Impact of Helicobacter pylori on multiple sclerosis-related clinically isolated syndrome.
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.
['Deretzi|G|G|', 'Gavalas|E|E|', 'Boziki|M|M|', 'Tsiptsios|D|D|', 'Polyzos|S A|SA|', 'Venizelos|I|I|', 'Zavos|C|C|', 'Koutlas|E|E|', 'Tsiptsios|I|I|', 'Katsinelos|P|P|', 'Kountouras|J|J|']
D000328:Adult D016022:Case-Control Studies D003711:Demyelinating Diseases D005260:Female D006115:Greece D015234:HLA-A Antigens D015235:HLA-B Antigens D016481:Helicobacter Infections D016480:Helicobacter pylori D006801:Humans D008297:Male D008875:Middle Aged D015995:Prevalence
Helicobacter pylori clinically isolated syndrome multiple sclerosis HLA alleles histological analysis proinflammatory cytokines