Helicobacter pylori associated antigastric autoantibodies: role in Sj\uf6gren's syndrome gastritis.

Background. Previous studies have shown that Helicobacter pylori seroprevalence in Sj\uf6gren\u2019s syndrome is comparable with that of the general population. However, the origin of the chronic gastropathy associated with this syndrome and the role of local autoimmunity \u2013 possibly triggered by bacterial infection \u2013 in its pathogenesis remain unclear. Materials and Methods. We initially determined the prevalence of IgG anti H. pylori in dyspeptic subjects with and without Sj\uf6gren\u2019s syndrome. In subsets of both groups we then determined anti CagA and human tissue-tested anticanalicular/antifoveolar autoantibodies. We also compared activity, atrophy and Mucosa Associated Lymphoid Tissue (MALT) scores, as well as symptoms, before and after bacterial eradication. Results. Prevalence of H. pylori in Sj\uf6gren\u2019s syndrome patients was similar to controls: 31/54 (57%) vs. 93/150 (62%). Anti CagA prevalence was also similar in the two groups. Twenty weeks after H. pylori eradication, histological activity decreased in both groups, however, atrophy and MALT decreased significantly only in controls. Sixteen months after H. pylori eradication, 75% of Sj\uf6gren\u2019s syndrome patients still complained of dyspepsia compared with 13% of controls. Finally, antigastric autoantibodies were present in 29% of tested Sj\uf6gren\u2019s syndrome patients vs. 28% of controls. Conclusions. H. pylori infection was equally prevalent among dyspeptic Sj\uf6gren\u2019s syndrome patients and dyspeptic controls. Likewise, there were no differences regarding anti CagA prevalence or antigastric autoantibodies among the two groups. The persistence of symptoms as well as of the lymphocytic infiltration and atrophy after H. pylori eradication in Sj\uf6gren\u2019s syndrome may underlie the \u2018endogenous\u2019 and still unknown nature of the gastropathy in this condition