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Intestinal Helminthiasis in Colombian Children Promotes a Th2 Response to Helicobacter pylori: Possible Implications for Gastric Carcinogenesis

¹ Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, Massachusetts; ² Department of Pathology, Universidad del Valle, Cali, Colombia; ³ Louisiana State University Health Sciences Center, New Orleans, Louisiana; and ⁴ Hospital San Andres, Tumaco, Colombia

Requests for reprints: Mark T. Whary, Division of Comparative Medicine, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Building 16-825A, Cambridge, MA 02139. Phone: 617-253-9435; Fax: 617-258-5708. E-mail: mwhary{at}mit.edu

Background: Colombians living in coastal Tumaco have a lower incidence of Helicobacter pylori–associated gastric cancer compared with residents of Pasto in the high Andes. Considering the risk for H. pylori disease seems affected by features of bacterial virulence and host polymorphisms, other poorly understood influences, such as concurrent helminthiasis, may also be important.

Methods: Fecal samples from 211 children were tested for parasites and sera from another cohort of 159 children and 92 adults were tested for IgE and H. pylori–specific IgG.

Results: Most individuals (95%) from both areas were H. pylori seropositive, with a predominant response of IgG1 followed by IgG2 and low IgG3 and IgG4 antibodies. Compared with Pasto children, Tumaco children were more commonly infected with helminths (P = 0.000), had higher serum IgE levels (P < 0.03), and had higher Th2-associated IgG1 responses to H. pylori (P < 0.0002). Other IgG isotype responses all increased with age but were not significantly different between children and adults from either area.

Conclusions: These results suggest that intestinal helminthiasis in children promotes Th2-polarizing responses to H. pylori and may decrease gastric cancer risk in these individuals later in life. Concurrent helminthiasis may alter inflammatory responses to H. pylori and thus affect the progression of gastritis to gastric atrophy, dysplasia, and cancer.