Submitted by Jim K on Sun, 2006-08-13 00:45

Editorial comment: A meta-analysis is a method which tries to group results from a number of different studies, statistically balancing for differences in the ways studies gather data as well as the numbers of subjects involved (and thus sensitivity levels) in different studies. There is a lot of controversy about the validity of the ways in which meta-analysis lumps apples and oranges together. Nonetheless, it is seen as a useful method to see the trends emerging when there is not yet a large-scale highly sensitive study of a problem area.This meta-analysis shows that MS is more strongly associated with Cpn DNA, and Cpn intrathecally synthesized immunoglobulins and immunoglobulins in the cerebrospinal fluid .  While the association is not strong enough to be "causal"  it is quite remarkable that a strong association is emergent from such disparite studies.Jim K 1: Mult Scler. 2006 Aug;12(4):397-411. LinksChlamydia pneumoniae infection and the risk of multiple sclerosis: a meta-analysis.Bagos PG, Nikolopoulos G, Ioannidis A.Department of Cell Biology and Biophysics, Faculty of Biology, University of Athens, Panepistimiopolis, Athens, 15701, Greece. pbagos@biol.uoa.grWe conducted a meta-analysis of studies comparing the presence of Chlamydia pneumoniae (Cpn) between multiple sclerosis (MS) patients and other neurological diseases patients or healthy controls. We identified 26 studies with 1332 MS patients and 1464 controls. Using random-effects methods, MS patients were found more likely to have detectable levels of Cpn DNA (OR = 3.216; 95% CI: 1.204, 8.585) in their cerebrospinal fluid, and intrathecally synthesized immunoglobulins (OR = 3.842; 95% CI: 1.317, 11.212), compared to other patients with neurological diseases. There is no evidence for increased levels of serum immunoglobulins (OR = 1.068; 95% CI: 0.745, 1.530), even though this result is confounded by the presence of studies using normal subjects as controls. Similarly, there is no evidence for association of immunoglobulins against Cpn in the cerebrospinal fluid (OR = 3.815; 95% CI: 0.715, 20.369). Up to 59.7% of the between-studies variability could be explained by the inappropriate matching of cases and controls for gender. In random-effects meta-regressions, adjusting for the confounding effect of gender differences results in stronger and statistically significant associations of MS with detectable levels of Cpn DNA, intrathecally synthesized immunoglobulins and immunoglobulins in the cerebrospinal fluid. Even though the presence of Cpn is clearly more likely in MS patients, these findings are insufficient to establish an etiologic relation.PMID: 16900753 [PubMed - in process]<!--break-->


I'm astonished that a meta-analysis (a genre that puts one in mind of Macbeth and Banquo's ride across the blasted heath: lightning flickers: dim figures are momentarily seen dropping things into a cauldron) produced such a positive result. Meta-analyses are, generally speaking, an unhappy form.

D W - [Myalgia and hypertension (typically 155/95.) Began (2003) taking doxycycline and macrolide and later adding metronidazole. No medication now. Morning BP typically 110/75]

David- Quite so. When all that "eye of newt" magical statistical formula actually churns out something, there must be something real going on somewhere. Could Cpn actually have something to do with MS? By God, a meta-analysis says... maybe!Combined Antibiotic Protocol for Chlamydia pneumonia in Chronic Fatigue Syndrome &amp; Fibromyalgia- Currently: 150mg INH, Doxycycline/Zithromycin, Tinidazole pulses. Northern Ohio, USA

Oh you guys! I just want to comment that in the nurses study there was an association with progressive MS and CPn. It is possible this data was included in the meta analysis making my comment pointless, but I wanted to say it anyway...abstract HERE It is not as if it is a new idea really
On CAP since Sept '05 for MS, RA, Asthma, sciatica. EDSS at start 5.5.
"Color out side the lines!"

On CAP since Sept '05 for MS, RA, Asthma, sciatica. EDSS at start 5.5.(early cane) Now 6 (cane full time) Originally on: Doxy 200, Azith 3x week, Tini cont. over summer '07, Revamp of protocol in Summer '08 by Stratton due to functional loss; clarithro

You guys indeed:  I thought my candida images were bad enough!  (Even if I was hungry and typed chlamydia accidentally first of all, then deleted them and started again.)..............Sarah  Started the Wheldon regime in August 2003, due to very aggressive SPMS.  Moved to intermittent therapy after one year.  In May 2006 still take this, two weeks every two months.  EDSS was about 7, now less than 2. An Itinerary in Light and Shadow  Berger.

Completed Stratton/Wheldon regime for aggressive secondary progressive MS in June 2007, after four years, three of which intermittent.   Still improving bit by bit and no relapses since finishing treatment.

Great meta analysis - CPN can either be a trigger for MS or exacerbate MS - clear in the full paper.  How will any medic argue against using the Wheldon CAP after this paper ?  Probably it will be ignored, despite its publication in the journal Multiple Sclerosis. Mark Walker - Oxford, England.RRMS since 91, Dx 97, CFS Jan03.  Patient of David Wheldon Feb06, started CAP Mar06. Pharmaceutical Consultant (until I stopped working in Jan03).

Mark Walker - Oxford, England.RRMS Nov 91, Dx 97. CFS Jan03. Copaxone + continuous CAP (NAC, Dox, Rox) Feb06 to May 07. Met pulses from Jun06. Intermittent Abx from June 07 onwards.

 Mark- great to see you back on the site. Haven't seen your posts for a while, and I miss your science-minded presence here. Combined Antibiotic Protocol for Chlamydia pneumonia in Chronic Fatigue Syndrome &amp; Fibromyalgia- Currently: 150mg INH, Doxycycline/Zithromycin, Tinidazole pulses. Northern Ohio, USA