Abstract

Helicobacter pylori (H. pylori) is a chronic infectious pathogen with high prevalence. This study investigated the interaction between environmental tobacco exposure and H. pylori infection on the incidence of chronic tonsillitis in Chinese children. Cross-sectional study performed in an outpatient clinic in China. Pediatric patients with chronic tonsillitis were enrolled. H. pylori infection was determined according to the presence of H. pylori CagA IgG antibodies. Serum cotinine levels and environmental tobacco smoke (ETS) exposure were determined for all participants. There was no significant difference in H. pylori infection between the children with chronic tonsillitis and children free of disease, but there was a significant difference in ETS between the two groups (P = 0.011). We next studied the association between ETS and chronic tonsillitis based on H. pylori infection status. In the patients with H. pylori infection, there was a significant difference in ETS distribution between the chronic tonsillitis and control groups (P = 0.022). Taking the participants without ETS as the reference, multivariate logistic regression analysis showed that those with high ETS had higher susceptibility to chronic tonsillitis (adjusted OR = 2.33; 95% CI: 1.67-3.25; adjusted P < 0.001). However, among those without H. pylori infection, ETS did not predispose towards chronic tonsillitis. Our findings suggest that tobacco exposure should be a putative mediator risk factor to chronic tonsillitis among children with H. pylori infection.

Highlights

  • Helicobacter pylori (H. pylori) is a chronic infectious pathogen with high prevalence

  • We aimed to investigate the interaction between environmental tobacco exposure and H. pylori infection regarding the incidence of chronic tonsillitis among Chinese children

  • There was no significant difference in H. pylori infection prevalence in the children with chronic tonsillitis, compared with subjects free from this condition. (P = 0.632) (Table 2)

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Summary

Introduction

Helicobacter pylori (H. pylori) is a chronic infectious pathogen with high prevalence. The H. pylori infection rate is as high as 70% in developing countries.[1] It commonly occurs in children before the age of 10 years and even as early as 6 years in some countries.[2] Typically, H. pylori infects the stomach, and has been associated with gastritis, peptic ulcer disease, gastric cancer and gastric mucosa-associated lymphoma in humans. H. pylori infection may participate in some non-digestive diseases, such as nutritional iron deficiency anemia, growth retardation, malnutrition, autoimmune idiopathic thrombocytopenic purpura and chronic urticaria in children, as well as the development of adult atherosclerosis-related cardiovascular diseases and some nervous system diseases.[3,4,5,6,7] Recently, several studies reported H. pylori colonization in locations outside the gastrointestinal cavity, such as adenotonsillar tissues and nasal and sinus mucosa.[3,8]

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