Association and Linkage of Definite Multiple Sclerosis with HLA and the Potential Protective Role of Helicobacter Pylori Infection Among Egyptians

Abstract

Background: Multiple sclerosis (MS) is the most common chronic inflammatory demyelinating disease of the central nervous system. The linkage of multiple sclerosis to the Human Leukocyte Antigen (HLA) has been known a few decades ago. Some investigators have shown a relationship between H. pylori infection and Multiple sclerosis development. However, this relationship is still controversial.

Objectives: This study was designed to detect the linkage between HLA-DRB1 types and Multiple Sclerosis development, clinical presentation and course, and to try solving the controversy of the role of H. pylori infection in Multiple Sclerosis.

Methods: This study was carried out on 130 Egyptian individuals at the Neurology department of Mansoura University Hospital in 20122015. Group I included 80 definite relapsing remittent MS patients and Group II included 50 healthy control people. Both patients and control groups were subjected to HLA-DRB1 typing using the INNOLiPA HLA-DRB1 Plus kit. Correlation of HLA-DRB1 type to clinical presentation and course of the disease was tested. Both study groups were subjected to H. pylori CagA and VacA IgG detection in their sera by qualitative immunoassay. All statistical analyses were performed using SPSS version 16.0.

Results: Data pooled from this study showed that number of MS cases with HLA-DRB1 * 1, 4 &7 is statistically significantly higher than it was in the control group (P=0.01, P=0.049 and P=0.02 respectively). The number of control individuals with HLA-DRB1 * 15g &11 types was statistically significantly higher than it was in MS patients (P=0.003 and P<0.001). Data also showed that the frequency of H. pylori antibody positive individuals is more than the negative ones in the MS patients’ group but the difference was statistically insignificant (P>0.05).

Conclusion: Carriers of HLA-DRB1 * 1, 4 &7 are at higher risk to develop MS, HLA-DRB1 * 15g &11 exhibit a protective role against the development of Multiple Sclerosis. H. pylori infection may have a controversial causative relation to Multiple Sclerosis development.