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02-02-2025 | Helicobacter Pylori | Review Article

Association between Helicobacter pylori, reflux and chronic rhinosinusitis: a systematic review

Authors: Jerome R. Lechien, Kamal Ragrag, Jason Kasongo, Valentin Favier, Miguel Mayo-Yanez, Carlos M. Chiesa-Estomba, Giannicola Iannella, Giovanni Cammaroto, Alberto M. Saibene, Luigi A. Vaira, Florent Carsuzaa, Kalamkas Sagandykova, Maxime Fieux, Quentin Lisan, Stephane Hans, Antonino Maniaci

Published in: European Archives of Oto-Rhino-Laryngology

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Abstract

Background

The prevalence, role, and clinical relevance of Helicobacter Pylori (HP) in sinonasal tissues of patients with chronic rhinosinusitis remain unclear.

Objective

To investigate the prevalence and clinical relevance of Helicobacter Pylori (HP) in chronic rhinosinusitis (CRS) with nasal polyps (CRSwNP) and without nasal polyps (CRSSNP).

Methods

Three investigators conducted a PubMed, Scopus, and Cochrane Library systematic review of the prevalence and clinical relevance of HP infection in CRS patients through the PRISMA framework. A bias analysis was conducted to identify potential heterogeneity and biases across studies.

Results

Of the 42 identified studies, 20 met the inclusion criteria, accounting for 741 CRS patients and 368 controls. HP was detected in 37.1% (n = 127/342) of polyps of CRSwNP patients with the polymerase chain reaction (PCR) and 32.7% (n = 37/113) of polyp tissue with the immunohistochemistry (IHC). Controls reported a nasal PCR and IHC detection rates of 14.8% (n = 36/243) and 3.6% (n = 3/84), respectively. The HP rate did not differ between CRSwNP and CRSsNP. Among patients with CRS, the enzyme-linked immunosorbent assay testing detected blood HP antigens in 48.7% (n = 74/152) of CRS patients and 41.6% (n = 37/89) of controls. The detection of HP in polyps was associated with the severity of gastroesophageal reflux disease (GERD). There was an important heterogeneity between studies for the inclusion criteria, methods of HP detection, and reflux outcomes.

Conclusion

Helicobacter Pylori can be detected in one-third of sinonasal tissues from patients with CRS and can be considered a biomarker of GERD. The potential role of HP in the development of CRS remains unclear. The heterogeneity between studies limits the drawing of valid conclusions.
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Literature
2.
go back to reference Fokkens WJ, De Corso E, Backer V, Bernal-Sprekelsen M, Bjermer L, von Buchwald C, Chaker A, Diamant Z, Gevaert P, Han J, Hopkins C, Hox V, Klimek L, Lund VJ, Lee S, Luong A, Mullol J, Peters A, Pfaar O, Reitsma S, Toppila-Salmi S, Scadding GK, Sedaghat AR, Viskens AS, Wagenmann M, Hellings PW (2024) EPOS2020/EUFOREA expert opinion on defining disease states and therapeutic goals in CRSwNP. Rhinology 62(3):287–298. https://doi.org/10.4193/Rhin23.415CrossRefPubMed Fokkens WJ, De Corso E, Backer V, Bernal-Sprekelsen M, Bjermer L, von Buchwald C, Chaker A, Diamant Z, Gevaert P, Han J, Hopkins C, Hox V, Klimek L, Lund VJ, Lee S, Luong A, Mullol J, Peters A, Pfaar O, Reitsma S, Toppila-Salmi S, Scadding GK, Sedaghat AR, Viskens AS, Wagenmann M, Hellings PW (2024) EPOS2020/EUFOREA expert opinion on defining disease states and therapeutic goals in CRSwNP. Rhinology 62(3):287–298. https://​doi.​org/​10.​4193/​Rhin23.​415CrossRefPubMed
9.
11.
go back to reference Thompson M, Tiwari A, Fu R, Moe E, Buckley DI (2012) A framework to facilitate the use of systematic reviews and meta-analyses in the design of primary research studies. Agency for Healthcare Research and Quality Thompson M, Tiwari A, Fu R, Moe E, Buckley DI (2012) A framework to facilitate the use of systematic reviews and meta-analyses in the design of primary research studies. Agency for Healthcare Research and Quality
12.
go back to reference McInnes MDF, Moher D, Thombs BD et al (2018) Preferred reporting items for a systematic review and meta-analysis of diagnostic test accuracy studies: the PRISMA-DTA statement. JAMA 319(4):388–396CrossRefPubMed McInnes MDF, Moher D, Thombs BD et al (2018) Preferred reporting items for a systematic review and meta-analysis of diagnostic test accuracy studies: the PRISMA-DTA statement. JAMA 319(4):388–396CrossRefPubMed
24.
go back to reference Včeva A, Danić D, Včev A, Birtić D, Mihalj H, Zubčić Z, Kotromanović Z, Danić HA (2012) The significance of Helicobacter pylori in patients with nasal polyposis. Med Glas (Zenica) 9(2):281–286PubMed Včeva A, Danić D, Včev A, Birtić D, Mihalj H, Zubčić Z, Kotromanović Z, Danić HA (2012) The significance of Helicobacter pylori in patients with nasal polyposis. Med Glas (Zenica) 9(2):281–286PubMed
27.
go back to reference Lechien JR, Debie G, Mahillon V, Thill MP, Rodriguez A, Horoi M, Kampouridis S, Muls V, Saussez S (2021) A 10-year follow-up of a randomized prospective study of 2 treatments for chronic rhinosinusitis without nasal polyps and investigation of the impact of gastroeosophageal reflux disease in the resistance to treatment. Ear Nose Throat J 100(5_suppl):569S-577S. https://doi.org/10.1177/0145561319892460CrossRefPubMed Lechien JR, Debie G, Mahillon V, Thill MP, Rodriguez A, Horoi M, Kampouridis S, Muls V, Saussez S (2021) A 10-year follow-up of a randomized prospective study of 2 treatments for chronic rhinosinusitis without nasal polyps and investigation of the impact of gastroeosophageal reflux disease in the resistance to treatment. Ear Nose Throat J 100(5_suppl):569S-577S. https://​doi.​org/​10.​1177/​0145561319892460​CrossRefPubMed
29.
go back to reference Cvorovic L, Brajovic D, Strbac M, Milutinovic Z, Cvorovic V (2008) Detection of Helicobacter pylori in nasal polyps: preliminary report. J Otolaryngol Head Neck Surg 37(2):192–195PubMed Cvorovic L, Brajovic D, Strbac M, Milutinovic Z, Cvorovic V (2008) Detection of Helicobacter pylori in nasal polyps: preliminary report. J Otolaryngol Head Neck Surg 37(2):192–195PubMed
30.
go back to reference Al-Kholy AF, Abadier MZ, Hassaan MM, Rageh EM, Shindy MF (2012) Screening for Helicobacter pylori Infection among patients with otorhinolaryngological diseases may spare need for surgical interference: a PCR confirmed study. J Am Sci 8:83–88 Al-Kholy AF, Abadier MZ, Hassaan MM, Rageh EM, Shindy MF (2012) Screening for Helicobacter pylori Infection among patients with otorhinolaryngological diseases may spare need for surgical interference: a PCR confirmed study. J Am Sci 8:83–88
31.
go back to reference Shokrollahi MR, Tabatabaei A, Farhadi M, Noorbakhsh S, Movahedi Z (2016) Role of Helicobacter pylori in nasal polyp formation: a case-control study in Tehran. Iran J Otolaryngol Adv 1:21–27CrossRef Shokrollahi MR, Tabatabaei A, Farhadi M, Noorbakhsh S, Movahedi Z (2016) Role of Helicobacter pylori in nasal polyp formation: a case-control study in Tehran. Iran J Otolaryngol Adv 1:21–27CrossRef
33.
go back to reference Khademi B, Kaviani M, Moosavi SA, Pira NA, Ashraf MJ, Chohedri AH (2012) Helicobacter pylori in nasal polyposis. Prof Med J 19:455–461 Khademi B, Kaviani M, Moosavi SA, Pira NA, Ashraf MJ, Chohedri AH (2012) Helicobacter pylori in nasal polyposis. Prof Med J 19:455–461
43.
Metadata
Title
Association between Helicobacter pylori, reflux and chronic rhinosinusitis: a systematic review
Authors
Jerome R. Lechien
Kamal Ragrag
Jason Kasongo
Valentin Favier
Miguel Mayo-Yanez
Carlos M. Chiesa-Estomba
Giannicola Iannella
Giovanni Cammaroto
Alberto M. Saibene
Luigi A. Vaira
Florent Carsuzaa
Kalamkas Sagandykova
Maxime Fieux
Quentin Lisan
Stephane Hans
Antonino Maniaci
Publication date
02-02-2025
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-025-09212-3