Helicobacter pylori induced Immune Thrombocytopenic Purpura and perspective role of Helicobacter pylori eradication therapy for treating Immune Thrombocytopenic Purpura

• Published in: AIMS microbiology Vol. 7; no. 3; pp. 284 - 303
• Main Authors: Ihtesham, Arham, Maqbool, Shahzaib, Nadeem, Muhammad, Bilawal Abbas Janjua, Muhammad, Sundus, Omaima, Bakht Naqqash, Ali, Inayat Mohamed, Waleed, Turab Haider, Syed, Ahmad, Muhmmad, Ahmad Talha Mustafa, Mir, Osama Mehboob, Hafiz
• Format: Journal Article
• Language: English
• Published: AIMS Press 01.01.2021
• Subjects: h-pylori eradication therapy; helicobacter pylori; immune thrombocytopenic purpura; Review
• ISSN: 2471-1888; 2471-1888
• DOI: 10.3934/microbiol.2021018

Immune thrombocytopenic purpura (ITP) is an autoimmune disease characterised by production of autoantibodies against platelet surface antigens. Recent studies have demonstrated a paramount association of ITP and Helicobacter pylori (H-pylori) infection with significant rise in platelet count following H-pylori eradication therapy. The H-pylori infection induced ITP is validated by many proposed mechanisms such as molecular mimicry due to production of autoantibodies against H-pylori surface virulent factors (CagA) and cross reactivity of these antibodies with platelet surface antigens (GP IIb/IIIa, GP Ib/IX, and GP Ia/IIa), phagocytic perturbation due to enhanced phagocytic activity of monocytes, enhanced dendritic cell numbers and response, platelets aggregation due to presence of anti- H-pylori IgG and von Willebrand factor (vWf) and finally host immune response against H-pylori virulent factors CagA and VacA leading to ITP. The effectiveness of H-pylori eradication therapy has also been demonstrated with platelet count being used as a predictive factor for assessment of treatment efficacy. Out of 201 patients 118 were responding to the triple therapy and remaining 83 patients were non-responders, showing the response rate of 58.7%. Out of 118 responders 69 patients were showing complete response (CR) and 49 were showing partial response (PR) to the H-pylori eradication therapy. However, more studies are required to elucidate this association and treatment efficacy.