Can helicobacter pylori infection reduce the risk of Multiple sclerosis? A systematic review and meta-analysis

Abstract

Background: Several studies propose the protective effect of Helicobacter pylori (HP) in reducing the risk of Multiple sclerosis (MS) whereas the others reported high HP seropositivity in the MS population. Hence, we aimed to perform a comprehensive systematic review and meta-analysis to investigate the association between the risk of MS and HP infection. Methods: A systematic literature search was performed using three databases including PubMed, Scopus, and Web of Science in June 2022. We selected observational studies (cross-sectional, casecontrol, and cohort) that assessed the association between MS and HP. Results: A total of 14 articles with 2307 patients with MS and 2024 controls were included in our systematic review and meta-analysis. The pooled odds ratio (OR) estimates for HP was 0.70 (CI 95%: 0.53-0.93) which indicates HP might reduce the risk of MS. The OR for HP in developed countries was 0.71 (CI 95%: 0.57-0.87) while it was 0.72 (CI 95%: 0.43-1.21) in developing countries. Furthermore, the pooled prevalence of HP in patients with MS was 45% (CI 95%: 35%-56%). The overall prevalence estimated for HP in MS patients in developed countries was 32% (CI 95%: 22%-41%). The prevalence of HP in MS patients from developing countries was 56% (CI 95%: 43%-69%) which was higher than in developed countries. Conclusion:In conclusion, this systematic review and meta-analysis showed a lower rate of HP infection in patients with MS, suggesting that HP may reduce the risk of MS occurrence. However, further investigation with a large sample size while adjusting for the effect of other leading factors should be conducted to confirm our results.