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Epidemiological studies consistently demonstrate an inverse relationship between\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>H. pylori<\/jats:italic>\n                    <\/jats:styled-content>\n                    infection and IBD development, particularly Crohn's disease (CD). Meta\u2010analyses reveal a significantly lower prevalence of\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>H. pylori<\/jats:italic>\n                    <\/jats:styled-content>\n                    among IBD patients compared to healthy controls, supporting the hypothesis of a potential protective effect. This negative correlation appears particularly strong for virulent strains expressing\n                    <jats:italic>CagA<\/jats:italic>\n                    , suggesting strain\u2010specific immunomodulatory properties. The protective mechanisms may involve\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>H. pylori<\/jats:italic>\n                    <\/jats:styled-content>\n                    's ability to modulate host immune responses and maintain gut microbial homeostasis. Experimental models show that\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>H. pylori<\/jats:italic>\n                    <\/jats:styled-content>\n                    colonization can induce regulatory T\u2010cell responses and downregulate pro\u2010inflammatory cytokines, potentially creating an immunological balance that protects against IBD development. Conversely,\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>H. pylori<\/jats:italic>\n                    <\/jats:styled-content>\n                    eradication has been associated with increased IBD incidence and disease flares, possibly through disruption of established microbial ecosystems and immune regulation. Clinical observations further support this relationship, demonstrating that\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>H. pylori<\/jats:italic>\n                    <\/jats:styled-content>\n                    \u2010positive CD patients often experience milder disease courses with fewer complications. However, the interaction remains complex, as\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>H. pylori<\/jats:italic>\n                    <\/jats:styled-content>\n                    infection may also exert detrimental effects in certain contexts. The bacterium's influence appears to depend on multiple factors, including infection timing, strain characteristics, and host genetic background. Current evidence highlights the crucial interplay between\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>H. pylori<\/jats:italic>\n                    <\/jats:styled-content>\n                    , gut microbiota composition, and mucosal immunity in shaping IBD pathogenesis. Future research should focus on elucidating precise molecular mechanisms and evaluating whether targeted modulation of\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>H. pylori<\/jats:italic>\n                    <\/jats:styled-content>\n                    could offer therapeutic potential, while considering potential risks.\n                  <\/jats:p>","DOI":"10.1002\/jgh3.70319","type":"journal-article","created":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T02:40:17Z","timestamp":1766976017000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["<scp>\n                      <i>Helicobacter pylori<\/i>\n                    <\/scp>\n                    and Inflammatory Bowel Disease: Unraveling the Complex Interactions and Clinical Implications"],"prefix":"10.1002","volume":"9","author":[{"given":"Elaheh","family":"Karimzadeh\u2010Soureshjani","sequence":"first","affiliation":[{"name":"Student Research Committee Abadan University of Medical Sciences  Abadan Iran"},{"name":"Clinical Research Development Unit Abadan University of Medical Sciences  Abadan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farab","family":"Pourhasan","sequence":"additional","affiliation":[{"name":"Student Research Committee Abadan University of Medical Sciences  Abadan Iran"},{"name":"Clinical Research Development Unit Abadan University of Medical Sciences  Abadan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pouria","family":"Ahmadi Simab","sequence":"additional","affiliation":[{"name":"Universal Scientific Education and Research Network (USERN)  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6379-3827","authenticated-orcid":false,"given":"Nabi","family":"Jomehzadeh","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Faculty of Medicine Ahvaz Jundishapur University of Medical Sciences  Ahvaz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6167-1412","authenticated-orcid":false,"given":"Ali","family":"Saeedi\u2010Boroujeni","sequence":"additional","affiliation":[{"name":"Department of Basic Medical Sciences, Faculty of Medicine Abadan University of Medical Sciences  Abadan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,28]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-immunol-042617-053055"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2011.10.001"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/19490976.2023.2265028"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v20.i1.91"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2023.09.019"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-804024-9.00028-8"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41392-022-00974-4"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000039051"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-18014-5"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v27.i37.6224"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2017.57"},{"issue":"8336","key":"e_1_2_12_13_1","first-page":"1273","article-title":"Unidentified Curved Bacilli on Gastric Epithelium in Active Chronic Gastritis","volume":"1","author":"Warren J. 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