Helicobacter pylori infection and risk of multiple sclerosis: An updated meta‐analysis

Abstract

Background There is considerable controversy around the question as to whether Helicobacter pylori (H. pylori) infection has a protective or causative role in the development of multiple sclerosis (MS). This study evaluated published information to assess the association between H. pylori infection and MS. Methods We conducted a comprehensive systematic review of relevant observational studies in international databases. A random‐effects model was used to calculate pooled odds ratio (OR) and 95% confidence interval (CI). I2 statistic was used to assess the between‐study heterogeneity. Subgroup and meta‐regression analyses were applied to identify the source of heterogeneity. Results In total, 22 studies (25 datasets) were eligible for the meta‐analysis: 17 datasets had prevalence data and eight datasets had data on the mean titer of anti‐H. pylori IgG. The pooled prevalence of H. pylori was 44.1% (908/2606) in the MS patients and 46.1% (1016/2200) in the controls, indicating a non‐significant protective effect of H. pylori on MS (OR, 0.82; 95%CI, 0.58–1.17). In the subgroup analysis, studies that used ELISA yielded a significant protective association (OR, 0.59; 95%CI, 0.46–0.77), while a positive non‐significant association (OR, 1.33; 95%CI, 0.83–2.15) was found from studies that used other serological methods; interestingly, a significant positive association (OR, 6.64; 95%CI, 2.40–13.76) was found from studies that used histological methods to detect H. pylori infection. Conclusions Our findings do not support the hypothesis that H. pylori infection represents a protective factor against the development of MS; however, the results varied depending on the diagnostic method(s). Particularly, a significant positive association was identified when studies introduced results based on histological examination, suggesting that active H. pylori infection might be a risk factor for development of MS. Thus, further studies are needed utilizing accurate diagnostic methods to elucidate the association between active H. pylori infection and MS.

Can helicobacter pylori infection reduce the risk of Multiple sclerosis? A systematic review and meta-analysis

“…Income, educational and economic situation, and environmental health factors are differences between developing and developed countries (45). A previous systematic review and meta-analysis by Arjmandi et al investigated the association between HP and MS recently (15). They found that there was no protective effect for HP against MS which depends on diagnostic tests also.…”

“…A previous Neurology Letters. 2023; 2: e2 Neurology Letters│www.neurologyle ers.com between HP and MS, but we believed that a new study with a better methodology is required (15). Hence, we aimed to perform a comprehensive systematic review and meta-analysis to investigate the association between the risk of MS and HP infection.…”

Controlling the Impact of Helicobacter pylori-Related Hyperhomocysteinemia on Neurodegeneration

“…In this regard, Helicobacter pylori ( H. pylori ) infection consists one of the most common chronic infections since it affects more than 50% of the world population [ 22 ]. Emerging evidence supports its involvement in the pathophysiology of many neurodegenerative disorders [ 21 , 23 , 24 , 25 , 26 , 27 , 28 ]. Specifically, found in gastric mucosa of ≥50% of humans worldwide, H. pylori can infect children, becoming chronic during adulthood if untreated; in most patients, H. pylori infections are acquired in childhood and, if untreated, persist throughout life [ 29 ], causing the chronic inflammatory process of the stomach lining and leading to many gastric as well as other upper and lower gastrointestinal and extra-gastrointestinal pathologies [ 30 , 31 , 32 , 33 ].…”

“…Equivalent data may also be obtained for clinically isolated syndrome - multiple sclerosis sequence [ 25 , 28 , 130 ]. Indeed, our studies show that active H. pylori infection, apart from multiple sclerosis [ 28 , 130 ], is also common in clinically isolated syndrome, a prodromic condition predisposing for subsequent development of multiple sclerosis, accompanied by increased homocysteine levels.…”

“…Equivalent data may also be obtained for clinically isolated syndrome - multiple sclerosis sequence [ 25 , 28 , 130 ]. Indeed, our studies show that active H. pylori infection, apart from multiple sclerosis [ 28 , 130 ], is also common in clinically isolated syndrome, a prodromic condition predisposing for subsequent development of multiple sclerosis, accompanied by increased homocysteine levels. Moreover, eradication of this bacterium could constrain the progression of clinically isolated syndrome to the development of multiple sclerosis [ 25 ]; BCT is observed in both clinically isolated syndrome and multiple sclerosis [ 130 ].…”