{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T02:33:15Z","timestamp":1788489195528,"version":"build-2803163510"},"reference-count":79,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,8,31]],"date-time":"2022-08-31T00:00:00Z","timestamp":1661904000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Helicobacter"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There is considerable controversy around the question as to whether <jats:italic>Helicobacter pylori<\/jats:italic> (<jats:italic>H. pylori<\/jats:italic>) infection has a protective or causative role in the development of multiple sclerosis (MS). This study evaluated published information to assess the association between <jats:italic>H. pylori<\/jats:italic> infection and MS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a comprehensive systematic review of relevant observational studies in international databases. A random\u2010effects model was used to calculate pooled odds ratio (OR) and 95% confidence interval (CI). <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> statistic was used to assess the between\u2010study heterogeneity. Subgroup and meta\u2010regression analyses were applied to identify the source of heterogeneity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 22 studies (25 datasets) were eligible for the meta\u2010analysis: 17 datasets had prevalence data and eight datasets had data on the mean titer of anti\u2010<jats:italic>H. pylori<\/jats:italic> IgG. The pooled prevalence of <jats:italic>H. pylori<\/jats:italic> was 44.1% (908\/2606) in the MS patients and 46.1% (1016\/2200) in the controls, indicating a non\u2010significant protective effect of <jats:italic>H. pylori<\/jats:italic> on MS (OR, 0.82; 95%CI, 0.58\u20131.17). In the subgroup analysis, studies that used ELISA yielded a significant protective association (OR, 0.59; 95%CI, 0.46\u20130.77), while a positive non\u2010significant association (OR, 1.33; 95%CI, 0.83\u20132.15) was found from studies that used other serological methods; interestingly, a significant positive association (OR, 6.64; 95%CI, 2.40\u201313.76) was found from studies that used histological methods to detect <jats:italic>H. pylori<\/jats:italic> infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings do not support the hypothesis that <jats:italic>H. pylori<\/jats:italic> infection represents a protective factor against the development of MS; however, the results varied depending on the diagnostic method(s). Particularly, a significant positive association was identified when studies introduced results based on histological examination, suggesting that active <jats:italic>H. pylori<\/jats:italic> infection might be a risk factor for development of MS. Thus, further studies are needed utilizing accurate diagnostic methods to elucidate the association between active <jats:italic>H. pylori<\/jats:italic> infection and MS.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hel.12927","type":"journal-article","created":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T06:25:03Z","timestamp":1662013503000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["<i>Helicobacter pylori<\/i> infection and risk of multiple sclerosis: An updated meta\u2010analysis"],"prefix":"10.1111","volume":"27","author":[{"given":"Delaram","family":"Arjmandi","sequence":"first","affiliation":[{"name":"Immunoregulation Research Center, Health Research Institute Babol University of Medical Sciences  Babol Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Abdollahi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, Tehran Medical 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