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Helicobacter pylori and pregnancy-related disorders

机译:幽门螺杆菌与妊娠相关疾病

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摘要

Helicobacter pylori (H. pylori) infection is investigated in gastric diseases even during pregnancy. In particular, this Gram-negative bacterium seems to be associated with hyperemesis gravidarum, a severe form of nausea and vomiting during pregnancy. During the last decade, the relationship among H. pylori and several extra-gastric diseases strongly emerged in literature. The correlation among H. pylori infection and pregnancy-related disorders was mainly focused on iron deficiency anemia, thrombocytopenia, fetal malformations, miscarriage, pre-eclampsia and fetal growth restriction. H. pylori infection may have a role in the pathogenesis of various pregnancy-related disorders through different mechanisms: depletion of micronutrients (iron and vitamin B12) in maternal anemia and fetal neural tube defects; local or systemic induction of pro-inflammatory cytokines release and oxidative stress in gastrointestinal disorders and pre-eclampsia; cross-reaction between specific anti-H. pylori antibodies and antigens localized in placental tissue and endothelial cells (pre-eclampsia, fetal growth restriction, miscarriage). Since H. pylori infection is most likely acquired before pregnancy, it is widely believed that hormonal and immunological changes occurring during pregnancy could activate latent H. pylori with a negative impact not only on maternal health (nutritional deficiency, organ injury, death), but also on the fetus (insufficient growth, malformation, death) and sometime consequences can be observed later in life. Another important issue addressed by investigators was to determine whether it is possible to transmit H. pylori infection from mother to child and whether maternal anti-H. pylori antibodies could prevent infant’s infection. Studies on novel diagnostic and therapeutic methods for H. pylori are no less important, since these are particularly sensitive topics in pregnancy conditions. It could be interesting to study the possible correlation between H. pylori infection and other pregnancy-related diseases of unknown etiology, such as gestational diabetes mellitus, obstetric cholestasis and spontaneous preterm delivery. Since H. pylori infection is treatable, the demonstration of its causative role in pregnancy-related disorders will have important social-economic implications.
机译:甚至在怀孕期间,在胃部疾病中也研究了幽门螺杆菌(H. pylori)感染。特别是,这种革兰氏阴性细菌似乎与妊娠呕吐有关,后者是怀孕期间恶心和呕吐的一种严重形式。在过去的十年中,幽门螺杆菌与几种胃外疾病之间的关系在文献中很强。幽门螺杆菌感染与妊娠相关疾病之间的相关性主要集中在缺铁性贫血,血小板减少症,胎儿畸形,流产,先兆子痫和胎儿生长受限。幽门螺杆菌感染可能通过不同的机制在各种妊娠相关疾病的发病机理中起作用:贫血和胎儿神经管缺陷中微量营养素(铁和维生素B12)的消耗;在胃肠道疾病和先兆子痫中局部或全身诱导促炎性细胞因子释放和氧化应激;特异性抗H之间的交叉反应。幽门螺杆菌抗体和抗原位于胎盘组织和内皮细胞中(先兆子痫,胎儿生长受限,流产)。由于幽门螺杆菌感染最有可能在怀孕之前获得,因此普遍认为,怀孕期间发生的激素和免疫学改变会激活潜在的幽门螺杆菌,不仅对孕产妇健康造成不良影响(营养缺乏,器官损伤,死亡),而且也会对胎儿造成影响(生长,畸形,死亡不足),有时在以后的生活中会观察到后果。研究人员解决的另一个重要问题是确定是否有可能将幽门螺杆菌感染从母亲传给孩子,以及母亲是否有抗H的能力。幽门螺杆菌抗体可以预防婴儿的感染。幽门螺杆菌的新型诊断和治疗方法的研究也同样重要,因为这些都是妊娠状况中特别敏感的话题。研究幽门螺杆菌感染与其他病因不明的妊娠相关疾病之间的可能相关性可能很有趣,例如妊娠糖尿病,产科胆汁淤积和自发早产。由于幽门螺杆菌感染是可以治疗的,因此证明其在与妊娠有关的疾病中具有致病作用将具有重要的社会经济意义。

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