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H. pylori and Parkinson's disease: Meta-analyses including clinical severity.
Clin Neurol Neurosurg. 2018 12; 175:16-24.CN

Abstract

The exact etiology of Parkinson's disease (PD) remains unclear. Some evidence supports Helicobacter pylori infection as a trigger or driving event, but detection and eradication of H. pylori are not part of PD management. The aims of this case-control study and meta-analysis were to determine (i) the prevalence of H. pylori infection in PD patients, (ii) associations between H. pylori infection and clinical status, and (iii) differences in motor status in PD patients before and after H. pylori eradication. A literature search was performed using the PubMed database. The prevalence of H. pylori infection in PD, its association with the unified Parkinson's disease rating scale (UPDRS), and the association of H. pylori eradication therapy with the UPDRS-III score were determined by calculating the odds ratios (OR) and the standardized mean differences (SMD) with 95% confidence intervals (CI). Fixed- and random-effects models were applied. Ten studies were included in the first meta-analysis (5043 PD patients, 23,449 HCs); H. pylori infection prevalence was higher in PD patients than in HCs [OR (95% CI): 1.47 (1.27, 1.70), Pz<0.00001]. In seven studies reporting UPDRS scores (150 H. pylori infected, 228 non-infected PD patients), there was a significant association between H. pylori infection and mean UPDRS scores [SMD (95% CI): 0.33 (0.12, 0.54), Pz = 0.003]. Regarding H. pylori eradication, in five studies (90 PD patients), there was a significant reduction in UPDRS-III scores after treatment [SMD (95% CI): 6.83 (2.29, 11.38), Pz = 0.003]. In conclusion, the present meta-analysis revealed a higher prevalence of H. pylori infection in PD patients suggesting that H. pylori may contribute to PD pathophysiology. In addition, the significantly lower UPDRS scores in non-infected PD patients and in patients after H. pylori eradication therapy demonstrate that the infection may deteriorate the clinical severity of the disease.

Authors+Show Affiliations

Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece. Electronic address: edar@med.uth.gr.Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece.Public Health Laboratories, Hellenic Pasteur Institute, Athens, Greece; Department of Microbiology, University Hospital of Larissa, University of Thessaly, Larissa, Greece.Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece.Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece.Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece.Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece.Department of Rheumatology and Clinical Immunology, University Hospital of Larissa, University of Thessaly, Larissa, Greece; Cellular Immunotherapy & Molecular Immunodiagnostics, Biomedical Section, Centre for Research and Technology-Hellas (CERTH), Institute for Research and Technology-Thessaly (IRETETH), Larissa, Greece.Department of Neurology, Papageorgiou General Hospital, Thessaloniki, Greece.Department of Medicine, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Pub Type(s)

Journal Article
Meta-Analysis
Review

Language

eng

PubMed ID

30308319

Citation

Dardiotis, Efthimios, et al. "H. Pylori and Parkinson's Disease: Meta-analyses Including Clinical Severity." Clinical Neurology and Neurosurgery, vol. 175, 2018, pp. 16-24.
Dardiotis E, Tsouris Z, Mentis AA, et al. H. pylori and Parkinson's disease: Meta-analyses including clinical severity. Clin Neurol Neurosurg. 2018;175:16-24.
Dardiotis, E., Tsouris, Z., Mentis, A. A., Siokas, V., Michalopoulou, A., Sokratous, M., Dastamani, M., Bogdanos, D. P., Deretzi, G., & Kountouras, J. (2018). H. pylori and Parkinson's disease: Meta-analyses including clinical severity. Clinical Neurology and Neurosurgery, 175, 16-24. https://doi.org/10.1016/j.clineuro.2018.09.039
Dardiotis E, et al. H. Pylori and Parkinson's Disease: Meta-analyses Including Clinical Severity. Clin Neurol Neurosurg. 2018;175:16-24. PubMed PMID: 30308319.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - H. pylori and Parkinson's disease: Meta-analyses including clinical severity. AU - Dardiotis,Efthimios, AU - Tsouris,Zisis, AU - Mentis,Alexios-Fotios A, AU - Siokas,Vasileios, AU - Michalopoulou,Amalia, AU - Sokratous,Maria, AU - Dastamani,Metaxia, AU - Bogdanos,Dimitrios P, AU - Deretzi,Georgia, AU - Kountouras,Jannis, Y1 - 2018/10/01/ PY - 2018/01/05/received PY - 2018/09/24/revised PY - 2018/09/26/accepted PY - 2018/10/12/pubmed PY - 2019/11/22/medline PY - 2018/10/12/entrez KW - Eradication KW - Helicobacter pylori KW - Infection KW - Meta-analysis KW - Parkinson’s disease KW - UPDRS SP - 16 EP - 24 JF - Clinical neurology and neurosurgery JO - Clin Neurol Neurosurg VL - 175 N2 - The exact etiology of Parkinson's disease (PD) remains unclear. Some evidence supports Helicobacter pylori infection as a trigger or driving event, but detection and eradication of H. pylori are not part of PD management. The aims of this case-control study and meta-analysis were to determine (i) the prevalence of H. pylori infection in PD patients, (ii) associations between H. pylori infection and clinical status, and (iii) differences in motor status in PD patients before and after H. pylori eradication. A literature search was performed using the PubMed database. The prevalence of H. pylori infection in PD, its association with the unified Parkinson's disease rating scale (UPDRS), and the association of H. pylori eradication therapy with the UPDRS-III score were determined by calculating the odds ratios (OR) and the standardized mean differences (SMD) with 95% confidence intervals (CI). Fixed- and random-effects models were applied. Ten studies were included in the first meta-analysis (5043 PD patients, 23,449 HCs); H. pylori infection prevalence was higher in PD patients than in HCs [OR (95% CI): 1.47 (1.27, 1.70), Pz<0.00001]. In seven studies reporting UPDRS scores (150 H. pylori infected, 228 non-infected PD patients), there was a significant association between H. pylori infection and mean UPDRS scores [SMD (95% CI): 0.33 (0.12, 0.54), Pz = 0.003]. Regarding H. pylori eradication, in five studies (90 PD patients), there was a significant reduction in UPDRS-III scores after treatment [SMD (95% CI): 6.83 (2.29, 11.38), Pz = 0.003]. In conclusion, the present meta-analysis revealed a higher prevalence of H. pylori infection in PD patients suggesting that H. pylori may contribute to PD pathophysiology. In addition, the significantly lower UPDRS scores in non-infected PD patients and in patients after H. pylori eradication therapy demonstrate that the infection may deteriorate the clinical severity of the disease. SN - 1872-6968 UR - https://www.unboundmedicine.com/medline/citation/30308319/H__pylori_and_Parkinson's_disease:_Meta_analyses_including_clinical_severity_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0303-8467(18)30401-3 DB - PRIME DP - Unbound Medicine ER -