Systematic Reviews
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 21, 2015; 21(31): 9430-9436
Published online Aug 21, 2015. doi: 10.3748/wjg.v21.i31.9430
Helicobacter pylori and gastric mucin expression: A systematic review and meta-analysis
Yaron Niv
Yaron Niv, Department of Gastroenterology, Rabin Medical Center, Tel Aviv University, Petach Tikva 49100, Israel
Author contributions: Niv Y solely contributed to this paper.
Conflict-of-interest statement: There is no conflict of interest.
Data sharing statement: No additional data available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yaron Niv, MD, AGAF, FACG, Professor, Department of Gastroenterology, Rabin Medical Center, Tel Aviv University, 39 Jabotinski Street, Petach Tikva 49100, Israel. yniv@clalit.org.il
Telephone: +972-3-9377237 Fax: +972-3-9210313
Received: March 7, 2015
Peer-review started: March 11, 2015
First decision: April 13, 2015
Revised: April 22, 2015
Accepted: June 16, 2015
Article in press: June 16, 2015
Published online: August 21, 2015
Abstract

AIM: To investigate the relationship between Helicobacter pylori (H. pylori) and mucin expression in gastric mucosa.

METHODS: English Medical literature searches were conducted for gastric mucin expression in H. pylori infected people vs uninfected people. Searches were performed up to December 31th 2014, using MEDLINE, PubMed, EMBASE, Scopus, and CENTRAL. Studies comparing mucin expression in the gastric mucosa in patients positive and negative for H. pylori infection, were included. Meta-analysis was performed by using Comprehensive meta-analysis software (Version 3, Biostat Inc., Englewood, NJ, United States). Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated compared mucin expression in individual studies by using the random effects model. Heterogeneity between studies was evaluated using the Cochran Q-test, and it was considered to be present if the Q-test P value was less than 0.10. I2 statistic was used to measure the proportion of inconsistency in individual studies, with I2 > 50% representing substantial heterogeneity. We also calculated a potential publication bias.

RESULTS: Eleven studies, which represent 53 sub-studies of 15 different kinds of mucin expression, were selected according to the inclusion criteria. Every kind of mucin has been considered as one study. When a specific mucin has been studied in more than one paper, we combined the results in a nested meta-analysis of this particular mucin: MUC2, MUC6, STn, Paradoxical con A, Tn, T, Type 1 chain mucin, LeA, SLeA, LeB, AB-PAS, MUC1, and MUC5AC. The odds ratio of mucin expression in random analysis was 2.33, 95%CI: 1.230-4.411, P = 0.009, higher expression in H. pylori infected patients. Odds ratio for mucin expression in H. pylori positive patients was higher for MUC6 (9.244, 95%CI: 1.567-54.515, P = 0.014), and significantly lower for MUC5AC (0.447, 95%CI: 0.211-0.949, P = 0.036). Thus, H. pylori infection may increase MUC6 expression and decrease MUC5AC expression by 924% and 52%, respectively.

CONCLUSION: H. pylori inhibits MUC5AC expression in the gastric epithelium, and facilitates colonization. In contrast, increased MUC6 expression may help inhibiting colonization, using MUC6 antibiotics properties.

Keywords: Helicobacter pylori, Gastric mucin, Stomach, Secretion

Core tip: In this meta-analysis we looked at studies that investigated the relationship between Helicobacter pylori (H. pylori) and mucin expression in the human gastric mucosa. English Medical literature searches were conducted for studies comparing mucin expression in the gastric mucosa in patients positive and negative for H. pylori infection. Meta-analysis was performed, and pooled odds ratios were calculated compared mucin expression in individual studies. Eleven studies, which represent 53 sub studies of 15 different kinds of mucin, were found. H. pylori inhibited MUC5AC expression and facilitated colonization. In contrast, increased MUC6 expression may help inhibiting colonization, using MUC6 antibiotics properties.