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Helicobacter pylori infection implicated in RA

GENOVA, ITALY. It is well established that an infection with Helicobacter pylori bacteria is a major cause of peptic (stomach) ulcers. Most stomach ulcers can now be completely cured by a one- to two-week course of antibiotics and auxiliary medications. More recent research has found an association between the presence of H. pylori and autoimmune diseases such as Raynaud's and Sjogren's syndromes.

Researchers at the University of Genova now report that a H. pylori infection may also be involved in rheumatoid arthritis (RA). Their clinical trial involved 52 patients (42 women, 10 men) who had been diagnosed with RA. All patients underwent biopsies to check for the presence of H. pylori in their stomachs. Thirty of the 52 patients tested positive for H. pylori. The positive patients were given eradication therapy, which was successful in 20 patients and unsuccessful in 10 patients. All patients were evaluated for pain, morning stiffness, number of swollen and tender joints, and overall functional ability at the start of the study and four months later. Erythrocyte sedimentation rate (ESR) and other blood parameters were also measured. At the end of the four-month study period it was very clear that the patients who had undergone successful H. pylori eradication had improved significantly both compared to their own baseline status and compared to the 10 patients where H. pylori eradication was unsuccessful and the 20 patients who had tested negative. The ESR was down by 40 per cent and very close to normal values. The duration of morning stiffness was cut in half to little over an hour and the swollen joint count was down by an impressive 23 per cent.

The researchers speculate that H. pylori may be a potent trigger of inflammation and recommend that eradication of these bacteria be strongly considered in rheumatoid arthritis patients who are infected with them.
Seriolo, Bruno, et al. Helicobacter pylori infection in rheumatoid arthritis. Journal of Rheumatology, Vol. 28, May 2001, pp. 1195-96 (letter to the editor)

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