Submitted: 20 Jan 2016
Revised: 10 Mar 2016
Accepted: 21 Mar 2016
First published online: 23 Apr 2016
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The Correlation Between Multiple Sclerosis and <em>Helicobacter pylori </em> Infection

Int J Enteric Pathog, 4(3), 9-36402; DOI:10.15171/ijep.2016.09


The Correlation Between Multiple Sclerosis and Helicobacter pylori Infection

Seyed Farshad Allameh1 ,*, Shahriar Nafissi2, Maziar Seyedian3, Parisa Ayatollahi2, Mehdi Nooraei4, Ali Zargaran1

1 Internal Medicine Department, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
2 Neurology Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
3 Neurology Department, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
4 Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

*Corresponding Author: Seyed Farshad Allameh, Internal Medicine Department, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-9122170093; Fax: +98-2166939922; Email:

Keywords: Multiple Sclerosis, Helicobacter pylori Infection

Dear Editor,

Multiple sclerosis (MS) is a demyelinating disease of central nervous system and has variety of signs and symptoms and many factors affect its development and progression. MS prevalence varies considerably from high levels in North America and Europe to low rates in Eastern Asia and sub-Saharan Africa. In addition, geographical correlations between MS and its prevalence rates have been reported worldwide.

The etiology of MS is still unknown but probably a combination of infectious and non-infectious environmental factors trigger the pathogenesis process in each individual.1 A high Helicobacter pylori frequency has been reported in various disorders of both CNS and MS. Another study indicates the presence of immunomodulating properties of H. pylori administration in an experimental model of MS, suggesting the possible role of H. pylori infection in the pathophysiology of the MS disease.2

Risks such as genetic factors, infectious causes, vitamin D insufficiency, exposure to cigarette smoke, and geographic residence have all been well documented in the literature for MS. But, stress, vaccines, traumatic events and allergies have not been identified as risk factors for MS.2-4 Nowadays, H. Pylori infection is being evaluated for its relationship with MS are considered. We designed a case-control study to evaluate H. Pylori infection status in MS patients.

In this study 21 cases (relapsing-remitting MS) and 35 controls (other neurological diseases) were participated. Patients did not use any antibiotic and proton pump inhibitors. They also did not use steroid and immunosuppressive drugs. Blood samples were collected and serologic studies of H. pylori using ELISA IgG and IgA were performed. We completed demographic form for each patient and control group. There was 16 females and 5 males in MS group and 21 females and 14 males in control group. Mean age of MS patients and the controls was 31.09 years and 32.48 years, respectively. IgG of MS patients and controls was 66.7% and 85.7%, respectively. Mean IgG titer in MS patients and controls was 20.07 and 25.16, respectively. Similarly, mean of IgA titer in MS and control group was 18.57 and 12.88, respectively. Although IgG titer and positivity was lower in MS patients as compared with control group but this difference was not statistically significant.

Low education was seen in 23.8% and 57.1% of MS patients and the controls (P = 0.02, OR = 4.26, CI = 1.27-14.26). Education was not a confounding factor for the association between MS and H. pylori.

This study shows that previous infection with H. pylori may be a protective factor for MS, but this was not statistically significant. It might have been because of low number of patients in case and control groups. This is a pilot study and it should be continued for better results. Some studies support our data5-10 and they mentioned that H. pylori infection could have a protective effect in MS. This can be a part of the ‘hygiene hypothesis.’ Early life infections are essential to prime the immune system for protection against allergic and autoimmune conditions later in life. To reach a strong conclusion, we should carry out another study with a larger number of patients.


We acknowledge the Tehran University of Medical Sciences.

Authors Contributions

SFA, SN and MS developed the original idea. SFA and PA collected the data and MN analyzed the data. SFA and AZ wrote the manuscript.

Conflict of Interest Disclosures



Support was provided by the Tehran University of Medical Sciences.


  1. Leray E, Moreau T, Fromont A, et al. Epidemiology of multiple sclerosis. Rev Neurol (Paris) 2016;172(1):3-13. doi:10.1016/j.neurol.2015.10.006. [Crossref]
  2. Xiao D, Ye X, Zhang N, et al. A meta-analysis of interaction between Epstein-Barr virus and HLA-DRB1*1501 on risk of multiple sclerosis. Sci Rep 2015;5:18083. doi:10.1038/srep18083. [Crossref]
  3. Moses H Jr, Sriram S. An infectious basis for multiple sclerosis: perspectives on the role of chlamydia pneumoniae and other agents. BioDrugs 2001;15(3):199-206.
  4. Leibovitch EC, Jacobson S. Evidence linking HHV-6 with multiple sclerosis: an update. Curr Opin Virol 2014;9:127-133. doi:10.1016/j.coviro.2014.09.016. [Crossref]
  5. Li W, Minohara M, Su JJ, et al. Helicobacter pylori infection is a potential protective factor against conventional multiple sclerosis in the Japanese population. J Neuroimmunol 2007;184(1-2):227-231. doi:10.1016/j.jneuroim.2006.12.010. [Crossref]
  6. Cook KW, Crooks J, Hussain K, et al. Helicobacter pylori infection reduces disease severity in an experimental model of multiple sclerosis. Front Microbiol 2015;6:52. doi:10.3389/fmicb.2015.00052. [Crossref]
  7. Kira J. Helicobacter pylori infection might prove the hygiene hypothesis in multiple sclerosis. J Neurol Neurosurg Psychiatry 2015;86(6):591-592. doi:10.1136/jnnp-2014-309759. [Crossref]
  8. Pedrini MJ, Seewann A, Bennett KA, et al. Helicobacter pylori infection as a protective factor against multiple sclerosis risk in females. J Neurol Neurosurg Psychiatry 2015;86(6):603-607. doi:10.1136/jnnp-2014-309495. [Crossref]
  9. Mohebi N, Mamarabadi M, Moghaddasi M. Relation of helicobacter pylori infection and multiple sclerosis in Iranian patients. Neurol Int 2013;5(2):31-3.
  10. Gavalas E, Kountouras J, Deretzi G, et al. Helicobacter pylori and multiple sclerosis. J Neuroimmunol 2007;188(1-2):187-189. doi:10.1016/j.jneuroim.2007.06.007. [Crossref]