Maria Chiara Mentella

Helicobacter pylori infection in patients with Hashimoto's thyroiditis

Recent studies have suggested a role for some infectious agents, including Cytotoxin-associated gene A (CagA)-positive strains of H. pylori, in the pathogenesis of Hashimoto’s thyroiditis (HT), an autoimmune disorder of the thyroid gland defined by the detection of antibodies against thyroglobulin (anti-Tg) and thyroperoxidase (anti-TPO) [1–5]. To verify the possible role of H. pylori in HT we have designed a pilot study with two complementary aims: 1, to compare the prevalence of H. pylori infection (with Cag-positive and -negative strains) in patients with HT and in subject with no evidence of thyroid disease; and 2, to explore the possibility of a molecular mimicry between either anti-Tg or anti-TPO antibodies and any antigenic constituent of H. pylori. Sixteen patients (two men and 14 women, mean age 43.6 ± 11 years) with HT were evaluated for H. pylori infection by 13C urea breath test. Sera from all patients were tested for specific anti-CagA immunoglobulin G (IgG) using a commercial enzyme-linked immunosorbent assay (ELISA) (Radim, Pomezia, Italy). A control group of 20 blood donors (two men and 18 women, mean age 44.2 ± 12 years) without HT was also evaluated. Levels of anti-Tg and antiTPO antibodies in equal amounts of serum were evaluated through immunofluorescence either at enrollment or after absorption [6] with CagA-positive and CagA-negative H. pylori strains as well as with other Gram-negative bacteria, such as Campylobacter jejuni, Pseudomonas aeruginosa, Klebsiella spp. and Escherichia coli. Overall, 37.5% of the patients (six of 16; five women and one man; mean age 47 ± 12 years) with HT had H. pylori infection, compared to 35% of the controls (p > .05). Among infected subjects, 50% of the patients and 45% of the controls were infected by CagA-positive strains (p > .05). None of the absorbance tests with any of the bacteria induced significant changes in the levels of either anti-Tg or anti-TPO antibodies in the sera of patients with HT. The similar prevalence of H. pylori-infection (with and without CagA-positive strains) in patients and controls, as well as the lack of effect of the in vitro absorbance test on the relevant serum antibody titers, indicates that, in contrast to previous observations, an association between H. pylori infection and HT is unlikely. To further explore this relationship, we are currently conducting a clinical trial based on the evaluation of anti-Tg and anti-TPO antibody titers before and after eradication of H. pylori. Another area that may deserve further investigation is the possible cross-reactivity between anti-CagA antibodies and thyroid antigens other than TPO and Tg.

Nutrition and IBD: Malnutrition and/or Sarcopenia? A Practical Guide

Malnutrition is a major complication of inflammatory bowel disease (IBD). This mini review is focusing on main determinants of malnutrition in IBD, the most important components of malnutrition, including lean mass loss and sarcopenia, as an emerging problem. Each one of these components needs to be well considered in a correct nutritional evaluation of an IBD patient in order to build a correct multidisciplinary approach. The review is then focusing on possible instrumental and clinical armamentarium for the nutritional evaluation.

Binge Drinking among adolescents is related to the development of Alcohol Use Disorders: results from a Cross-Sectional Study

Binge drinking (BD) is a common pattern of alcohol consumption among adolescents. At present few data are available on the possible relationship between BD and alcohol use disorders (AUD) in adolescents. The aim of this study was to assess the prevalence of BD and relationship between BD behavior and AUD among adolescents. A total of 2704 students attending 10 purposively selected high schools from three Italian provinces were surveyed. Questionnaires regarding socio-demographic data, pattern and amount of alcohol intake, smoking habits, use of illicit drugs, and physical activity were administered. AUD and affective disorders were also evaluated. Alcohol intake was reported by 2126 participants; 1278 reported at least one episode BD in the last year and 715 in the last month. A diagnosis of AUD was made in 165 adolescents. The prevalence of AUD was higher in adolescents that reported BD behavior than in those that did not report BD (11.6% vs 0.9%, respectively; p < 0.0001). Logistic regression showed a positive relationship between a diagnosis of AUD and BD behavior (OR 9.6; 95% CI 4.7–22·9; p < 0.0001). In conclusion alcohol consumption with the pattern of BD among adolescents is highly related to development of AUD.

Author Correction: Binge Drinking among adolescents is related to the development of Alcohol Use Disorders: results from a Cross-Sectional Study

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