Original Article
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Dec 21, 2011; 17(47): 5156-5165
Published online Dec 21, 2011. doi: 10.3748/wjg.v17.i47.5156
Helicobacter pylori's virulence and infection persistence define pre-eclampsia complicated by fetal growth retardation
Simona Cardaropoli, Alessandro Rolfo, Annalisa Piazzese, Antonio Ponzetto, Tullia Todros
Simona Cardaropoli, Alessandro Rolfo, Annalisa Piazzese, Tullia Todros, Department of Obstetric and Gynecology, University of Turin, Turin 10126, Italy
Antonio Ponzetto, Department of Internal Medicine, University of Turin, Turin 10126, Italy
Author contributions: Ponzetto A and Todros T designed the research, supervised, edited and proof read the manuscript; Cardaropoli S analyzed the data; Piazzese A recruited patients and collected samples; and Cardaropoli S and Rolfo A performed the research and wrote the paper.
Supported by The Italian Ministry of Health, Programma per la Ricerca Sanitaria 2007, Programma Strategico, Salute della donna/Area materno infantile, No. RFPS-2007-4-638281
Correspondence to: Simona Cardaropoli, PhD, Department of Obstetric and Gynecology, University of Turin, Turin 10126, Italy. simona.cardaropoli@unito.it
Telephone: +39-011-3134433 Fax: +39-011-3134450
Received: March 7, 2011
Revised: June 9, 2011
Accepted: June 16, 2011
Published online: December 21, 2011
Abstract

AIM: To better understand the pathogenic role of Helicobacter pylori (H. pylori) in pre-eclampsia (PE), and whether it is associated or not with fetal growth retardation (FGR).

METHODS: Maternal blood samples were collected from 62 consecutive pregnant women with a diagnosis of PE and/or FGR, and from 49 women with uneventful pregnancies (controls). Serum samples were evaluated by immunoblot assay for presence of specific antibodies against H. pylori antigens [virulence: cytotoxin-associated antigen A (CagA); ureases; heat shock protein B; flagellin A; persistence: vacuolating cytotoxin A (VacA)]. Maternal complete blood count and liver enzymes levels were assessed at delivery by an automated analyzer.

RESULTS: A significantly higher percentage of H. pylori seropositive women were found among PE cases (85.7%) compared to controls (42.9%, P < 0.001). There were no differences between pregnancies complicated by FGR without maternal hypertension (46.2%) and controls. Importantly, persistent and virulent infections (VacA/CagA seropositive patients, intermediate leukocyte blood count and aspartate aminotransferase levels) were exclusively associated with pre-eclampsia complicated by FGR, while virulent but acute infections (CagA positive/VacA negative patients, highest leukocyte blood count and aspartate aminotransferase levels) specifically correlated with PE without FGR.

CONCLUSION: Our data strongly indicate that persistent and virulent H. pylori infections cause or contribute to PE complicated by FGR, but not to PE without feto-placental compromise.

Keywords: Helicobacter pylori; Virulence factors; Pre-eclampsia; Fetal growth retardation; Cytotoxin-associated antigen A; Vacuolating cytotoxin A