Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2007, vol. 16, nr 4, July-August, p. 537–542

Publication type: original article

Language: English

Helicobacter spp. Infection and Chronic Liver Diseases

Zakażenie Helicobacter spp. a przewlekłe choroby wątroby

Monika Biernat1,, Grażyna Gościniak1,, Krzysztof Simon2,, Brygida Knysz2,, Katarzyna Rotter2,, Joanna Grabińska1,, Katarzyna Fleischer2,

1 Department of Microbiology, Silesian Piasts University of Medicine in Wrocław, Poland

2 Department of Infectious Diseases, Hepatology, and Acquired Immunodeficiency Syndromes, Silesian Piasts University of Medicine in Wrocław, Poland

Abstract

Background. Studies on spiral−sharped bacteria of the genus Helicobacter have focused mainly on Helicobacter pylori. However, in the last few years a great number of novel Helicobacter species have been isolated from animals and humans.
Objectives. The aim of the study was to determine the correlation between infection by Helicobacter spp. such as H. pylori, H. hepaticus, and H. bilis and pathological hepatic changes in patients with chronic liver diseases.
Material and Methods. The study included 56 patients aged 20–60 years diagnosed for various chronic liver diseases, e.g. chronic viral hepatitis types B or C, co−infection of HBV and HCV, autoimmune hepatitis, hemochromatosis, Wilson’s disease, and non−alcoholic fatty liver disease (NAFLD). Thick−needle hepatic biopsy specimens and serum samples from each patient were analyzed. The presence of Helicobacter spp. in the biopsy specimens was determined by culture on solid media and polymerase chain reaction (PCR). The level of anti−H. pylori IgG antibodies in the patients’ sera was detected by ELISA.
Results. Examination of the hepatic biopsies for Helicobacter spp. infection by different culture methods was negative for all samples. The Helicobacter ureB gene was identified by PCR in 7 of the 56 biopsies (12.5%). Among these patients, 5 were diagnosed for hepatitis C or B, 1 for hemochromatosis, and 1 for NAFLD with no identified viral infection. Anti−H. pylori IgG antibodies in the serum samples were detected in 52% of the examined subjects and in all 7 patients with positive PCR results.
Conclusion. The coexistence of H. pylori infection and chronic liver disease, especially viral hepatitis, might be possible in humans. Further studies are needed to clarify the relationship between H. pylori, H. hepaticus, and H. bilis infection and pathological hepatic changes in humans. So far, a detrimental effect of Helicobacter species on the liver could not be confirmed or excluded. There was no correlation between the presence of DNA detected by PCR assay of liver samples and the presence of specific antibodies in the patients’ sera.

Streszczenie

Wprowadzenie. Badania nad drobnoustrojami z rodzaju Helicobacter koncentrowały się do tej pory głównie na zakażeniach wywołanych przez H. pylori. Jednocześnie donoszono o nowych gatunkach tych spiralnych bakterii u zwierząt i ludzi.
Cel pracy. Ustalenie zależności między obecnością zakażenia drobnoustrojami z rodzaju Helicobacter: H. pylori, H. hepaticus i H. bilis a patogenezą zmian patologicznych w wątrobie u pacjentów z przewlekłymi chorobami tego narządu.
Materiał i metody. Badaniami objęto 56 pacjentów obojga płci w wieku 20–60 lat, diagnozowanych i leczonych w Katedrze i Klinice Chorób Zakaźnych, Chorób Wątroby i Nabytych Niedoborów Odpornościowych AM we Wrocławiu z powodu przewlekłych chorób wątroby, takich jak: wirusowe zapalenie wątroby typu B lub C, koinfekcja HBV i HCV, autoimmunologiczne zapalenie wątroby, choroba Wilsona, hemochromatoza, cholestaza, pierwotna marskość żółciowa (PBC) oraz niealkoholowa choroba stłuszczeniowa wątroby (NAFLD – non alcoholic fatty liver disease). Przedmiotem badań było 56 bioptatów pobranych z wątroby (za pomocą biopsji gruboigłowej) oraz 56 próbek surowicy. Badania diagnostyczne wykonano w Katedrze i Zakładzie Mikrobiologii AM we Wrocławiu.
Wyniki. Z materiału biopsyjnego, pobranego od chorych z przewlekłymi chorobami wątroby, nie udało się wyizolować i wyhodować drobnoustrojów z rodzaju Helicobacter. Metodą PCR zidentyfikowano gen ure H. pylori w 7/56 bioptatach (n = 7), tj. u 12,5% pacjentów. U 5 spośród tych pacjentów wykazano zakażenie HBV lub HCV (n = 5), jeden pacjent był chory na hemochromatozę (n = 1), u jednego chorego stwierdzono marskość ze współ− istniejącym stłuszczeniem wątroby i ujemny wynik na obecność zakażenia wirusami hepatotropowymi (n = 1). Przeciwciała klasy IgG anty−H. pylori stwierdzono u 52% zbadanych chorych, przy czym wśród pacjentów z dodatnim wynikiem badania PCR w kierunku zakażenia H. pylori przeciwciała wykryto u 7/7 badanych (100%).
Wnioski. Zakażenie Helicobacter pylori być może współistnieje z przewlekłymi chorobami wątroby u ludzi, a zwłaszcza z zapaleniem wątroby na tle zakażenia wirusami hepatotropowymi. Związek między zakażeniem H. pylori, H. hepaticus, H. bilis a chorobami wątroby u człowieka wymaga dalszych badań, ponieważ dotychczasowe obserwacje nie pozwoliły ani na potwierdzenie, ani na wykluczenie szkodliwego oddziaływania Helicobacter spp. na wątrobę.

Key words

Helicobacter spp., chronic liver diseases

Słowa kluczowe

Helicobacter spp., przewlekłe choroby wątroby

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