Helicobacter pylori in children with asthmatic conditions at school age, and their mothers

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1. W. J. den Hollander^1,2,*, 
2. A. M. M. Sonnenschein-van der Voort^2,3,4, 
3. I. L. Holster¹, 
4. J. C. de Jongste³, 
5. V. W. Jaddoe^2,5, 
6. A. Hofman⁴, 
7. G. I. Perez-Perez⁶, 
8. H. A. Moll⁵, 
9. M. J. Blaser⁶, 
10. L. Duijts^3,4,7 and
11. E. J. Kuipers^1,8
12. 1. 1. Abstract

       Background

       Helicobacter pylori prevalence in Western countries has been declining simultaneously with increases in childhood asthma and allergic diseases; prior studies have linked these phenomena.

       
       

       Aims

       To examine the association between H. pylori colonisation in children and risk of asthma and related conditions at school age. We secondly examined additional effects of maternal H. pylori status by pairing with children's status.

       
       

       
       

       Methods

       This study was embedded in a multi-ethnic population-based cohort in Rotterdam, The Netherlands. We measured anti-H. pylori and anti-CagA antibodies in serum of children obtained at age 6 years, and of their mothers obtained during midpregnancy. Asthma or related conditions were reported for children at age 6 years. We used multivariate logistic regression analyses among 3797 subjects.

       
       

       Results

       In children, the H. pylori positivity rate was 8.7%, and 29.2% of these were CagA-positive. A child's colonisation with a CagA-negative-H. pylori strain was associated with an increased risk of asthma (Odds ratio 2.11; 95% CI 1.23–3.60), but this differed for European (3.64; 1.97–6.73) and non-European (0.52; 0.14–1.89) children. When taking into account maternal H. pylori status, only H. pylori-positive children with anH. pylori-negative mother had increased risk of asthma (2.42; 1.11–5.27), accounting for 3.4% of the asthma risk.

       
       

       Conclusions

       Colonisation of a European child with a CagA-negative-H. pylori strain at age 6 was associated with an increased prevalence of asthma, but there was no association for non-European children. The underlying mechanisms for the observed risk differences require further research.
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