The role of Helicobacter pylori in the ethiopathogenesis of the nasal polyposis

Nasal polyposis can be defined as a chronic inflammatory disease of the upper airway, leading to the protrusion of benign edematous polyps from the meatus into the nasal cavities. Histologically, nasal polyps are covered with respiratory epithelium and filled with an edematous stroma, a rather striking density of fibroblasts and inflammatory cells of which the most prevalent cell type is the eosinophyl. Polyp histology typically shows chronic, eosinophilic inflammationAltough there are a series of theories about ethiopathogenesis of nasal polyposis, the mechanisms and resolution are largely unknown.The treatment of nasal polyposis, and the prevention of relapses of this common disorder, is a subject of much debate among clinicians and researchersRecently, attention has been directed toward the role of gastroesophageal or esophagonasopharyngeal reflux in the pathogenesis of rhinosinusitis. It has been suggested that direct reflux of gastric juice into the nasopharynx may cause mucosal edema and inflammation, leading to secondary obstruction of sinus ostia, but the exact mechanism remains unclear. A significant percentage of patients with gastroesophageal reflux disease are actually infected with H.pyloriHelicobacter pylori normally inhabits the gastric mucus layer. It is associated with chronic gastritis, as well as gastric and duodenal ulceration, and has recently been linked to gastric carcinomaColonization by H.pylori has been found in dental plaque, saliva, tonsils, and adenoids. Because the oral cavity is located near the nose and sinuses, direct transmission of H.pylori infection from the oral cavity to these structures might occur. However, the role of H.pylori in the pathogenesis of sinusitis and nasal polyposis has rarely been discussed. How H.pylori infection is transmitted remains unclear, and little is known about the role of H.pylori in extragastrointestinal diseasesIn our study, we used the PCR, urea breaht tests, to investigate the H.pylori status of nasal polyps, obtained from patients with nasal polyposisAlthough our study involved only a small group of patients, the results suggest the presence of H.pylori in nasal polyps, nasal mucosa. These results may have interesting implications for a possible role of H.pylori in nasal polyposis.