1. Helicobacter pylori infection was less common in female patients with Multiple Sclerosis (MS) than their unaffected counterparts.
2. H. pylori infection more commonly found in primary progressive MS cases than in other types of MS.
Evidence Rating Level: 3 (Average)
Study Rundown: The increase of autoimmune disease in the developed world has led many researchers to hypothesize that increased hygiene and use of antibiotics may lead to a greater risk of developing autoimmune disease. As chronic H. pylori infection is less prevalent in developed countries, it was hypothesized that the rate of seropositivity to H. pylori would be lower in MS patients. In testing this hypothesis, this study showed that H. pylori seropositivity was less prevalent in female patients with MS than control patients without MS. The rate of seropositivity for case and control males was statistically equal. In addition, it was shown that the seropositivity of H. pylori was more prevalent in female patients with primary progressive MS than in other types of MS, with male patients again not showing this association.
This study adds evidence to support the hygiene hypothesis of autoimmune disease, but it is difficult to interpret exactly how H. pylori itself my impact MS incidence, or vice versa. It is possible that H. pylori infection is a product of another condition that is protective against MS, and at best, the evidence presented in this study can only allow one to conclude that H. pylori infection is a potential biomarker of MS risk, though this would also need more validation. A more rigorous experimental design, such as a prospective cohort study, would be needed to establish a more definitive link between H. pylori infection and MS risk.
Relevant Reading: Environmental Factors and Multiple Sclerosis
In-Depth [case-control study]: 550 Caucasian Western Australian patients were enrolled into the Perth Demyelinating Disease Database with 299 gender, age, and ethnicity matched controls from the Busselton Community Health Study. Serpositivity for H. pylori was based on a concentration of IgG antibodies of >10U/mL obtained with a enzyme immunoassay. Females controls had a higher rate of H. pylori infection than MS patients (p = 0.03) while males had statistically equal levels of H. pylori (p = 1.0). In addition, female MS patients with primary progressive MS had a higher rate of H. pylori seropositivity than their female controls (p = 0.03), while again males showed no association (p = 0.88).
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