Peptic ulcers, Nobel Prizes and Multiple Sclerosis

It has been a decade now since Barry Marshall and Robin Warren from the University of Western Australia (UWA) were awarded the Nobel Prize for Medicine for discovering the link between Helicobacter Pylori (H.pylori) and the development of peptic ulcers. Famously, their discovery involved Marshall ingesting the bacteria himself in order to prove his hypothesis. In keeping with very many Nobel Prize winners, the duo had to contend with fierce opposition from colleagues within the medical fraternity who simply refused to believe that there was any suggestion that ulcers could be due to infectious organisms.

A decade on, the multiple sclerosis (MS) research group from UWA have collaborated with Barry Marshall to investigate the possible connections between H.pylori and MS development. In a paper that appears in this month’s issue of JNNP, the authors have explored the ‘hygiene hypothesis’ in MS http://jnnp.bmj.com/content/86/6/603.abstract . This hypothesis contends that exposure to infections early in life are able to potentially reduce development of allergic and immune disease later in life through priming of the immune system. In their paper, the authors provide evidence that evidence of exposure to H.pylori is lower in MS patients than in controls. They also demonstrate that female MS patients who have evidence of previous exposure to H.pylori have lower rates of disability than those who do not. In terms of future research, the authors suggest that it would be important to work out why this relationship is only noted female patients and not in male patients.