Parkinsonism: differential age-trend in Helicobacter pylori antibody.
BACKGROUND
Parkinsonism is associated with prodromal peptic ulceration. Dopamine antagonists provoke experimental ulcer, dopaminergic agents protect, and might inhibit growth of Helicobacter pylori.


OBJECTIVE
To describe the relationship between H. pylori serology and parkinsonism.


METHODS
Serum H. pylori anti-urease-IgG antibody was measured in 105 people with (idiopathic) parkinsonism, 210 without, from same locality. None had received specific eradication therapy.


RESULTS
Controls showed a birth-cohort effect: antibody titre rose from 30 to 90 years (P < 0. 001). Parkinsonism obliterated this (disease status. age interaction, P < 0.05), the differential age trend not being attributable to social class. Those with diagnosed parkinsonism were more likely to be seropositive (odds ratio 2.04 (95% CI: 1.04, 4.22) P < 0.04) before 72.5 years. Overall, titre fell (P=0.01) by 5 (1, 9)% per unit increase in a global, 30-point rating (median 14 (interquartile range 10.5, 17)) of disease severity. No individual category of anti-parkinsonian medication (92% taking) had a differential lowering effect.


CONCLUSIONS
Higher prevalence of seropositivity in parkinsonism, before 8th decade, may be due to host susceptibility/reaction, or, conversely, infection with particular H. pylori strain(s) lowering dopaminergic status. Absence of a birth cohort effect in parkinsonism, despite similar social class representation, may be consequent on eradication, spontaneous (gastric atrophy) or by anti-parkinsonian medication.
Dobbs
R J
RJ
Therapeutics in the Elderly, Research Group, Northwick Park and St Mark's Hospitals, Harrow, UK. dobbs@wellers.demon.co.uk
Charlett
A
A
Dobbs
S M
SM
Weller
C
C
Peterson
D W
DW
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000907:Antibodies, Bacterial / Q000097:blood*; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D016480:Helicobacter pylori / Q000276:immunology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D010300:Parkinson Disease / Q000097:blood / Q000382:microbiology*; D012698:Serologic Tests; D012923:Social Class; D014510:Urease / Q000276:immunology
D000907:Antibodies, Bacterial; D007074:Immunoglobulin G; D014510:Urease