Lack of association between Helicobacter pylori and pediatric atopy: Evidence from a Latin American multicenter cohort

OBJECTIVES: Owing to the regulatory effect of the immune response associated with Helicobacter pylori (H. pylori) a protective role for this infection in the development of atopic conditions in children has been postulated. We aim to study the potential inverse association between H. pylori infection and the presence of asthma/rhinitis/eczema in Latin American children. METHODS: This was a cross-sectional study with prospective recruitment of consecutive symptomatic patients referred for endoscopy in Cuba, Ecuador, and Chile. Demographic data and asthma, rhinitis, and eczema (International Study of Asthma and Allergies in Childhood III) questionnaires were administered. Atopy was defined as the presence of at least one of the three diseases. A child was considered H. pylori-infected if one endoscopy-based invasive test result was positive. Multiple regression model analyses were performed. RESULTS: Two hundred fifty-one patients were enrolled. Of these, 53% were male, aged 11 ± 2.7 years. Additionally, 114 (45%) were infected by H. pylori, and 141 (56.2%) had some atopic condition, with no differences by country. Atopy was more prevalent in males than females (59% vs. 41%, p < 0.05). No significant association was observed between atopy and the presence of H. pylori: 68 (59.6%) infected children presented with atopy compared to 73 (53.3%) uninfected children. Logistic regression showed that H. pylori infection was positively associated with age (odds ratio [OR]: 1.21 [1.05-1.42], p = 0.0117) and rhinitis (OR: 1.89 [1.08-3.35], p = 0.0279) and negatively associated with eosinophilic esophagitis (OR: 0.11 [0.01-0.65], p = 0.042). CONCLUSIONS: In this study, H. pylori-infected and uninfected children presented similar frequencies of atopy. Further studies with larger cohorts are needed to clarify the role of H. pylori in atopic conditions.