Helicobacter pylori infection in Neuromyelitis Optica and Multiple Sclerosis

Neuroimmunomodulation. 2013;20(2):107-12. doi: 10.1159/000345838. Epub 2012 Dec 28.

Abstract

Objective: To determine the Helicobacter pylori infection status in patients with multiple sclerosis (MS) and neuromyelitis optica (NMO) spectrum.

Methods: H. pylori infection was certified by indirect immunofluorescence assay. Aquaporin-4 (AQP4) antibody was detected by cell-based assay. H. pylori seroprevalence was measured in 118 patients with NMO (n = 52), high-risk NMO (hrNMO, longitudinally extensive transverse myelitis, n = 17 and recurrent optic neuritis, n = 7), MS (n = 42) and healthy controls (n = 27). Logistic regression analysis was used to determine associations between H. pylori infection and NMO and MS.

Results: H. pylori antibodies were present in 119 serum samples (82.1%, 119/145), with antibody positivity in 90.4% (47/52) of the patients with NMO, 95.8% (23/24) of the patients with hrNMO, 73.8% (31/42) of the patients with MS and 59.3% (16/27) of the controls. NMO spectrum patients had greater positivity for H. pylori than MS patients (p < 0.05) and controls (p < 0.05). The frequency of H. pylori seropositivity did not significantly differ between MS patients and controls (p = 0.726). H. pylori seropositivity was significantly higher in AQP4 antibody-positive patients (54/58, 93.1%; p = 0.038) than in AQP4 antibody-negative patients (48/60, 80%). Logistic regression analysis showed that H. pylori seropositivity was significantly associated with hrNMO [odds ratio (OR) = 9.311, p = 0.005] or hrNMO + NMO (OR = 6.350, p = 0.028).

Conclusion: H. pylori infection was present in most Chinese patients with NMO and hrNMO, and may be a risk factor for the NMO spectrum.

MeSH terms

  • Adolescent
  • Adult
  • Aquaporin 4 / immunology
  • Autoantibodies / blood
  • Autoantibodies / immunology
  • Autoantigens / immunology
  • Female
  • Fluorescent Antibody Technique, Indirect
  • Helicobacter Infections / complications
  • Helicobacter Infections / epidemiology*
  • Helicobacter pylori
  • Humans
  • Male
  • Middle Aged
  • Multiple Sclerosis / immunology
  • Multiple Sclerosis / microbiology*
  • Neuromyelitis Optica / immunology
  • Neuromyelitis Optica / microbiology*
  • Seroepidemiologic Studies
  • Young Adult

Substances

  • AQP4 protein, human
  • Aquaporin 4
  • Autoantibodies
  • Autoantigens