<b><i>Helicobacter pylori</i></b> Infection in Neuromyelitis Optica and Multiple Sclerosis

Abstract

<b><i>Objective:</i></b> To determine the <i>Helicobacter pylori</i> infection status in patients with multiple sclerosis (MS) and neuromyelitis optica (NMO) spectrum. <b><i>Methods:</i></b><i>H. pylori</i> infection was certified by indirect immunofluorescence assay. Aquaporin-4 (AQP4) antibody was detected by cell-based assay. <i>H. pylori</i> seroprevalence was measured in 118 patients with NMO (n = 52), high-risk NMO (hrNMO, longitudinally extensive transverse myelitis, n = 17 and recurrent optic neuritis, n = 7), MS (n = 42) and healthy controls (n = 27). Logistic regression analysis was used to determine associations between <i>H. pylori</i> infection and NMO and MS. <b><i>Results:</i></b><i>H. pylori</i> antibodies were present in 119 serum samples (82.1%, 119/145), with antibody positivity in 90.4% (47/52) of the patients with NMO, 95.8% (23/24) of the patients with hrNMO, 73.8% (31/42) of the patients with MS and 59.3% (16/27) of the controls. NMO spectrum patients had greater positivity for <i>H. pylori</i> than MS patients (p < 0.05) and controls (p < 0.05). The frequency of <i>H. pylori</i> seropositivity did not significantly differ between MS patients and controls (p = 0.726). <i>H. pylori</i> seropositivity was significantly higher in AQP4 antibody-positive patients (54/58, 93.1%; p = 0.038) than in AQP4 antibody-negative patients (48/60, 80%). Logistic regression analysis showed that <i>H. pylori</i> seropositivity was significantly associated with hrNMO [odds ratio (OR) = 9.311, p = 0.005] or hrNMO + NMO (OR = 6.350, p = 0.028). <b><i>Conclusion:</i></b><i>H. pylori</i> infection was present in most Chinese patients with NMO and hrNMO, and may be a risk factor for the NMO spectrum.