Helicobacter pylori infection and low vitamin D – several studies

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Vitamin D and Its Association with H. pylori Prevalence and Eradication: A Comprehensive Review - Aug 2023

Nutrients 2023, 15(16), 3549; https://doi.org/10.3390/nu15163549
by Maria Oana Săsăran 1,†ORCID,Cristina Oana Mărginean 2,*ORCID,Ancuta Lupu 3,†ORCID andAna Maria Koller 4

Taking into account previous data that sustain a relationship between vitamin D deficiency and higher H. pylori infection positivity rates, this review aims to assess the influence of vitamin D deficiency and/or insufficiency upon the prevalence of H. pylori infection and its eradication success. Three major databases were searched for articles that analyzed a relationship between vitamin D status and H. pylori infection. The literature search retrieved a total of 37 reports, after the article selection process.
Hypovitaminosis D emerged as a potential risk factor for H. pylori infection, given the higher prevalence of vitamin D deficiency and/or insufficiency among H. pylori-positive subjects. Furthermore, the same type of micronutrient deficiency has been directly linked to H. pylori eradication failure. An inverse linear relationship between vitamin D status and gastric cancer risk exists, but the additional involvement of H. pylori in this correlation is still in question. The potential benefit of oral supplements in enhancing the success of classical therapeutic regimens of H. pylori still requires future research. Future population-based studies from larger geographical areas are warranted to address this subject in more depth.
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Helicobacter pylori infection 11 X more likely if low vitamin D – meta-analysis Aug 2019

Effect of vitamin D on Helicobacter pylori infection and eradication: A meta-analysis
Helicobacter. 2019 Aug 14:e12655. doi: 10.1111/hel.12655.
Yang L1, He X1, Li L1, Lu C1.
Department of Gastroenterology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
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BACKGROUND:
Various studies reported the relationship between Helicobacter pylori (H pylori) and vitamin D, but there is some controversy around that. This study aimed to conduct a meta-analysis to clarify the relationship between vitamin D and H pylori infection, and vitamin D and H pylori eradication.

METHODS:
Articles published until June 1, 2019, in the PubMed, MEDLINE, and EMBASE databases with English-language medical studies were searched. According to the inclusion criteria, relevant statistical data were extracted to Microsoft Excel and analyzed by STATA15.1.

RESULTS:
Ten articles were finally included. It was demonstrated that average 25(OH)D level in H pylori-positive patients was lower than H pylori-negative (SMD = -0.53 ng/mL, 95% CI = (-0.91, -0.16 ng/mL)). For H pylori eradication individuals, the result showed that average 25(OH)D level in H pylori successful eradication individuals was higher than unsuccessful (SMD = 1.31 ng/mL, 95% CI = [0.60, 2.02 ng/mL]).
In addition, individuals with vitamin D deficiency had lower H pylori eradicate rate (OR = 0.09, 95% CI = [0.02, 0.41]). Sensitivity analysis showed that the meta-analysis results were stable and reliable.

CONCLUSIONS:
Vitamin D was a protective factor to H pylori infection. Moreover, vitamin D can improve the success rate of H pylori eradication.

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The study was cited 33 times as of July 2023

• Vitamin D and Gastric Cancer: A Ray of Sunshine? - Sept 2021 DOI: 10.7759/cureus.18275 FREE PDF

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2X worse response to Helicobacter Pylori Treatment if poor VDR - July 2023

Association Between Vitamin D Receptor Polymorphism and the Response to Helicobacter Pylori Treatment
Infect Drug Resist. 2023 Jul 8;16:4463-4469. doi: 10.2147/IDR.S414186Yousry Esam-Eldin Abo-Amer 1, Amal Ahmed Mohamed 2, Mohamed Mahmoud Elhoseeny 3, Samar M Rezk 4, Sherief Abdel-Salam 5, Abdulmohsen H Alrohaimi 6, Asmaa Sayed Abdelgeliel 7, Seham Saeed Alzahrani 8, Ibrahim Jafri 8, Leena S Alqahtani 9, Eman Fayad 8, Mohamed Fakhry 10, Moataz Yousry Soliman 11

Background & aims: This research aimed to determine how variations in the vitamin D receptor gene affected the response of H. pylori infections to eradication therapy.

Patients and methods: On 105 adult H. Pylori-positive patients, a prospective cohort study was carried out. PCR was used to genotype all patients' VDR gene polymorphisms. The patients in the study received standard triple eradication medication (clarithromycin 500 mg, amoxicillin 1000 mg, and omeprazole 20 mg) twice daily for 14 days. A stool test for H. pylori Ag was conducted 4 weeks following the end of treatment.

Results: In our study, the usual triple therapy's H. pylori eradication rate was 75.2%. The successful eradication of H. pylori and VDR rs 2228570 gene polymorphisms was more prevalent in CT gene polymorphism (64.6%) compared to non-responders (19.2%), while treatment failure was more prevalent in CC gene polymorphism (73.1% in non-responders compared to responders 24.1%), which is statistically significant.
In regards to the eradication of H. pylori and VDR rs7975232 gene polymorphisms, the success of eradication was more prevalent in AC gene polymorphism (54.4%) vs non-responders (30.4%), while all patients (14) with gene AA (17.7%) are responders to standard treatment, while the failure of treatment was more prevalent in CC gene polymorphism (69.2% in non-responder vs 27.8% in responders) which is statistically significant. Our findings demonstrated a strong correlation between patients' responses to H. pylori treatment and polymorphisms in the VDR gene (ApaI and TaqI) (P 0.05).

Conclusion: As far as we are aware, this is the first study to identify a potential link between the FokI and Apal VDR polymorphism and treatment response in H pylori-positive patients. To evaluate the findings, more research with larger number of patients and different population is required.
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Helicobacter pylori reduced in mice by vitamin D – Dec 2022

Vitamin D3 eradicates Helicobacter pylori by inducing VDR-CAMP signaling
Front Microbiol . 2022 Dec 8;13:1033201. doi: 10.3389/fmicb.2022.1033201. eCollection 2022.
Ye Zhang 1, Chunya Wang 1, Li Zhang 1, Jie Yu 2, Wenjie Yuan 1, Lei Li 1

Background: Vitamin D3 [VitD3, 1,25 (OH)2D3] is known to have immunomodulatory and anti-microbial properties; however, its activity against Helicobacter pylori is unclear. In this study, we established H. pylori infection models in wild-type and VitD3 receptor (VDR) knockdown mice and analyzed the effects of VitD3 and their underlying mechanisms.

Methods: VDR+/+ and VDR+/- mice were intragastrically infected with the H. pylori SS1 strain. After confirmation of H. pylori infection, mice were treated with different doses of VitD3. The infection levels in stomach tissues were quantified using the colony-forming assay, and the expression levels of the VDR and cathelicidin antimicrobial peptide (CAMP) in the gastric mucosa were analyzed by immunohistochemistry and western blotting.

Results: The gastric mucosa of VDR+/- mice was more susceptible to H. pylori colonization and had lower levels of VDR and CAMP expression than that of VDR+/+ mice. H. pylori infection upregulated VDR and CAMP expression in the stomach of both wild-type and mutant mice, and VitD3 treatment resulted in further increase of VDR and CAMP levels, while significantly and dose-dependently decreasing the H. pylori colonization rate in both mouse groups, without affecting blood calcium or phosphorus levels.

Conclusion: Our data indicate that oral administration of VitD3 reduces the H. pylori colonization rate and upregulates VDR and CAMP expression in the gastric mucosa, suggesting a role for VitD3/VDR/CAMP signaling in the eradication of H. pylori in the stomach. These findings provide important insights into the mechanism underlying the anti-H. pylori activity of VitD3 and should be useful in the development of measures to eradicate H. pylori.
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Vitamin D3 Inhibits Helicobacter pylori Infection by Activating the VitD3/VDR-CAMP Pathway in Mice - Oct 2020

Front. Cell. Infect. Microbiol., 23 October 2020 | https://doi.org/10.3389/fcimb.2020.566730
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Anni Zhou1†, Lei Li2†, Guiping Zhao1, Li Min1, Si Liu1, Shengtao Zhu1, Qingdong Guo1, Chunjie Liu3, Shutian Zhang1* and Peng Li1*

Helicobacter pylori (H. pylori) infection is closely associated with the occurrence and development of gastric diseases. Therefore, eliminating H. pylori infection should help to prevent gastric diseases. Vitamin D3 (VitD3, 1,25(OH)2D3) was previously observed to exhibit anti-H. pylori infection activity in clinic, but these results were reported in heterogeneous in vivo studies without elucidation of the underlying mechanisms. In the present study, we established H. pylori infection models in both wild-type and VDR knockdown (VDR-KD) mice, which were used to demonstrate that VitD3 inhibits H. pylori infection by enhancing the expression of VitD receptor (VDR) and cathelicidin antimicrobial peptide (CAMP). Furthermore, VDR-KD mice that exhibited lower VDR expression were more susceptible to H. pylori infection. In cultured mouse primary gastric epithelial cells, we further demonstrated that the VitD3/VDR complex binds to the CAMP promoter region to increase its expression. These data provide a mechanistic explanation of the anti-H. pylori infection activity of VitD3 at the molecular level in mice and suggest a new avenue for the clinical management of H. pylori eradication therapy.

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The effect of vitamin D deficiency on eradication rates of Helicobacter pylori infection – Oct 2018

JGH Open. 2018 Dec; 2(6): 270–275. doi: 10.1002/jgh3.12081, PMCID: PMC6308038. PMID: 30619936
Mohamed S El Shahawy,corresponding author 1 Mahmoud H Hemida, 2 Ibrahim El Metwaly, 3 and Zakarya M Shady 4

Background/Aim
Many studies have investigated risk factors other than antibiotic resistance linked to Helicobacter pylori (H. pylori) eradication failure. The aim of this study was to study the effect of serum levels of 25‐hydroxy‐vitamin D (25OHD) on eradication rates of H. pylori infection.

Methods
This study included 150 patients diagnosed with H. pylori gastritis using magnifying narrow‐band imaging endoscopy supported by stool antigen test. Serum 25‐OH vitamin D levels were measured via the Enzyme‐Linked Immune Sorbent assay (ELISA) method before starting eradication therapy of H. pylori infection. All patients were treated with clarithromycin‐based triple therapy for 14 days. H. pylori eradication was determined via a stool antigen test performed 4 weeks after the end of therapy. According to the serum level of 25‐OH vitamin D levels, the patients were divided into two groups: group I (sufficient) had a vitamin D level of ≥20 ng/mL, while group II (deficient) had a vitamin D level of <20 ng/mL.

Results
Our results revealed that eradication was successful in 105 (70%) patients and failed in 45 (30%) patients. The mean 25OHD level was significantly lower in the eradication failure group compared to the successful treatment group (14.7 ± 4.5 vs 27.41 ± 7.1; P < 0.001). Furthermore, there were significantly more patients with deficient 25OHD levels in the failed treatment group, 30 (66.6%), compared to the successful group, 10 (9.5%) (P < 0.001).

Conclusions
Our results demonstrated that 25‐OH vitamin D deficiency may be considered a risk factor related to eradication failure of H. pylori infection. In addition, a further randomized trial to evaluate the effect of vitamin D supplementation in H. pylori eradication is mandatory.
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Helicobacter pylori Eradication: 88% if high vitamin D vs 38% if low - Feb 2021

Is Vitamin D Deficiency a Risk Factor for Helicobacter Pylori Eradication Failure?
Clin Lab . 2021 Feb 1;67(2). doi: 10.7754/Clin.Lab.2020.200118.
Mokhtar M Shatla, Ahmed S Faisal, Mahmoud Z El-Readi

Background: Host factors related to failure of eradication of Helicobacter pylori (H. pylori) are increasingly studied. This work aimed to study the influence of 25-hydroxy-vitamin D 25(OH)-vitD status on the rate of H. pylori eradication.

Methods: One hundred and fifty patients infected with H. pylori were tested for serum 25(OH)-vitD level prior to 14 days clarithromycin-based triple eradication therapy. Accordingly, patients were divided into: group I (eradication successful) and group II (eradication failure). Both groups were compared regarding mean level of serum 25(OH)-vitD and number and percentage of patients with deficient 25 (OH)-vitD.

Results: Overall rate of eradication was 72%. Mean serum level of 25(OH)-vitD was higher in the eradication successful group compared to the group of eradication failure (28.12 ± 8.10 vs. 13.54 ± 6.37; p < 0.001). The percentage of patients with 25(OH)-vitD deficiency was higher in the group of eradication failure compared to the group of successful eradication [30 (71.5%) vs. 19 (17.5%); p < 0.001]. Patients with sufficient 25(OH)-vitD had a higher rate of eradication compared to patients with deficient 25(OH)-vitD (88% vs. 38.5%).

Conclusions: This study suggested that deficiency of 25(OH)-vitD could be a risk factor for H. pylori eradication failure, and it recommends to investigate the effect of vitamin D supplementation on H. pylori eradication.

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Several micronutrients (such as Vit D) enable the immune system to fight Helicobacter pylori - March 2022

The Effects of Vitamins and Micronutrients on Helicobacter pylori Pathogenicity, Survival, and Eradication: A Crosstalk between Micronutrients and Immune System
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H. pylori increases risk of certain kind of stomach, or gastric, cancer by 8 X

WebMED
See also Gastric Cancer, Vitamin D, VDR, UV - many studies

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Can probably fight Helicobacter pylori better with Gut-Friendly Vitamin D

Gut-friendly forms include topical and mucosal which totally by-pass the stomach

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18,700 results from search of "Helicobacter pylori " "vitamin d" as of Aug 2023

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• The Effect of vitamin D on Eradication of Helicobacter Pylori - May 2023 10.33762/bsurg.2023.138317.1044 FREE PDF
• The Association between Serum Vitamin D Levels and Helicobacter pylori Presence and Eradication 0 Jan 2021 https://doi.org/10.3390/nu13010278 FREE PDF
• Response of Helicobacter Pylori Eradication Treatment in Patients With Normal and Below-Normal Serum Vitamin D Levels April 2021 10.7759/cureus.14777 FREE PDF
• Helicobacter Pylori Interacts with Serum Vitamin D to Influence Hypertension - 2021 https://doi.org/10.2174/1874609813666200925104248
• Influence of adding vitamin D3 to standard clarithromycin-based triple therapy on the eradication rates of Helicobacter pylori infection 0 Sept 2021 https://doi.org/10.1016/j.ajg.2021.08.002
• Association of hypertension with helicobacter pylori: A systematic review and meta‑analysis May, 2022 https://doi.org/10.1371/journal.pone.0268686  PDF

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