Abstract
Association between H. pylori infection, iron deficiency and iron deficiency anaemia has been described, but the mechanisms involved have not been established. We hypothesized that in H. pylori infected children increased gastric concentrations of IL-1β and/or TNF-α, both potent inhibitors of gastric acid secretion that is essential for iron absorption, are predictors for low blood concentrations of ferritin and haemoglobin, markers of early depletion of iron stores and anaemia, respectively. We evaluated 125 children undergoing endoscopy to clarify the origin of gastrointestinal symptoms. Gastric specimens were obtained for H. pylori status and cytokine evaluation and blood samples for determination of iron deficiency/iron deficiency anaemia parameters and IL1 cluster and TNFA polymorphisms that are associated with increased cytokine secretions. Higher IL-1β and TNF-α gastric concentrations were observed in H. pylori-positive (n = 47) than in -negative (n = 78) children. Multiple linear regression models revealed gastric IL-1β, but not TNF-α, as a significant predictor of low ferritin and haemoglobin concentrations; results were reproduced in young children in whom IL1RN polymorphic genotypes associated with higher gastric IL-1β expression and lower blood ferritin and haemoglobin concentrations. In conclusion, high gastric levels of IL-1β can be the link between H. pylori infection and iron deficiency/iron deficiency anaemia in childhood.
Publication types
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Research Support, Non-U.S. Gov't
MeSH terms
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Adolescent
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Anemia, Iron-Deficiency / genetics
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Anemia, Iron-Deficiency / metabolism
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Anemia, Iron-Deficiency / microbiology*
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Child
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Child, Preschool
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Endoscopy / methods
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Female
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Ferritins / genetics
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Ferritins / metabolism
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Gastric Mucosa / metabolism*
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Genotype
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Helicobacter Infections / blood
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Helicobacter Infections / genetics
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Helicobacter Infections / metabolism*
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Helicobacter Infections / microbiology
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Helicobacter pylori / isolation & purification*
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Humans
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Interleukin 1 Receptor Antagonist Protein / genetics
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Interleukin 1 Receptor Antagonist Protein / metabolism
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Interleukin-1beta / genetics
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Interleukin-1beta / metabolism*
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Iron / blood
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Iron / metabolism*
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Male
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Polymorphism, Genetic
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Stomach / microbiology*
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Tumor Necrosis Factor-alpha / genetics
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Tumor Necrosis Factor-alpha / metabolism
Substances
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IL1RN protein, human
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Interleukin 1 Receptor Antagonist Protein
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Interleukin-1beta
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Tumor Necrosis Factor-alpha
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Ferritins
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Iron
Grants and funding
The study was supported by the Sixth Framework Programme of the European Union, Project CONTENT (INCO-DEV-3-032136); Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq/Brazil); Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES/Brazil) and Instituto de Biomedicina do Semi-Árido (INCT-IBISAB/Brazil). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.