders.
The researchers observed that H pylori virulence factors and the urease activity were not associated with the response.
In addition, the team noted that the titers of anti-CagA antibodies in the responders were significantly higher than those in the nonresponders.
Dr Suzuki's team concludes, “H pylori eradication treatment is a favorable therapeutic option for H pylori-positive patients with chronic idiopathic thrombocytopenic purpura.”
“Moreover, an ELISA titer of serum anti-CagA antibody may be a good predictor of platelet recovery.”
“Immunological reaction between platelet and anti-CagA antibodies may have some relation to the pathogenesis of H pylori-positive patients with chronic idiopathic thrombocytopenic purpura.”