Background: A decline in the prevalence of Helicobacter pylori infection has been claimed to increase the probability of developing atopic diseases. Aims: To evaluate the prevalence of atopic disorders in a pediatric population according to seropositivity against H. pylori. Methods: Children referred to the local Pediatric Hospital were investigated to identify risk factors, especially H. pylori infection, associated with atopic disorders. A questionnaire, including demographics, house size, history of breastfeeding, residence, school or daycare center attendance, exposure to animals, and a diagnosis of atopy, was filled out by a trained pediatrician according to parents’ answers. A blood sample was collected from each participant. Results: Seroprevalence of H. pylori infection was 11.7% among 492 children (240 females); 32 of them had a diagnosis of asthma and 12 of allergy. No one child showed both conditions. Statistically significant differences in H. pylori seropositivity were not detected between children with or without atopy (8.4 vs. 12.6; p=0.233). Although atopic disorders were more frequent in children exposed to traditional risk factors none showed to be significant after adjusting for all covariates. Conclusions: H. pylori infection, serologically assessed, was not significantly associated with a reduced risk of atopic diseases in children.

Background. In the central-eastern region of the Mediterranean island of Sardinia more than two decades ago, a mountain area was identified where the population displays exceptional longevity, especially among men (the longevity Blue Zone, LBZ). This community was thoroughly investigated seeking to understand the underlying factors of this phenomenon. In the present study, 11 genetic markers previously associated with longevity in several long-lived populations were analyzed. Methods. APOE (rs429358 and rs7412), APOE promoter (rs449647, rs769446, and rs405509), ACE1 (rs1799752), IL6 ‒174G/C (rs1800795), TNFα ‒308G/A (rs1800629), FOXO3A (rs2802292), KLOTHO (rs9536314) and G6PD (c.563C→T) were investigated. PCR-based genotyping was performed following genomic DNA extraction from 150 nonagenarians living in the LBZ and 150 controls from a nearby area. Results. No significant deviation of the frequency of the analyzed markers was detected between the two groups except a weak association with the –174G>C gene variant of the IL-6 gene (p=0.040), a major modulator of the inflammatory response. Conclusions. The findings of this study do not support a significant association of known genetic variants on survival in the population of the Sardinian LBZ. Other genetic or epigenetic traits might play a role not yet identified.

Background. Helicobacter pylori infection has long been suspected to increase the risk of thyroid diseases but evidence from literature is conflicting. In a cohort of patients from Northern Sardinia, Italy, who underwent upper endoscopy, we investigated the association between current and long-lasting Helicobacter pylori infection and thyroid disease, both autoimmune and non-autoimmune, by adjusting for potential confounds. Methods. By using multivariable logistic regression we analyzed a cohort of 8490 adults aged 6–93 years: 730 were diagnosed with autoimmune thyroid disease (AITD) and 448 with nonautoimmune thyroid diseases. Results. We found a significant association between H. pylori long-lasting infection and AITD independently of age, sex, body mass index, smoke, hypertension and dyslipidemia (OR 1.42; 95%CI 1.20‒1.66) while the opposite was found regarding current infection (OR 0.75; 95%CI 0.63‒0.89). Current infection was not significantly associated to non-autoimmune thyroiditis. Conclusions. H. pylori infection is an independent risk factor for AITD in the population of Northern Sardinia, therefore it is advisable to eradicate the pathogen in subjects at risk of AITD.

Inflammatory bowel diseases, comprising Crohn’s disease (CD) and ulcerative colitis (UC), are chronic, relapsing and remitting immune-mediated inflammatory diseases affecting the gastrointestinal tract. Ustekinumab (UST) is a monoclonal antibody blocking the p40 subunit of the anti-interleukin (IL) 12/23. Pivotal trials (CERTIFI and UNITI-IM for CD, UNIFI for UC) established the efficacy of UST for the induction and maintenance of remission in both CD and UC, with the most favorable results in naïve patients to biologics. In recent years, a wealth of ‘real-world’ data has emerged supporting positive clinical, endoscopic, and histological outcomes in patients treated with UST, as well as reassuring safety data. More recently, the results of the first head-to-head trials of UST and tumor necrosis factor (TNF) antagonists have been reported. Moreover, a number of studies exploring the role of UST in specific clinical settings, such as perianal CD, postoperative complications and recurrence, extraintestinal manifestations, chronic antibiotic-refractory pouchitis, and pregnancy, have been reported. This review explores results reported to date on UST, including those from pivotal trials, real-world data, and emerging studies regarding therapeutic drug monitoring and immunogenicity. The safety profile of UST was also reviewed.