The Possible Role of Helicobacter pylori in the Development of Sjogren's Syndrome and Chronic Sialadenitis

Abstract

Background: Sjogren’s syndrome (SS) is a chronic autoimmune disease characterized by lymphocytic infiltration of exocrine glands, which can be triggered by environmental factors such as viral infection. Chronic obstructive sialadenitis is the most common type of chronic sialadenitis and many different bacterial infections develop as a result of ductal obstruction. Objectives: This study was conducted to assess the association of these lesions with the presence of Helicobacter pylori. Patients and Methods: A total of 56 biopsies diagnosed as Sjogren's syndrome (SS) and chronic sialadenitis (CS) due to sialolithiasis in submandibular glands, sublingual and minor salivary glands were selected (56 samples as examined group and 20 samples as control group). All the paraffin blocks were cut for hematoxylin and eosin (H and E) staining to confirm the diagnoses and then the samples were prepared for immunohistochemistry (IHC) staining to detect H. pylori. Chi-squared test was used for statistical analysis. Results: Chi-squared test showed a significant difference between H. pylori positivity in the groups examined (P = 0.046) and between SS group and normal tissue samples (P = 0.013). There was no significant difference between gender and H. pylori positivity in examined groups examined (P = 0.574, P = 0.543, respectively). In addition, there was no significant difference between gender and H. pylori positivity in SS group (P = 0.119, P = 0.331, respectively) also in CS group (P = 0.981, P = 0.571). Conclusions: Bacterial infection has been suggested in the pathogenesis of both SS and CS. In addition, H. pylori is a resident of the oral cavity, thus may be involved in the development and progression of these lesions. Hence, search for H. pylori antibody in blood of patients with SS is suggested.