title: Impact of Helicobacter pylori on multiple sclerosis-related clinically isolated syndrome.
abstract: OBJECTIVE
  There are no data regarding the relationship between Helicobacter pylori infection (Hp-I) and clinically isolated syndrome (CIS) suggestive of multiple sclerosis. The purpose of this pilot study was to investigate the association between active Hp-I, confirmed by histology, and CIS and to evaluate the impact of Hp eradication on the CIS clinical course.
  
  
  METHODS
  We conducted a study on 48 patients with CIS and 20 matched controls. At baseline, apart from histology, serum anti-Hp-specific IgG titer, inflammatory mediators, and HLA-A, HLA-B, HLA-DR genetic polymorphisms were estimated. Hp-positive patients received standard triple eradication regimen, and all patients were followed up for 2 years.
  
  
  RESULTS
  The prevalence of Hp-I was significantly higher in patients with CIS (43/48, 89.6%) than in control (10/20, 50%) (P < 0.001, OR: 8.6, 95% CI: 2.4-30.8). When compared with controls, patients with CIS also showed significantly higher serum anti-Hp IgG titer and HLA-A26, HLA-A30, and HLA-B57 frequencies. Hp-positive patients also showed higher serum concentrations of inflammatory cytokines and homocysteine. At 2-year clinical endpoint, in the subgroup of CIS patients with successful Hp eradication, the number of patients who presented with a second episode was significantly lower accompanied by significant improvement in mean Expanded Disability Status Scale score.
  
  
  CONCLUSIONS
  Hp-I seems more frequent in a Greek CIS cohort and its eradication might delay CIS progression, suggesting a possible link between Hp-I and CIS.
authors.affiliation: Multiple Sclerosis Unit, Department of Neurology, "Papageorgiou" Hospital, Thessaloniki, Greece.
authors.forename: G
authors.initials: G
authors.lastname: Deretzi
authors.affiliation: Department of Medicine, Second Medical Clinic, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Greece.
authors.forename: E
authors.initials: E
authors.lastname: Gavalas
authors.affiliation: 2nd Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: M
authors.initials: M
authors.lastname: Boziki
authors.affiliation: Multiple Sclerosis Unit, Department of Neurology, "Papageorgiou" Hospital, Thessaloniki, Greece.
authors.forename: D
authors.initials: D
authors.lastname: Tsiptsios
authors.affiliation: Department of Medicine, Second Medical Clinic, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Greece.
authors.forename: S A
authors.initials: SA
authors.lastname: Polyzos
authors.affiliation: Department of Medicine, Second Medical Clinic, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Greece.
authors.forename: I
authors.initials: I
authors.lastname: Venizelos
authors.affiliation: Department of Medicine, Second Medical Clinic, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Greece.
authors.forename: C
authors.initials: C
authors.lastname: Zavos
authors.affiliation: Multiple Sclerosis Unit, Department of Neurology, "Papageorgiou" Hospital, Thessaloniki, Greece.
authors.forename: E
authors.initials: E
authors.lastname: Koutlas
authors.affiliation: Multiple Sclerosis Unit, Department of Neurology, "Papageorgiou" Hospital, Thessaloniki, Greece.
authors.forename: I
authors.initials: I
authors.lastname: Tsiptsios
authors.affiliation: Department of Medicine, Second Medical Clinic, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Greece.
authors.forename: P
authors.initials: P
authors.lastname: Katsinelos
authors.affiliation: Department of Medicine, Second Medical Clinic, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Greece.
authors.forename: J
authors.initials: J
authors.lastname: Kountouras
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003711:Demyelinating Diseases / Q000097:blood / Q000453:epidemiology*; D005260:Female; D006115:Greece; D015234:HLA-A Antigens / Q000097:blood; D015235:HLA-B Antigens / Q000097:blood; D016481:Helicobacter Infections / Q000097:blood / Q000453:epidemiology*; D016480:Helicobacter pylori / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence
chemical_list: D015234:HLA-A Antigens; C039683:HLA-A*26 antigen; C069526:HLA-A*30 antigen; D015235:HLA-B Antigens; C103707:HLA-B57 antigen
keywords: HLA alleles; Helicobacter pylori; clinically isolated syndrome; histological analysis; multiple sclerosis; proinflammatory cytokines