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Yu Chen, PhD, MPH; Martin J. Blaser, MD

Arch Intern Med. 2007;167(8):821-827.

Background  Acquisition of Helicobacter pylori, which predominantly occurs before age 10 years, may reduce risks of asthma and allergy.

Methods  We evaluated the associations of H pylori status with history of asthma and allergy and with skin sensitization using data from 7663 adults in the Third National Health and Nutrition Examination Survey. Adjusted odds ratios (ORs) for currently and ever having asthma, allergic rhinitis, allergy symptoms in the previous year, and allergen-specific skin sensitization were computed comparing participants seropositive for cagA^– or cagA⁺ strains of H pylori with those without H pylori.

Results  The presence of cagA⁺ H pylori strains was inversely related to ever having asthma (OR, 0.79; 95% confidence interval [CI], 0.63-0.99), and the inverse association of cagA positivity with childhood-onset (age 15 years) asthma was stronger (OR, 0.63; 95% CI, 0.43-0.93) than that with adult-onset asthma (OR, 0.97; 95% CI, 0.72-1.32). Colonization with H pylori, especially with a cagA⁺ strain, was inversely associated with currently (OR, 0.77; 95% CI, 0.62-0.96) or ever (OR, 0.77; 95% CI, 0.62-0.94) having a diagnosis of allergic rhinitis, especially for childhood onset (OR, 0.55; 95% CI, 0.37-0.82). Consistent inverse associations were found between H pylori colonization and the presence of allergy symptoms in the previous year and sensitization to pollens and molds.

Conclusion  These observations support the hypothesis that childhood acquisition of H pylori is associated with reduced risks of asthma and allergy.

Author Affiliations: Departments of Environmental Medicine (Dr Chen), Medicine (Dr Blaser), and Microbiology (Dr Blaser) and New York University Cancer Institute (Dr Chen), New York University School of Medicine, and Department of Veterans Affairs New York Harbor Healthcare System (Dr Blaser), New York.

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