Helicobacter pylori infection contributes to placental impairment in preeclampsia: basic and clinical evidences

Abstract\r\nBackground: Preeclampsia (PE) is a major cause of maternal and neonatal morbidity\r\nand mortality. Epidemiological association between Helicobacter pylori (Hp) infection\r\nand PE onset has been widely shown. The aim of this study was to analyze a possible\r\ncorrelation between Hp infection and the severity of clinical presentation of PE and to\r\nidentify an immunologic mechanism triggered by Hp infection potentially contributing\r\nto the pathogenesis of PE.\r\nMaterials and Methods: Sera from 93 preeclamptic women and 87 healthy pregnant\r\nwomen were tested for Hp infection by immunoassay and for anti-CagA\r\nantibodies by\r\nWestern blot assay. The serologic results were correlated with the clinical features of\r\nPE. The functional effect of serum IgG fractions, positive or negative for Hp, from\r\npreeclamptic women or controls were tested on trophoblast and endothelial cell cultures\r\nand in a murine model of angiogenesis.\r\nResults: Preeclamptic women showed higher seroprevalence of Hp infection (57.0%)\r\ncompared to controls (33.3%) (P<.001). The seropositivity for CagA-positive\r\nstrains of\r\nHp was 45.2% in preeclamptic women vs 13.7% in controls (P<.001). In PE women, Hp\r\ninfection was associated with abnormality of uterine arteries Doppler (P<.001). Hp+\r\nIgG fractions from preeclamptic women bound to trophoblast and endometrial\r\nendothelial cell cultures, reducing in vitro invasiveness and angiogenesis, respectively,\r\nand inhibited angiogenesis in mice.\r\nConclusions: Our data show, for the first time, an association between Hp infection\r\nand PE with abnormal uterine arteries Doppler velocimetry, suggesting a role for Hp\r\ninfection in impairing placental development and increasing the risk to develop PE.\r\nThis study opens the new perspective of a potential screening and treatment for Hp\r\ninfection in pregnancy.