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Helicobacter pylori infection and risk of multiple sclerosis: an updated meta-analysis

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Abstract

Numerous studies have proposed that Helicobacter pylori infection may possess a protective effect in terms of future risk of multiple sclerosis (MS), however is poorly evidenced. We performed a systematic review and meta-analysis to obtain the pooled results regarding the prevalence of H. pylori infection in persons with multiple sclerosis (pwMS) and healthy controls. A comprehensive database search was performed in PubMed, Embase, and medRxiv for all relevant literature published from the inception of the databases until the August 1, 2022. The retrieved articles were first screened by title and abstract, followed by full-text screening based on the pre-established eligibility criteria. The risk of bias was assessed using the ROBINS-I tool. Data on the seroprevalence of H. pylori in pwMS and healthy controls was extracted, and a meta-analysis was performed in Review Manager Version 5.4.1. Sub-group analysis was performed in accordance with the geographical distribution (Eastern and Western countries) and the method of detection of H. pylori infection enzyme-linked-immunoassay (ELISA), Immunofluorescence, Immunochromatography). Furthermore, sensitivity analyses and publication bias were determined. The preliminary database search retrieved a total of 822 studies. Seventeen case–control studies with a total of 2721 pwMS and 2245 controls were included as a final sample size for the meta-analysis. The overall risk of bias was moderate. Overall, the rate of H. pylori infection in pwMS was not significantly different than in healthy controls (OR: 0.79 (95% CI = 0.58–1.08); I2 = 79%, p = 0.14). Subgroup analysis revealed that the rate of H. pylori infection among PwMS was not significant in both Eastern and Western countries (OR: 0.75 (95% CI = 0.52–1.08); I2 = 81%, p = 0.12). In contrast, data revealed that the prevalence of H. pylori infection in pwMS was significantly lower than that of control based on studies utilizing ELISA assays detection (OR: 0.71 (95% CI = 0.50–1.00); I2 = 81%, p = 0.05), while no significant difference was seen on studies using other assays than ELISA (OR: 1.19 (95% CI = 0.81–1.77); I2 = 0%, p = 0.38). Our findings of statistically indifferent prevalence of H. pylori infection as compared between pwMS and healthy controls suggested the absence of protective effect for risk of MS following H. pylori infection.

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Authors and Affiliations

  1. Jacobs Comprehensive MS Treatment and Research Center,, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA

    Sangharsha Thapa & Dejan Jakimovski

  2. Institute of Medicine, Tribhuvan University, Maharajgunj, 44600, Nepal

    Abhinav Bhattarai, Sangam Shah & Sakchhyam Timsina

  3. Rochester General Hospital, Rochester, NY, USA

    Swati Chand

  4. Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street , Buffalo, NY, 14203, USA

    Dejan Jakimovski

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AB, ST, and ST wrote the entire manuscript. SS, SC, and DJ reviewed and edited the manuscript.

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Correspondence to Dejan Jakimovski.

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The systematic review and meta-analysis utilized only data published in the literature and did not include any subjects. The Ethical approval was not necessary.

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Thapa, S., Bhattarai, A., Shah, S. et al. Helicobacter pylori infection and risk of multiple sclerosis: an updated meta-analysis. Neurol Sci (2024). https://doi.org/10.1007/s10072-024-07328-8

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