Helicobacter pylori infection 11 X more likely if low vitamin D – meta-analysis Aug 2019

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Effect of vitamin D on Helicobacter pylori infection and eradication: A meta-analysis - Aug 2019

Helicobacter. 2019 Aug 14:e12655. doi: 10.1111/hel.12655.
Yang L1, He X1, Li L1, Lu C1.
Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
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BACKGROUND:
Various studies reported the relationship between Helicobacter pylori (H pylori) and vitamin D, but there is some controversy around that. This study aimed to conduct a meta-analysis to clarify the relationship between vitamin D and H pylori infection, and vitamin D and H pylori eradication.

METHODS:
Articles published until June 1, 2019, in the PubMed, MEDLINE, and EMBASE databases with English-language medical studies were searched. According to the inclusion criteria, relevant statistical data were extracted to Microsoft Excel and analyzed by STATA15.1.

RESULTS:
Ten articles were finally included. It was demonstrated that average 25(OH)D level in H pylori-positive patients was lower than H pylori-negative (SMD = -0.53 ng/mL, 95% CI = (-0.91, -0.16 ng/mL)). For H pylori eradication individuals, the result showed that average 25(OH)D level in H pylori successful eradication individuals was higher than unsuccessful (SMD = 1.31 ng/mL, 95% CI = [0.60, 2.02 ng/mL]).
In addition, individuals with vitamin D deficiency had lower H pylori eradicate rate (OR = 0.09, 95% CI = [0.02, 0.41]). Sensitivity analysis showed that the meta-analysis results were stable and reliable.

CONCLUSIONS:
Vitamin D was a protective factor to H pylori infection. Moreover, vitamin D can improve the success rate of H pylori eradication.

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Vitamin D3 Inhibits Helicobacter pylori Infection by Activating the VitD3/VDR-CAMP Pathway in Mice - Oct 2020

Front. Cell. Infect. Microbiol., 23 October 2020 | https://doi.org/10.3389/fcimb.2020.566730
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Anni Zhou1†, Lei Li2†, Guiping Zhao1, Li Min1, Si Liu1, Shengtao Zhu1, Qingdong Guo1, Chunjie Liu3, Shutian Zhang1* and Peng Li1*

Helicobacter pylori (H. pylori) infection is closely associated with the occurrence and development of gastric diseases. Therefore, eliminating H. pylori infection should help to prevent gastric diseases. Vitamin D3 (VitD3, 1,25(OH)2D3) was previously observed to exhibit anti-H. pylori infection activity in clinic, but these results were reported in heterogeneous in vivo studies without elucidation of the underlying mechanisms. In the present study, we established H. pylori infection models in both wild-type and VDR knockdown (VDR-KD) mice, which were used to demonstrate that VitD3 inhibits H. pylori infection by enhancing the expression of VitD receptor (VDR) and cathelicidin antimicrobial peptide (CAMP). Furthermore, VDR-KD mice that exhibited lower VDR expression were more susceptible to H. pylori infection. In cultured mouse primary gastric epithelial cells, we further demonstrated that the VitD3/VDR complex binds to the CAMP promoter region to increase its expression. These data provide a mechanistic explanation of the anti-H. pylori infection activity of VitD3 at the molecular level in mice and suggest a new avenue for the clinical management of H. pylori eradication therapy.

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The effect of vitamin D deficiency on eradication rates of Helicobacter pylori infection – Oct 2018

JGH Open. 2018 Dec; 2(6): 270–275. doi: 10.1002/jgh3.12081, PMCID: PMC6308038. PMID: 30619936
Mohamed S El Shahawy,corresponding author 1 Mahmoud H Hemida, 2 Ibrahim El Metwaly, 3 and Zakarya M Shady 4

Background/Aim
Many studies have investigated risk factors other than antibiotic resistance linked to Helicobacter pylori (H. pylori) eradication failure. The aim of this study was to study the effect of serum levels of 25‐hydroxy‐vitamin D (25OHD) on eradication rates of H. pylori infection.

Methods
This study included 150 patients diagnosed with H. pylori gastritis using magnifying narrow‐band imaging endoscopy supported by stool antigen test. Serum 25‐OH vitamin D levels were measured via the Enzyme‐Linked Immune Sorbent assay (ELISA) method before starting eradication therapy of H. pylori infection. All patients were treated with clarithromycin‐based triple therapy for 14 days. H. pylori eradication was determined via a stool antigen test performed 4 weeks after the end of therapy. According to the serum level of 25‐OH vitamin D levels, the patients were divided into two groups: group I (sufficient) had a vitamin D level of ≥20 ng/mL, while group II (deficient) had a vitamin D level of <20 ng/mL.

Results
Our results revealed that eradication was successful in 105 (70%) patients and failed in 45 (30%) patients. The mean 25OHD level was significantly lower in the eradication failure group compared to the successful treatment group (14.7 ± 4.5 vs 27.41 ± 7.1; P < 0.001). Furthermore, there were significantly more patients with deficient 25OHD levels in the failed treatment group, 30 (66.6%), compared to the successful group, 10 (9.5%) (P < 0.001).

Conclusions
Our results demonstrated that 25‐OH vitamin D deficiency may be considered a risk factor related to eradication failure of H. pylori infection. In addition, a further randomized trial to evaluate the effect of vitamin D supplementation in H. pylori eradication is mandatory.
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