Those managing cases of Helicobacter pylori infection (according to the World Health Organization the most common infection worldwide) should be alert to the association of Helicobacter infection and autoimmune diseases. The authors of a paper published in the journal Biomedicine & Pharmacotherapy discuss this connection, beginning with the autoimmune component of cardiovascular disease:

“In the last few years several studies have been performed on the association between H. pylori infection and a miscellany of extragastric disorders which also include autoimmune diseases. In particular, emerging evidence seems to give a potential role for H. pylori in ischaemic heart disease via a cross mimicry between antibodies against heat shock protein 65 which are produced in the consequence of infection, but which are also expressed in atherosclerotic lesions.”

They note that other autoimmune diseases have been recognized in this regard:

“In cases of healing of Sjogren syndrome and Schonlein-Henoch purpura have also been reported. A recent study, moreover, showed that eradication of H. pylori infection may be effective in the disappearance of autoimmune thrombocytopenia. Finally, a role for H. pylori has also been postulated in other autoimmune diseases such as membranous nephropathy and some acute immune polyneuropathies.”

We can also appreciate a paper just published in the journal Oral Diseases in which the authors observe:

“Helicobacter pylori (H. pylori) is a widely prevalent microbe, with between 50 and 80% of the population infected worldwide. Clinically, infection with H. pylori is commonly associated with peptic ulcer disease, but many of those infected remain asymptomatic.”

They proceed to elaborate on the implications for autoimmune disorders:

“H. pylori has evolved a number of means to affect the host immune response and has been implicated in many diseases mitigated by immune dysregulation, such as immune thrombocytopenic purpura (ITP), atrophic gastritis, and mucosa associated lymphoid tissue (MALT) lymphoma. Autoimmune diseases, such as systemic lupus erythematosus, rheumatoid arthritis, and Sjogren’s syndrome, are the result of a dysregulated host immune system which targets otherwise healthy tissues…Because of its prevalence and ability to affect human immune function, many researchers have hypothesized that H. pylori might contribute to the development of autoimmune diseases. In this article, we review the available literature regarding the role of chronic H. pylori infection in various autoimmune disease states.”

Case management of H. pylori infection requires vigilance for the possibility of an autoimmune condition, and for those suffering an autoimmune diagnosis the possibility of infection should be ruled out.

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It’s hard to overemphasize the importance. Consider this paper published in Nature Reviews Rheumatology in which the authors assert that the…

“…immunoregulatory and anti-inflammatory properties” of vitamin D can be used for the “control of autoimmune diseases.”

They note that…

“…Epidemiological evidence indicates a significant association between vitamin D deficiency and an increased incidence of several autoimmune diseases,”

Which include…

“a variety…from rheumatoid arthritis to systemic lupus erythematosus, and possibly also multiple sclerosis, type 1 diabetes, inflammatory bowel diseases, and autoimmune prostatitis.”

(Extra highlight for autoimmune prostatitis because very few are aware how common this is.) Of great practical importance is their observation that…

“The net effect of the vitamin D system on the immune response is an enhancement of innate immunity coupled with multifaceted regulation of adaptive immunity.”

We are awash in studies on vitamin D, here’s one more for good measure. This paper, recently published in the journal Psychoneuroendocrinology, focuses on its use in the treatment of autoimmune disease that attacks the brain and nervous system. The authors begin by noting that…

“It has been known for more than 20 years that vitamin D exerts marked effects on immune and neural cells…it has been shown that diminished levels of vitamin D…is a risk factor for various brain diseases.”

They further state that…

“…vitamin D has been found to be a strong candidate risk-modifying factor for Multiple Sclerosis (MS)…”

And proceed to..

“…assess how vitamin D imbalance may lay the foundation for a range of adult disorders, including brain pathologies (Parkinson’s disease, epilepsy, depression) and immune-mediated disorders (rheumatoid arthritis, type I diabetes mellitus, systemic lupus erythematosus or inflammatory bowel diseases).”

These are some of the reasons why I always screen for vitamin D sufficiency.

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