title: Eradication of Helicobacter pylori may be beneficial in the management of Alzheimer's disease.
abstract: Infectious agents have been proposed as potential causes of Alzheimer's disease (AD). Recently, we documented a high prevalence of Helicobacter pylori (Hp) infection in patients with AD. We aim to access the effect of Hp eradication on the AD cognitive (MMSE: Mini Mental State Examination and CAMCOG: Cambridge Cognitive Examination for the Elderly) and functional (FRSSD: Functional Rating Scale for Symptoms of Dementia) status parameters. In the first part of the study, a total of 50 consecutive patients with AD and 30 age-matched anaemic controls underwent an upper gastrointestinal endoscopy, and gastric mucosal biopsies were obtained to detect the presence of Hp infection by histologic analysis and rapid urease test. Serum anti-Hp-specific IgG level was analysed by enzyme-linked immunosorbent assay. In the second part, Hp-positive AD patients received a triple eradication regimen (omeprazole, clarithromycin and amoxicillin), and all patients were followed up for 2 years, while under the same treatment with cholinesterase inhibitors. Hp was detected in 88% of AD patients and in 46.7% of controls (P < 0.001). Hp eradication was successful in 84.8% of treated patients. At the 2-year clinical endpoint, cognitive and functional status parameters improved in the subgroup of patients where Hp eradication was successful (P < 0.001 and P = 0.049 for MMSE and CAMCOG, respectively; P < 0.001 for FRSSD), but not in the other patients. Hp eradication may positively influence AD manifestations, suggesting a possible common link between Hp and AD.
authors.affiliation: Department of Gastroenterology, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece. jannis@med.auth.gr
authors.forename: Jannis
authors.initials: J
authors.lastname: Kountouras
authors.forename: Marina
authors.initials: M
authors.lastname: Boziki
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Gavalas
authors.forename: Christos
authors.initials: C
authors.lastname: Zavos
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Grigoriadis
authors.forename: Georgia
authors.initials: G
authors.lastname: Deretzi
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Tzilves
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Katsinelos
authors.forename: Magda
authors.initials: M
authors.lastname: Tsolaki
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Chatzopoulos
authors.forename: Ioannis
authors.initials: I
authors.lastname: Venizelos
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000453:epidemiology* / Q000517:prevention & control; D000658:Amoxicillin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D000897:Anti-Ulcer Agents / Q000008:administration & dosage; D001706:Biopsy; D017291:Clarithromycin / Q000008:administration & dosage; D003072:Cognition Disorders / Q000188:drug therapy / Q000382:microbiology / Q000517:prevention & control; D015897:Comorbidity; D023381:Endpoint Determination; D005260:Female; D005753:Gastric Mucosa / Q000187:drug effects / Q000382:microbiology / Q000473:pathology; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009853:Omeprazole / Q000008:administration & dosage; D015995:Prevalence; D016896:Treatment Outcome; D014510:Urease / Q000032:analysis / Q000097:blood
chemical_list: D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D000658:Amoxicillin; D014510:Urease; D017291:Clarithromycin; D009853:Omeprazole