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Z Gastroenterol 2001; 39(4): 311-320
DOI: 10.1055/s-2001-12872
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© Karl Demeter Verlag im Georg Thieme Verlag Stuttgart · New York

Extragastrale Manifestationen einer H.-pylori-Infektion

Extragastric manifestations of H. pylori infectionP. C. Konturek, E. G. Hahn
  • Priv.-Doz. Dr. med. Peter Konturek, Medizinische Klinik I (Direktor Prof. Dr. E. G. Hahn), Universität Erlangen-Nürnberg
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Publication History

9.3.2000

5.6.2000

Publication Date:
31 December 2001 (online)

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Zusammenfassung

In letzter Zeit wurde man auf mögliche Assoziationen zwischen der Infektion mit Helicobacter pylori und extragastralen Erkrankungen aufmerksam. Dabei handelt es sich um ein breites Spektrum von verschiedenen Erkrankungen wie Gefäßerkrankungen, Hauterkrankungen, Autoimmunerkrankungen, Nahrungsmittelallergie, Lebererkrankungen, hämatologische Erkrankungen, Diabetes mellitus, pädiatrische Erkrankungen (z. B. plötzlicher Kindstod, Wachstumsstörungen) extragastrale MALT-Lymphome und sogar kolorektale Karzinome. Eine potenzielle Rolle von H. pylori bei der Auslösung von extragastralen Erkrankungen stützt sich auf folgende Beobachtungen: 1. die Infektion mit H. pylori löst nicht nur eine chronische Entzündung in der Magenschleimhaut aus, sondern geht auch mit einer systemischen Immunantwort einher; 2. im Rahmen der Gastritis werden verschiedene entzündliche Mediatoren ins Blut abgegeben, die Erkrankungen außerhalb des Magens auslösen können; 3. eine erfolgreiche Eradikationstherapie führt zur partiellen oder kompletten Remission der extragastralen Erkrankungen. Die bisher publizierten Studien liefern zum Teil sehr widersprüchliche Ergebnisse, die durch verschiedene Störfaktoren in den epidemiologischen Studien erklärbar sind. Anhand der derzeit verfügbaren Daten konnte keine dieser Assoziationen gesichert werden, was die Notwendigkeit weiterer prospektiver Studien zur endgültigen Klärung der Rolle von H. pylori bei der Entstehung von extragastralen Erkrankungen unterstützt.

Extragastric manifestations of H. pylori infection

Recently, H. pylori has been associated with several extradigestive diseases such as cardio-vascular, cutaneous, autoimmune, allergic, liver, hematologic disorders, diabetes mellitus, pediatric diseases (sudden infant death syndrome, growth retardation), extragastric MALT-type lymphomas and even colorectal cancer. The potential role of H. pylori infection in the pathogenesis of these extradi­gestive disorders has been based on the follow­ing facts: 1) local gastric infection with H. pylori may exert systemic effects; 2) during chronic H. pylori induced gastritis several different inflammatory mediators are released that are able to cause disorders remote to the primary site of infection and 3) the successful eradication of H. pylori infection improves partly or completely the extradigestive disorders. The available data is conflicting because of the presence of several confound­ing factors in epidemiological studies. On the basis of the published data any of these associations has been proved. Further prospective studies to explain the association between H. pylori and extradigestive disorders are needed.

Schlüsselwörter

Helicobacter pylori - extragastrale Erkrankungen

Key words

Helicobacter Pylori - Extragastric Manifestations

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Anschrift für die Verfasser

Priv.-Doz. Dr. med. Peter Konturek

Medizinische Klinik I
Universität Erlangen-Nürnberg

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91054 Erlangen

Fax: 0 91 31/8 53 69 09

Email: Peter.Konturek@med1.imed.uni-erlangen.de