ADVERTISEMENT

If you are seeing this message, you may be experiencing temporary network problems. Please wait a few minutes and refresh the page. If the problem persists, you may wish to report it to your local Network Manager.

It is also possible that your web browser is not configured or not able to display style sheets. In this case, although the visual presentation will be degraded, the site should continue to be functional. We recommend using the latest version of Microsoft or Mozilla web browser to help minimise these problems.

Wiley InterScience

< Previous Abstract  |  Next Abstract >

Save Article to My Profile      Download Citation      Request Permissions

Abstract |  References  |  Full Text: HTML, PDF (Size: 219K)  | Related Articles | Citation Tracking

Role of Chronic Infection and Inflammation in the Gastrointestinal Tract in the Etiology and Pathogenesis of Idiopathic Parkinsonism
Part 3: Predicted Probability and Gradients of Severity of Idiopathic Parkinsonism Based on H. pylori Antibody Profile
Clive Weller * , André Charlett , Norman L. Oxlade , Sylvia M. Dobbs *† , R. John Dobbs *† , Dale W. Peterson § and Ingvar T. Bjarnason
  * Section of Clinical Neuropharmacology, Institute of Psychiatry,   Department of Gastroenterology, Guy's, King's, St Thomas' School of Medicine,   Statistics Unit, Health Protection Agency, London,   § Physiology and Pharmacology, University of Hertfordshire, Hatfield, Hertfordshire, UK
Correspondence to   Reprint requests to: John and Sylvia Dobbs (Therapeutics Research Group), Clinical Neuropharmacology, Institute of Psychiatry, De Crespigny Park, London, SE5 8AF, UK. E-mail: dobbs@wellers.demon.co.uk
Copyright © 2005 Blackwell Publishing Ltd
KEYWORDS
Biomarker • idiopathic parkinsonism • Helicobacter pylori • serum antibody immunoblot profile • objective measures facets • biological gradients

ABSTRACT

AbstractMethodsResultsDiscussionReferences

Background. Eradicating Helicobacter may convert rapidly progressive idiopathic parkinsonism to quieter disease, however only a minority of probands have evidence of current infection.

Aim. To explore the cross-sectional fit of parkinsonism as an extra-alimentary consequence of Helicobacter pylori, using the serum antibody profile.

Methods. A discriminant index for parkinsonism was based on the Western Blot pattern of IgG antibodies against electrophoretically separated H. pylori antigens in 124 subjects with idiopathic parkinsonism, 196 without. In parkinsonism, association was assessed between index and 1, anthropometric measures; 2, current and 3, increase over 4 years in hypokinetic and psychomotor/psychometric disability; and 4, a global score of current severity.

Results. Predicted probability of being labeled parkinsonian was greatest with cytotoxin-associated-gene-product (CagA) positivity and vacuolating-toxin negativity (p = .03 and .004, respectively, for antibody-age interactions), and urease-B negativity (p = .03, irrespective of age). In this circumstance, the odds for parkinsonism increased fivefold by age 80 years (p = .001). Helicobacter status, according to anti-urease enzyme-linked immunosorbent assay (ELISA), did not complement the model. Gradients, of clinically relevant size, were found between index and disease burden, despite the potentially confounding effect of antiparkinsonian medication. The higher the index 1, the worse was posture, as gauged by forward displacement of occiput (p = .04), 2, the shorter mean stride-length (p = .003), longer reaction time (= .002) and lesser cognitive efficiency (= .03), 3, the greater their deterioration (p = .006, .002, and .03 respectively), and 4, the greater the overall severity of parkinsonism (< .001).

Conclusion. The apparent importance of H. pylori in the etiology/pathogenesis of idiopathic parkinsonism is not confined to those with evidence of current infection.


DIGITAL OBJECT IDENTIFIER (DOI)
10.1111/j.1523-5378.2005.00329.x About DOI

Related Articles

  • Find other articles like this in Wiley InterScience
  • Find articles in Wiley InterScience written by any of the authors

Wiley InterScience is a member of CrossRef.

Cross Ref Member


Sign Up Now
Sign Up Now
E-mail alerts
Sign up for e-alerts
Click here
Sign Up Now
Wiley Medical Twitter