HELICOBACTER PYLORI AND THE ATHEROGENIC PROCESS IN CARDIOVASCULAR DISEASE
Background: Conventional risk factors do not explain completely the atherogenic process. Chronic Helicobacter pylori (HP) infection may cause arterial inflammation and has been epidemiologically linked to the occurrence of atherosclerosis. Studies about the association of HP infection with peripheral arterial disease are limited.
Objective: Evaluate the presence of HP using a monoclonal antibody anti-HP in the atherosclerotic plaques of the superficial femoral artery in patients submitted to amputation above-knee.
Material and methods: We searched for the presence of HP in 29 non-consecutive patients with Leriche-Fontaine grade IV lower limb ischemia, submitted to amputation above-knee. Femoral artery was isolated and an atherosclerotic plaque specimen immediately distal to the amputation level, was removed, fixed in formalin and evaluated for HP, using a mono clonal antibody, anti-HP.
Results: The mean age of the 29 patients was 82 years. 18 were men (62.1 %). Risk factors for cardiovascular disease were present in the majority of patients. Only one patient had known history of HP infection in the past. Morbidity rate was 30%. The mortality rate was 13.8 % (4 cases). In all cases, anti-HP showed no evidence of HP at the atherosclerotic plaque.
Discussion/Conclusion: HP infection has been associated both epidemiologically and pathogenetically with atherosclerosis. However, HP was not found in this study at the atherosclerotic plaques of the superficial femoral artery.
2. Kaplan M, Yavuz SS, Cinar B, Koksal V, Kut MS, Yapici F et al. Detection of Chlamydia pneumoniae and Helicobacter pylori in atherosclerotic plaques of carotid artery by polymerase chain reaction. International Journal of Infectious Diseases (2006) 10, 116–123
3. Bloemenkamp DG, Mali WP, Tanis BC, Rosendal FR, van den Bosch MA, Kemmeren JM et al. Chlamydia pneumoniae, Helicobacter pylori and cytomegalovirus infections and the risk of peripheral arterial disease
in young women. Atherosclerosis 163 (2002) 149_/156.
4. Martínez AT and Martínez MG. Helicobacter pylori: a New Cardiovascular Risk Factor? Rev Esp Cardiol 2002;55(6):652–6
5. Hamed SA, Amine NF, Gala GM, Helal SR, Tag El-Din, Shawky OA et al. Vascular Risks and Complications in Diabetes Mellitus: The Role of Helicobacter Pylori Infection. Journal of Stroke and Cerebrovascular Diseases, Vol. 17, No. 2 (March-April), 2008: pp 86–94
6. Vijayvergiya R, Vadivelu R. Role of Helicobacter pylori infection in pathogenesis of atherosclerosis. World J Cardiol 2015 March 26; 7(3): 134–143
7. Varu VN, Hogg ME, Kibbe MR. Critical limb ischemia. J Vasc Surg 2010;51:230–241
8. Blasi F, Denti F, Erba M, Cosentini R, Raccanelli R, Rinaldi A et al. Detection of Chlamydia pneumoniae but Not Helicobacter pylori in Atherosclerotic Plaques of Aortic Aneurysms. Journal of Clinical Microbiology, Nov. 1996, Vol. 34, No. 11 p. 2766–2769
9. Shmuelya H, Passarob DJ, Vaturic M, Sagie A, Pitlik S, Samra Z et al. Association of CagA+ Helicobacter pylori infection with aortic atheroma. Atherosclerosis 179 (2005) 127–132
10. Grau AJ, Buggle F, Lichy C, Brandt T, Becher H and Rudi J. Helicobacter pylori infection as an independent risk factor for cerebral ischemia of atherothrombotic origin. Journal of the Neurological Sciences 186 Ž2001. 1–5
11. Ludewig B, Kreb P and Scandella E. Immunopathogenesis of atherosclerosis. J. Leukoc. Biol. 76: 300–306; 2004.
12. Kędzia A, Ciecierski M, Wierzbowska M, Kufel A and Kwapisz E. Isolation of Helicobacter pylori from femoral or iliac atherosclerotic plaques. Acta Angiol 2010; 16, 3: 129–134
13. Kacar F, Çulhac N, Yukselen V, Meteo, E Dikicio and E Levi. Histologic demonstration of Helicobacter Pylori in gastric biopsies : Witch is the best staining method. The Internet Journal Pathology. 2004 Vol 3 N 1.
14. Birnie DH, Holme ER, McKay IC, Hood S, McColl KE and Hillis WS. Association between antibodies to heat shock protein 65 and coronary atherosclerosis. European Heart Journal (1998) 19, 387–394.
15. Lynch NA. Helicobacter pylori and Ulcers: a Paradigm Revised. Federation of American Societies for Experimental Biology. http://www.faseb.org/opar