TY - JOUR
T1 - Inverse association of esophageal eosinophilia with Helicobacter pylori based on analysis of a US pathology database
AU - Dellon, Evan S.
AU - Peery, Anne F.
AU - Shaheen, Nicholas J.
AU - Morgan, Douglas R.
AU - Hurrell, Jennifer M.
AU - Lash, Richard H.
AU - Genta, Robert M.
N1 - Funding Information:
Funding Supported in part by National Institutes of Health award T32 DK 07634 (to A.F.P.), National Institutes of Health award KL2RR025746 from the National Center for Research Resources (to E.S.D.), and a Junior Faculty Development Award from the American College of Gastroenterology (to E.S.D.).
PY - 2011/11
Y1 - 2011/11
N2 - Background & Aims: Eosinophilic esophagitis (EoE) is of increasing prevalence and believed to result from allergic processes. Helicobacter pylori has been inversely associated with allergic diseases, but there is no known relationship between H pylori, EoE, and esophageal eosinophilia. We investigated the association between esophageal eosinophilia and H pylori infection. Methods: We performed a cross-sectional study of data, collected from a US pathology database, on 165,017 patients in the United States who underwent esophageal and gastric biopsies from 2008 through 2010. Patients with and without H pylori on gastric biopsy were compared, and odds of esophageal eosinophilia were determined. Results: From the data analyzed, 56,301 (34.1%) had normal esophageal biopsy specimens, 5767 (3.5%) had esophageal eosinophilia, and 11,170 (6.8%) had H pylori infection. Esophageal eosinophilia was inversely associated with H pylori (odds ratio [OR], 0.77; 95% confidence interval [CI], 0.69-0.87). Compared with patients with normal esophageal biopsy specimens, odds of H pylori were reduced among patients with ≥15 eosinophils per high-power field (eos/hpf) (OR, 0.79; 95% CI, 0.70-0.88), ≥45 eos/hpf (OR, 0.75; 95% CI, 0.61-0.93), ≥75 eos/hpf (OR, 0.72; 95% CI, 0.50-1.03), and ≥90 eos/hpf (OR, 0.52; 95% CI, 0.31-0.87) (P for trend <.001). A similar dose-response trend was observed for increasing clinical suspicion for EoE and decreasing prevalence of H pylori. Additionally, severity of histologic effects of H pylori was inversely associated with esophageal eosinophilia. All trends held in multivariate analysis. Conclusions: In a large cross-sectional analysis, H pylori infection was inversely associated with esophageal eosinophilia. This relationship could have implications for the pathogenesis and epidemiology of EoE.
AB - Background & Aims: Eosinophilic esophagitis (EoE) is of increasing prevalence and believed to result from allergic processes. Helicobacter pylori has been inversely associated with allergic diseases, but there is no known relationship between H pylori, EoE, and esophageal eosinophilia. We investigated the association between esophageal eosinophilia and H pylori infection. Methods: We performed a cross-sectional study of data, collected from a US pathology database, on 165,017 patients in the United States who underwent esophageal and gastric biopsies from 2008 through 2010. Patients with and without H pylori on gastric biopsy were compared, and odds of esophageal eosinophilia were determined. Results: From the data analyzed, 56,301 (34.1%) had normal esophageal biopsy specimens, 5767 (3.5%) had esophageal eosinophilia, and 11,170 (6.8%) had H pylori infection. Esophageal eosinophilia was inversely associated with H pylori (odds ratio [OR], 0.77; 95% confidence interval [CI], 0.69-0.87). Compared with patients with normal esophageal biopsy specimens, odds of H pylori were reduced among patients with ≥15 eosinophils per high-power field (eos/hpf) (OR, 0.79; 95% CI, 0.70-0.88), ≥45 eos/hpf (OR, 0.75; 95% CI, 0.61-0.93), ≥75 eos/hpf (OR, 0.72; 95% CI, 0.50-1.03), and ≥90 eos/hpf (OR, 0.52; 95% CI, 0.31-0.87) (P for trend <.001). A similar dose-response trend was observed for increasing clinical suspicion for EoE and decreasing prevalence of H pylori. Additionally, severity of histologic effects of H pylori was inversely associated with esophageal eosinophilia. All trends held in multivariate analysis. Conclusions: In a large cross-sectional analysis, H pylori infection was inversely associated with esophageal eosinophilia. This relationship could have implications for the pathogenesis and epidemiology of EoE.
KW - Epidemiology
KW - Esophagus
KW - Histologic Analysis
KW - Inflammation
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U2 - 10.1053/j.gastro.2011.06.081
DO - 10.1053/j.gastro.2011.06.081
M3 - Article
C2 - 21762663
AN - SCOPUS:80054875484
SN - 0016-5085
VL - 141
SP - 1586
EP - 1592
JO - Gastroenterology
JF - Gastroenterology
IS - 5
ER -