Helicobacter pylori infection as a protective factor against multiple sclerosis risk in females
- Marzena J Fabis Pedrini1,
- Alexandra Seewann2,
- Kirsten A Bennett1,
- Alex J T Wood1,
- Ian James3,
- Jason Burton1,
- Barry J Marshall4,
- William M Carroll1,
- Allan G Kermode1,3
- 1Centre for Neuromuscular and Neurological Disorders, Western Australian Neuroscience Research Institute, The University of Western Australia, Sir Charles Gairdner Hospital, QEII Medical Centre, Nedlands, Australia
- 2Department of Neurology, VU University Medical Center, Amsterdam, Netherlands
- 3Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, Australia
- 4The Marshall Centre for Infectious Diseases Research and Training, The University of Western Australia, QEII Medical Centre, Nedlands, Australia
- Correspondence to Professor Allan G Kermode, Centre for Neuromuscular and Neurological Disorders, Western Australian Neuroscience Research Institute, 4th Floor, A Block, QEII Medical Centre, The University of Western Australia, Verdun St, Nedlands, W A 6009, Australia;
- Received 22 September 2014
- Revised 20 November 2014
- Accepted 30 November 2014
- Published Online First 19 January 2015
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.
Results H. 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.