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Eradication of Helicobacter pylori may be beneficial in the management of Alzheimer’s disease

Journal of Neurology volume 256, pages 758–767 (2009)Cite this article

Abstract

Infectious agents have been proposed as potential causes of Alzheimer’s disease (AD). Recently, we documented a high prevalence of Helicobacter pylori (Hp) infection in patients with AD. We aim to access the effect of Hp eradication on the AD cognitive (MMSE: Mini Mental State Examination and CAMCOG: Cambridge Cognitive Examination for the Elderly) and functional (FRSSD: Functional Rating Scale for Symptoms of Dementia) status parameters. In the first part of the study, a total of 50 consecutive patients with AD and 30 age-matched anaemic controls underwent an upper gastrointestinal endoscopy, and gastric mucosal biopsies were obtained to detect the presence of Hp infection by histologic analysis and rapid urease test. Serum anti-Hp-specific IgG level was analysed by enzyme-linked immunosorbent assay. In the second part, Hp-positive AD patients received a triple eradication regimen (omeprazole, clarithromycin and amoxicillin), and all patients were followed up for 2 years, while under the same treatment with cholinesterase inhibitors. Hp was detected in 88% of AD patients and in 46.7% of controls (P < 0.001). Hp eradication was successful in 84.8% of treated patients. At the 2-year clinical endpoint, cognitive and functional status parameters improved in the subgroup of patients where Hp eradication was successful (P < 0.001 and P = 0.049 for MMSE and CAMCOG, respectively; P < 0.001 for FRSSD), but not in the other patients. Hp eradication may positively influence AD manifestations, suggesting a possible common link between Hp and AD.

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Authors and Affiliations

  1. Department of Gastroenterology, Second Medical Clinic, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Jannis Kountouras, Emmanuel Gavalas, Christos Zavos, Georgia Deretzi, Dimitrios Tzilves, Dimitrios Chatzopoulos & Ioannis Venizelos

  2. B’ Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Marina Boziki & Nikolaos Grigoriadis

  3. Department of Endoscopy and Motility Unit, Central Hospital, Thessaloniki, Greece

    Panagiotis Katsinelos

  4. Third Neurological Clinic, Papanikolaou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Magda Tsolaki

  5. 8 Fanariou St, Byzantio, 551 33, Thessaloniki, Macedonia, Greece

    Jannis Kountouras

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  1. Jannis Kountouras
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  2. Marina Boziki
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  3. Emmanuel Gavalas
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Correspondence to Jannis Kountouras.

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Kountouras, J., Boziki, M., Gavalas, E. et al. Eradication of Helicobacter pylori may be beneficial in the management of Alzheimer’s disease. J Neurol 256, 758–767 (2009). https://doi.org/10.1007/s00415-009-5011-z

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