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Helicobacter pylori infection and risk of multiple sclerosis: An updated meta-analysis
Delaram Arjmandi1, Ali Abdollahi2, Ali Ardekani3
1Immunoregulation Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
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.
Insights
Helicobacter pylori (H. pylori) infection does not appear protective against multiple sclerosis (MS). However, histological evidence suggests H. pylori may be a risk factor for MS development, warranting further investigation.
Area of Science:
- Neurology
- Infectious Diseases
- Gastroenterology
Background:
- Investigating the controversial role of Helicobacter pylori (H. pylori) infection in multiple sclerosis (MS) etiology.
- Assessing whether H. pylori infection is protective or causative in MS development.
Approach:
- Conducted a systematic review and meta-analysis of observational studies.
- Utilized a random-effects model to calculate pooled odds ratios and confidence intervals.
- Performed subgroup and meta-regression analyses to explore heterogeneity.
Key Points:
- Pooled prevalence of H. pylori was similar in MS patients (44.1%) and controls (46.1%).
- Overall, H. pylori showed a non-significant protective effect (OR, 0.82).
- ELISA studies indicated a protective association (OR, 0.59), while histological methods suggested a positive association (OR, 6.64).
Conclusions:
- Findings do not support H. pylori as a protective factor against MS.
- Histological evidence suggests active H. pylori infection may be a risk factor for MS.
- Further research using accurate diagnostic methods is needed to clarify the association.
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