H. pylori Infection as a Protective Factor Against MS Risk
H. pylori Infection as a Protective Factor Against MS Risk
Background In recent years, a relationship between Helicobacter pylori and many disease conditions has been reported, however, studies in its relationship with multiple sclerosis (MS) have had contradictory results.
Objective To determine the association between the H. pylori infection and MS.
Methods 550 patients with MS were included in the study and were matched by gender and year of birth to 299 controls. Patients were assessed for clinical and demographic parameters. An enzyme immunoassay was used to detect the presence of specific IgG antibodies against H. pylori in the serum sample of both groups.
ResultsH. pylori seropositivity was found to be lower in the patients with MS than in controls (16% vs 21%) with the decrease pertaining to females (14% vs 22%, p=0.027) but not males (19% vs 20%, p=1.0). When adjusted for age at onset, year of birth and disease duration, H. pylori seropositive females presented with a lower disability score than seronegative females (p=0.049), while among males the reverse was true (p=0.025). There was no significant association between H. pylori seropositivity and relapse rate.
Conclusions Our results could reflect a protective role of H. pylori in the disease development. However, it may be that H. pylori infection is a surrogate marker for the 'hygiene hypothesis', a theory which postulates that early life infections are essential to prime the immune system and thus prevent allergic and autoimmune conditions later in life. The fact that the association between H. pylori seropositivity and MS risk was seen almost exclusively in females requires further investigation.
Multiple sclerosis (MS) is a heterogeneous, immune-mediated demyelinating disease of the central nervous system. Pathogenesis involves a complex interaction between genetic and environmental factors. Recently, many studies indicated a steady increase in autoimmune disease incidence in developed countries, which could suggest that the concurrent decline in infectious disease prevalence might explain the increased autoimmune disease incidence. About half of the world's population is infected with Helicobacter pylori.H. pylori infection is more prevalent in developing countries, while the incidence is decreasing in Western countries. The lower rate of infection with H. pylori in the West is largely attributed to higher hygiene standards and widespread use of antibiotics.
While the majority of H. pylori hosts remain asymptomatic, infection with it has a role in chronic gastritis, peptic ulcer disease, low-grade gastric mucosa-associated lymphoid tissue lymphoma and non-cardia gastric adenocarcinoma.H. pylori may also play a role in some extragut conditions. Paradoxically, there are many studies reporting benefits of infection, including a reduction in the likelihood of developing atopic disorders later in life if infected with H. pylori in childhood. Relatively unclear is any association it may have with a potentially autoimmune demyelinating condition such as MS.
The contradictory findings concerning the association between H. pylori infection and MS based on low numbers of patients led us to study a large group of Western Australian patients.
Abstract and Introduction
Abstract
Background In recent years, a relationship between Helicobacter pylori and many disease conditions has been reported, however, studies in its relationship with multiple sclerosis (MS) have had contradictory results.
Objective To determine the association between the H. pylori infection and MS.
Methods 550 patients with MS were included in the study and were matched by gender and year of birth to 299 controls. Patients were assessed for clinical and demographic parameters. An enzyme immunoassay was used to detect the presence of specific IgG antibodies against H. pylori in the serum sample of both groups.
ResultsH. pylori seropositivity was found to be lower in the patients with MS than in controls (16% vs 21%) with the decrease pertaining to females (14% vs 22%, p=0.027) but not males (19% vs 20%, p=1.0). When adjusted for age at onset, year of birth and disease duration, H. pylori seropositive females presented with a lower disability score than seronegative females (p=0.049), while among males the reverse was true (p=0.025). There was no significant association between H. pylori seropositivity and relapse rate.
Conclusions Our results could reflect a protective role of H. pylori in the disease development. However, it may be that H. pylori infection is a surrogate marker for the 'hygiene hypothesis', a theory which postulates that early life infections are essential to prime the immune system and thus prevent allergic and autoimmune conditions later in life. The fact that the association between H. pylori seropositivity and MS risk was seen almost exclusively in females requires further investigation.
Introduction
Multiple sclerosis (MS) is a heterogeneous, immune-mediated demyelinating disease of the central nervous system. Pathogenesis involves a complex interaction between genetic and environmental factors. Recently, many studies indicated a steady increase in autoimmune disease incidence in developed countries, which could suggest that the concurrent decline in infectious disease prevalence might explain the increased autoimmune disease incidence. About half of the world's population is infected with Helicobacter pylori.H. pylori infection is more prevalent in developing countries, while the incidence is decreasing in Western countries. The lower rate of infection with H. pylori in the West is largely attributed to higher hygiene standards and widespread use of antibiotics.
While the majority of H. pylori hosts remain asymptomatic, infection with it has a role in chronic gastritis, peptic ulcer disease, low-grade gastric mucosa-associated lymphoid tissue lymphoma and non-cardia gastric adenocarcinoma.H. pylori may also play a role in some extragut conditions. Paradoxically, there are many studies reporting benefits of infection, including a reduction in the likelihood of developing atopic disorders later in life if infected with H. pylori in childhood. Relatively unclear is any association it may have with a potentially autoimmune demyelinating condition such as MS.
The contradictory findings concerning the association between H. pylori infection and MS based on low numbers of patients led us to study a large group of Western Australian patients.
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