• Efthimios Dardiotis, Maria Sokratous, Zisis Tsouris, Vasileios Siokas, Alexios-Fotios A Mentis, Athina-Maria Aloizou, Amalia Michalopoulou, Dimitrios P Bogdanos, Georgia Xiromerisiou, Georgia Deretzi, Jannis Kountouras, and Georgios M Hadjigeorgiou.
• Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece.
• Eur. J. Clin. Invest. 2020 May 1; 50 (5): e13218.

BackgroundHelicobacter pylori (H pylori) is a Gram-negative bacterium, considered to trigger autoimmune gastrointestinal disorders. This pathogen has also been linked to the autoimmune sequelae in extra-gastrointestinal diseases and peripheral neuropathies. Guillain-Barré syndrome (GBS) is a serious autoimmune demyelinating disorder of peripheral nerves, usually with a post-infectious onset. About 30% of cases of GBS attributed to by Campylobacter jejuni, so, H pylori, could be also involved. Growing evidence suggests the likely involvement of H pylori infection in the development of GBS. The aim of the current study was to therefore estimate the prevalence of H pylori antibodies in GBS.MethodsA search of the literature was performed, using the PUBMED database, until December 2018. Data were extracted from six case-control studies, and a stratification analysis was conducted according to cerebrospinal fluid (CSF) or serum detection material.ResultsAmong 29 records found, 6 studies met in the inclusion criteria for the meta-analysis. In the CSF subgroup, 105 participants were involved (40 GBS patients and 65 controls), while the serum subgroup included 325 participants (152 GBS and 173 controls). Data were combined using a fixed-effects model. Anti-H pylori IgG were significantly more prevalent in GBS patients compared to controls, in both CSF (95% CI: 9.66-186.56, OR: 42.45, Pz < .00001) and serum (95% CI: 1.30-4.11, OR: 2.31, Pz: .004) subgroups.ConclusionThe present meta-analysis showed a strong association between GBS and the presence of H pylori antibodies, especially in CSF, thereby suggesting a role of H pylori infection in the pathophysiology of GBS.© 2020 Stichting European Society for Clinical Investigation Journal Foundation.

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