The Synergistic Role Of IL-8 And Serum C-Reactive Protein Levels in The Diagnosis of Helicobacter Pylori Infection

Abstract

Helicobacter pylori infection is one of the most frequently and globally emerged chronic bacterial infections and is strongly correlation with , peptic ulcer, gastritis, and gastric malignancies. The host inflammatory response plays a pivotal role in disease pathogenesis, highlighting the need for reliable non-invasive biomarkers to aid diagnosis. This study aims to investigate the diagnostic power of serum interleukin-8 (IL-8) and C-reactive protein (CRP) levels, individually and in combination, for the detection of H. pylori infection. A case–control study was conducted including 78 patients with confirmed H. pylori infection and 62 apparently healthy controls. Serum IL-8 levels were determined using enzyme-linked immunosorbent assay (ELISA), while CRP concentrations were determined by standard immunoturbidimetric methods. Differences between groups were assessed using independent samples t-tests, and the relationship between IL-8 and CRP was evaluated using Pearson correlation analysis. Receiver operating characteristic (ROC) curve analysis was conducted to investigate the diagnostic performance of each biomarker. Patients with H. pylori infection exhibited significantly higher serum IL-8 levels (72.4 ± 18.6 pg/mL) compared with controls (58.1 ± 15.2 pg/mL; P < 0.02). Similarly, CRP concentrations were significantly elevated in patients (4.8 ± 1.6 pg/mL) relative to controls (3.6 ± 1.3 pg/mL; P < 0.04). A moderate positive correlation was observed between IL-8 and CRP levels (r = 0.49, P < 0.001). ROC analysis revealed that IL-8 demonstrated superior diagnostic accuracy (AUC = 0.78) compared to CRP (AUC = 0.71). At an optimal cut-off value of 65.0 pg/mL, IL-8 yielded a sensitivity of 74.4% and specificity of 71.0%. These findings indicate that both IL-8 and CRP are significantly associated with H. pylori infection and that their combined assessment may enhance diagnostic accuracy. The results support the potential role of IL-8 and CRP as complementary, non-invasive biomarkers for the diagnosis of H. pylori-associated inflammation.

Keywords:

Interleukin-8, CRP, H. pylori, AUC, Sensitivity, Specificity

References

Al-Fahham, A. A. (2018). Development of new LSD formula when numbers of observations are unequal. Open Journal of Statistics, 8(2), 258–265.

Bäckhed, F., Torstensson, E., Seguin, D., Richter-Dahlfors, A., & Rokbi, B. (2003). Helicobacter pylori infection induces interleukin-8 receptor expression in the human gastric epithelium. Infection and immunity, 71(6), 3357–3360. https://doi.org/10.1128/IAI.71.6.3357-3360.2003

Bartchewsky, W., Jr, Martini, M. R., Masiero, M., Squassoni, A. C., Alvarez, M. C., Ladeira, M. S., Salvatore, D., Trevisan, M., Pedrazzoli, J., Jr, & Ribeiro, M. L. (2009). Effect of Helicobacter pylori infection on IL-8, IL-1beta and COX-2 expression in patients with chronic gastritis and gastric cancer. Scandinavian journal of gastroenterology, 44(2), 153–161. https://doi.org/10.1080/00365520802530853

Bickel M. (1993). The role of interleukin-8 in inflammation and mechanisms of regulation. Journal of periodontology, 64(5 Suppl), 456–460.

Cadamuro, A. C., Rossi, A. F., Maniezzo, N. M., & Silva, A. E. (2014). Helicobacter pylori infection: host immune response, implications on gene expression and microRNAs. World journal of gastroenterology, 20(6), 1424–1437. https://doi.org/10.3748/wjg.v20.i6.1424

Chen, L., Zhang, X., & Shi, P. (2025). Recent advances in biomarkers for detection and diagnosis of sepsis and organ dysfunction: a comprehensive review. European journal of medical research, 30(1), 1081. https://doi.org/10.1186/s40001-025-03324-6

Ibrahim, T. S., et al. (2023). Molecular detection of carbapenemase genes in multidrug-resistant clinical isolates from Iraq. Antibiotics. https://doi.org/10.3390/antibiotics12030456

Ishida, Y., Suzuki, K., Taki, K., Niwa, T., Kurotsuchi, S., Ando, H., Iwase, A., Nishio, K., Wakai, K., Ito, Y., & Hamajima, N. (2008). Significant association between Helicobacter pylori infection and serum C-reactive protein. International journal of medical sciences, 5(4), 224–229. https://doi.org/10.7150/ijms.5.224

Iskandar, A., Mayashinta, D. K., Robert, R., Samsu, N., Endharti, A. T., & Widjajanto, E. (2023). Correlation Between IL-8, C-Reactive Proteins (CRP) and Neutrophil to Lymphocyte Ratio (NLR) as Predictor of Mortality in COVID-19 Patients with Diabetes Mellitus Comorbidity. International journal of general medicine, 16, 2349–2354. https://doi.org/10.2147/IJGM.S412070

Jafarzadeh, A., Hassanshahi, G. H., & Nemati, M. (2009). Serum levels of high-sensitivity C-reactive protein (hs-CRP)in Helicobacter pylori-infected peptic ulcer patients and its association with bacterial CagA virulence factor. Digestive diseases and sciences, 54(12), 2612–2616. https://doi.org/10.1007/s10620-008-0686-z

Li, L., Li, J., Gao, M., Fan, H., Wang, Y., Xu, X., Chen, C., Liu, J., Kim, J., Aliyari, R., Zhang, J., Jin, Y., Li, X., Ma, F., Shi, M., Cheng, G., & Yang, H. (2021). Interleukin-8 as a Biomarker for Disease Prognosis of Coronavirus Disease-2019 Patients. Frontiers in immunology, 11, 602395. https://doi.org/10.3389/fimmu.2020.602395

Nasier-Hussain, M., Samanje, J. N., Mokhtari, K., Nabi-Afjadi, M., Fathi, Z., Hoseini, A., & Bahreini, E. (2025). Serum levels of oxidative stress, IL-8, and pepsinogen I/II ratio in Helicobacter pylori and gastric cancer patients: potential diagnostic biomarkers. BMC gastroenterology, 25(1), 2. https://doi.org/10.1186/s12876-024-03564-6

Oshima, T., Ozono, R., Yano, Y., Oishi, Y., Teragawa, H., Higashi, Y., Yoshizumi, M., & Kambe, M. (2005). Association of Helicobacter pylori infection with systemic inflammation and endothelial dysfunction in healthy male subjects. Journal of the American College of Cardiology, 45(8), 1219–1222. https://doi.org/10.1016/j.jacc.2005.01.019

Parikh NS, Ahlawat R (2025). Helicobacter Pylori. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534233/

Pepys, M. B., & Hirschfield, G. M. (2003). C-reactive protein: a critical update. The Journal of clinical investigation, 111(12), 1805–1812. https://doi.org/10.1172/JCI18921

Watanabe, J., & Kotani, K. (2021). The effect of Helicobacter pylori eradication on C-reactive protein: results from a meta-analysis. Archives of medical science: AMS, 18(4), 958–964. https://doi.org/10.5114/aoms/130288

Zorah, S. M. (2025). Helicobacter pylori and IL-8 signaling: Implications in gastritis and peptic ulcer disease. Al-Wataniya Journal of Medical Sciences, 5(2), 1–12.