Objective: The aim of this study was to investigate the association between Helicobacter pylori (H. pylori) infection and the risk of Parkinson’s disease (PD).

Background: Previous studies have produced controversial results regarding the association between Helicobacter pylori (H. pylori) infection and the risk of Parkinson’s disease (PD).

Method: We conducted a large retrospective cohort which included 118,531 subjects who underwent H. pylori breath tests during the years 2000-2012. Hierarchical Cox proportion hazard models, a logistic regression and Kaplan-Meier curves were applied in order to evaluate this association.

Results: Men with positive H. pylori breath test results had a significantly lower risk for PD (crude HR=0.65, 95%CI 0.48-0.88). Adjustment for age yielded a non-significant PD risk (HR=0.86, 95%CI 0.64-1.16). Stratification by socioeconomic status yielded the same trend for men with lower socioeconomic status (crude HR: 0.62, 95%CI 0.43-0.91, age-adjusted HR=0.85, 95%CI 0.58-1.24).  Sensitivity analyses of 1 year, 3 years and 5 years lag demonstrated  similar results, with lower risk for PD in men with positive H. pylori breath test result. The cumulative probability for PD among men with positive breath test result during a ten years follow-up period was also significantly lower (p=0.005), with the same trend for men with lower socioeconomic status (p=0.013). Finally, the risk of positive H. pylori breath test result among PD patients was statistically lower as compared to non-PD subjects.

Conclusion: Our findings do not support an association between H. pylori infection and increased risk for PD. Given the common practice that patients diagnosed with H. pylori are classically subjected to antibiotics treatment, leading to eradication of H. pylori and changes in the GI microbiome, we hypothesize that treating H. pylori infection may decrease the risk to develop PD through effect on the GI microbiome. Based on the present study, we propose that subjects who are at increased risk for PD due to genetic susceptibility should be screened for H. pylori infection by breath tests from age 40 onwards.

*Statistical analyses based on the present cohort were previously presented in the 6^th EAN congress in 2020. In the current submission we present new statistical analyses as well as a new medical hypothesis based on our results.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/can-treatment-of-helicobacter-pylori-decrease-parkinsons-disease-risk/