Paediatric Helicobacter pylori infection and allergic and inflammatory diseases: a contemporary systematic review with meta-analysis.

In 30 seconds

This systematic review and meta-analysis assessed recent evidence on Helicobacter pylori infection and allergic or immune-mediated diseases in children. It included 35 articles, with studies addressing asthma, celiac disease, eosinophilic esophagitis, inflammatory bowel disease, and mixed conditions. In the asthma meta-analysis, infection was not significantly associated with asthma overall (OR 0.75, 95% CI 0.54-1.05; I 2 = 67.3%). An inverse association appeared only in selected diagnostic subgroups, while findings for celiac disease and inflammatory bowel disease were mixed and no clear trends emerged for other conditions.

Key findings

• Across asthma studies, H. pylori infection was not significantly associated with asthma overall (OR 0.75, 95% CI 0.54-1.05; I 2 = 67.3%).
• An inverse asthma association was seen in studies using UBT/SAT, but not in histology-based studies; low-risk-of-bias studies also found no significant association.
• Evidence for celiac disease and inflammatory bowel disease was mixed, with no clear trends for eosinophilic esophagitis or other conditions.

Why it matters

The review synthesises paediatric evidence across several allergic and immune-mediated conditions, helping clarify that a proposed protective relationship between H. pylori and asthma is not supported overall. The subgroup differences also show why diagnostic methods and study bias matter when interpreting reported associations. Evidence remains insufficiently consistent to establish a broader relationship across these conditions.

What to keep in mind

The review reports inconsistent evidence across conditions and substantial heterogeneity in the asthma meta-analysis (I 2 = 67.3%); its conclusions are based on the available studies, which the authors say require supplementation by prospective paediatric research.