Fighting H. Pylori for Public Health
By Meghan Davis
More than half of the people on the planet are infected with the bacterium Helicobacter pylori. For most of them, the stomach-dwelling bug brings no discernible symptoms, although it is the most common cause of ulcers and causes a host of malnutrition issues around the globe.
Scientists at UAB suspect that aggressive treatment of H. pylori infections could provide a low-cost way to help millions of women and their children in developing countries, however. Their research recently received a vote of confidence from the Bill & Melinda Gates Foundation, which is funding a UAB-led study in India through its Grand Challenges Explorations initiative.
Mohammad Khaled, Ph.D., has spent much of his career researching H. pylori. Khaled, professor emeritus in the Department of Nutrition Sciences in the School of Health Professions, has studied how the bacteria affects different populations, including its role in blocking uptake of vitamins and minerals.
Khaled is particularly concerned about the role of H. pylori infections in a major malnutrition condition in women of childbearing age. Expectant mothers who don’t get enough nutrients face troublesome health risks, including iron-deficiency anemia.
Maternal iron anemia can lead to underweight babies, premature delivery, and postpartum depression; it also increases the risk of fetal and neonatal mortality, Khaled points out.
“Malnourished mothers, particularly in low-income countries, give birth to malnourished babies—who suffer from the consequences of poor infant nutrition for the rest of their lives,” Khaled says.
While nutrient supplements are usually an easy way to treat nutrient deficiencies, Khaled’s research has shown that H. pylori infection also keeps iron supplements from raising iron levels effectively.
Comparatively little attention “has been paid to maternal anemia of pregnancy due to iron deficiency, despite the fact that this is a major global health problem, currently affecting nearly half of all pregnant women worldwide,” Khaled says. He aims to address that imbalance with the Gates Foundation funding in India.
Khaled’s team of five research workers will recruit non-pregnant women of childbearing age and test them for H. pylori using a combination of urea breath tests and a finger prick. Those who test positive will be administered an aggressive regimen of three antibiotics during the course of a week. The combination of three antibiotics can be difficult to tolerate, Khaled notes, but it is necessary because H. pylori has shown resistance to common antibiotics in other studies. The project will evaluate whether treating H. pylori relieves anemia and increases the effectiveness of iron supplements for the women.
Breaking the Cycle
Khaled’s innovative, indirect approach attracted the attention of the Gates Foundation. Its Grand Challenges Explorations initiative funds ideas that break the mold in solving persistent global health and development challenges. “We believe... a single bold idea can pioneer solutions to our greatest health and development challenges,” says Chris Wilson, director of Global Health Discovery for the Bill & Melinda Gates Foundation. The UAB project was one of 110 Grand Challenges Explorations grants announced in 2011.
Khaled expects to complete his initial research by the end of 2012. If it shows positive results, he says, the next step may be a large-scale community trial that treats H. pylori infection in women of childbearing age and simultaneously provides them with iron supplements. “Our goal is to break the vicious cycle of malnutrition, particularly undernutrition affecting mothers and infants worldwide,” Khaled says.