Clinical characteristics of ulcerative colitis patients with different types of
Helicobacter pylori
infection
Authors: Liu Weidong , Jiang Qi , Xue Shenglong , Hui Wenjia , Kong Wenjie , Zhang Mengxia , Gao Feng 
Published: April 2024

There has been a suggestion of a potential protective effect of
Helicobacter pylori
(
H. pylori
) in the development of ulcerative colitis (UC). Virulence factor is an important factor in
H. pylori
, but little is known about the clinical characteristics of ulcerative colitis. In this retrospective study, a total of 322 patients with UC were analyzed. They were divided into three groups based on
H. pylori
antibody typing classification: type I
H. pylori
infection group, type II
H. pylori
infection group, and
H. pylori
-negative group. The study aimed to analyze the clinical characteristics of different types of
H. pylori
infection groups. The proportions of disease course, nationality, clinical type, and disease severity among UC patients in different types of
H. pylori
infection groups exhibited statistically significant differences (
P
< 0.05). However, no significant differences were observed in terms of sex, age, smoking status, alcohol consumption, body mass index (BMI), or lesion range (
P
> 0.05). Among the extraintestinal manifestations, the incidence of joint lesions in the type I
H. pylori
infection group was significantly lower compared with
H. pylori
-negative group (
P
< 0.05). The levels of red blood cell, hemoglobin, packed cell volume, albumin, A/G, and alanine aminotransferase were significantly higher in the type I
H. pylori
infection group compared with both the type II
H. pylori
infection group and
H. pylori
-negative group in the hematology index. Conversely, the levels of D-Dimer, C-reactive protein, and erythrocyte sedimentation rate were significantly lower in the type II
H. pylori
infection group (
P
< 0.05). In patients with UC, infections with the highly virulent type I
H. pylori
exhibit a negative correlation with both the severity of the disease and extraintestinal manifestations. While infections with the less virulent type II
H. pylori
are negatively correlated only with the disease severity. Therefore, the virulence factors of
H. pylori
play an important role in the regulation of UC.

IMPORTANCE

The number of patients with ulcerative colitis (UC) has increased dramatically worldwide, posing a global public health challenge, There has been a suggestion of a potential protective effect of
Helicobacter pylori
in the development of UC. Virulence factor is an important factor in
H. pylori
, but high-quality clinical evidence is lacking. This study comprehensively analyzed the clinical characteristics of UC patients with different types of
H. pylori
infection. Infections with the highly virulent type I
H. pylori
are found to be negatively correlated with the severity of the disease as well as extraintestinal manifestations, whereas infections with the less virulent type II
H. pylori
demonstrate a negative correlation solely with disease severity. These results suggest that the virulence factors of
H. pylori
play a pivotal role in UC. Consequently, virulence factors should be taken into consideration when targeting
H. pylori
eradication in clinical practice, particularly in UC patients. It is crucial to evaluate the individual benefits to optimize personalized eradication therapies.