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Impact of Helicobacter pylori on multiple sclerosis-related clinically isolated syndrome
G Deretzi1, E Gavalas2, M Boziki3
1Multiple Sclerosis Unit, Department of Neurology, "Papageorgiou" Hospital, Thessaloniki, Greece.
Objectives:
There are no data regarding the relationship between Helicobacter pylori infection (Hp-I) and clinically isolated syndrome (CIS) suggestive of multiple sclerosis. The purpose of this pilot study was to investigate the association between active Hp-I, confirmed by histology, and CIS and to evaluate the impact of Hp eradication on the CIS clinical course.
Material And Methods:
We conducted a study on 48 patients with CIS and 20 matched controls. At baseline, apart from histology, serum anti-Hp-specific IgG titer, inflammatory mediators, and HLA-A, HLA-B, HLA-DR genetic polymorphisms were estimated. Hp-positive patients received standard triple eradication regimen, and all patients were followed up for 2 years.
Results:
The prevalence of Hp-I was significantly higher in patients with CIS (43/48, 89.6%) than in control (10/20, 50%) (P < 0.001, OR: 8.6, 95% CI: 2.4-30.8). When compared with controls, patients with CIS also showed significantly higher serum anti-Hp IgG titer and HLA-A26, HLA-A30, and HLA-B57 frequencies. Hp-positive patients also showed higher serum concentrations of inflammatory cytokines and homocysteine. At 2-year clinical endpoint, in the subgroup of CIS patients with successful Hp eradication, the number of patients who presented with a second episode was significantly lower accompanied by significant improvement in mean Expanded Disability Status Scale score.
Conclusions:
Hp-I seems more frequent in a Greek CIS cohort and its eradication might delay CIS progression, suggesting a possible link between Hp-I and CIS.
Insights
Helicobacter pylori infection (Hp-I) is significantly more common in patients with clinically isolated syndrome (CIS). Eradicating Hp-I may delay CIS progression, suggesting a potential link between the infection and the syndrome.
Area of Science:
- Neurology
- Gastroenterology
- Immunology
Background:
- Limited data exists on the association between Helicobacter pylori infection (Hp-I) and clinically isolated syndrome (CIS).
- CIS is an early clinical presentation suggestive of multiple sclerosis.
- Understanding potential triggers or associated factors for CIS is crucial for early intervention.
Purpose of the Study:
- To investigate the association between active Hp-I and CIS.
- To determine if Hp-I is more prevalent in CIS patients compared to controls.
- To evaluate the impact of Hp eradication on the clinical course of CIS.
Main Methods:
- A pilot study involving 48 CIS patients and 20 matched controls.
- Assessment of Hp-I via histology and serum anti-Hp IgG titers.
- Analysis of inflammatory mediators and HLA genetic polymorphisms.
- Hp-positive patients underwent eradication therapy, with a 2-year follow-up.
Main Results:
- Hp-I prevalence was significantly higher in CIS patients (89.6%) than controls (50%) (P < 0.001).
- CIS patients exhibited higher anti-Hp IgG titers and specific HLA frequencies (HLA-A26, HLA-A30, HLA-B57).
- Successful Hp eradication in CIS patients led to fewer second episodes and improved Expanded Disability Status Scale scores.
Conclusions:
- Hp-I appears to be more frequent in a Greek CIS cohort.
- Hp eradication may potentially delay CIS progression.
- A possible link between Hp-I and CIS warrants further investigation.
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