Case Control Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 16, 2021; 9(23): 6686-6697
Published online Aug 16, 2021. doi: 10.12998/wjcc.v9.i23.6686
Innate immunity – the hallmark of Helicobacter pylori infection in pediatric chronic gastritis
Lorena Elena Meliț, Cristina Oana Mărginean, Maria Oana Săsăran, Simona Mocan, Dana Valentina Ghiga, Alina Bogliş, Carmen Duicu
Lorena Elena Meliț, Cristina Oana Mărginean, Carmen Duicu, Department of Pediatrics I, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology Târgu Mureș, Târgu Mureș 540136, Romania
Maria Oana Săsăran, Department of Pediatrics III, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology Târgu Mureș, Târgu Mureș 540136, Romania
Simona Mocan, Department of Pathology, Emergency County Hospital Târgu Mureș, Târgu Mureș 540139, Romania
Dana Valentina Ghiga, Scientific Medical Research Methodology, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology Târgu Mureș, Târgu Mureș 540136, Romania
Alina Bogliş, Department of Genetics, Center for Advanced Medical and Pharmaceutical Research, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology Târgu Mureș, Târgu Mureș 540136, Romania
Author contributions: Meliț LE, Duicu C, Mărginean CO, and Săsăran MO conceptualized and designed the study, drafted the initial manuscript, and reviewed and revised the manuscript; Bogliș A performed the genetic analyses; Mocanu S performed the histopathological exam; Ghiga DV performed the statistical analyses; All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
Supported by University of Medicine, Pharmacy, Sciences and Technology “George Emil Palade” of Târgu Mureş, Romania, No. 293/6/14.01.2020.
Institutional review board statement: Our study was approved by the Ethics Committee of the University of Medicine, Pharmacy, Sciences and Technology ‘George Emil Palade’ Târgu Mureş (No. 27/March 17th 2016, and No. 792/March 11th 2020), being performed according to the Helsinki Declaration.
Informed consent statement: All the parents/caregivers signed the informed consent prior to their children inclusion in the study.
Conflict-of-interest statement: The authors have no conflicts of interest to disclose.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement, and the manuscript was prepared and revised according to the STROBE Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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/
Corresponding author: Cristina Oana Mărginean, MD, PhD, Professor, Department of Pediatrics I, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology Târgu Mure, Gheorghe Marinescu Street No. 38, Târgu Mureș 540136, Romania. marginean.oana@gmail.com
Received: March 18, 2021
Peer-review started: March 18, 2021
First decision: June 3, 2021
Revised: June 14, 2021
Accepted: July 5, 2021
Article in press: July 5, 2021
Published online: August 16, 2021
Processing time: 139 Days and 18.1 Hours
ARTICLE HIGHLIGHTS
Research background

Innate immunity was found to be associated to both persistence of Helicobacter pylori (H. pylori) infection and increased risk for gastric cancer.

Research motivation

To identify the risk factors associated with H. pylori infection and to establish the role of TLR9 rs352140 in suppressing or promoting the inflammation related to this infection in children.

Research objectives

Environmental factors represent a major risk factor for H. pylori chronic gastritis in children. Peripheral blood parameters might be reliable indicators of systemic inflammation triggered by H. pylori infection. TLR9 polymorphisms seem to be involved in promoting or suppressing systemic inflammation in the setting of pediatric H. pylori chronic gastritis.

Research methods

A cross-sectional prospective study on 183 children.

Research results

Rural area and poor living conditions were significantly associated to H. pylori chronic gastritis (P = 0.0042/P < 0.0001). Both positive immunoglobulin A anti H. pylori and rapid urease test were significantly associated to H. pylori infection (P < 0.0001). Significantly higher values of leukocytes and neutrophils within the peripheral blood were found in children with H. pylori chronic gastritis (P = 0.111/P = 0.284). We found a significant positive correlation for variant TT genotype of TLR9 rs352140 polymorphism and both leucocytes and neutrophils (P = 0.0225/P = 0.0292).

Research conclusions

Environmental factors such as poor living conditions and rural area might result in an increased risk for H. pylori chronic gastritis in children. Serological and rapid urease tests could be used as reliable tests for the detection of H. pylori infection in children. Moreover, leukocytes and neutrophils are important non-invasive biomarkers for detecting the low-grade inflammatory status associated with this infection in pediatric patients. In terms of innate immunity, our findings emphasized that variant TT genotype carriers of the TLR9 rs352140 gene polymorphism might express a more severe degree of inflammation.

Research perspectives

Nevertheless, further studies are required on bigger samples of pediatric patients to identify the precise role of innate immunity and its TLR9 polymorphisms in the development of H. pylori gastritis.