Association of the Presence of Helicobacter in Gallbladder Tissue with Cholelithiasis and Cholecystitis

Abstract

The presence of Helicobacter DNA species has been investigated in the biliary epithelium of patients with biliary diseases. However, conflicting results have been observed that may have been due to the small number of subjects studied, difficulty in obtaining a healthy control group, absence of controlling for confounding factors, or differences among populations. Therefore, we investigated the presence of Helicobacter species by culture and nested PCR of 16S rRNA genes in gallbladder tissue and bile from 46 Brazilian subjects with and 18 without cholelithiasis. The control group was mainly composed of liver donors and of patients who had submitted to cholecystectomy as part of the surgical treatment for morbid obesity. No Helicobacter species were grown from the bile or gallbladder tissues. Helicobacter DNA was detected in the gallbladder tissue and bile from 31.3 and 42.9% of the patients, respectively. In a logistic regression model, cholelithiasis was positively and independently associated with the female gender (P ‫؍‬ 0.02), increasing age (P ‫؍‬ 0.002), and the presence of Helicobacter DNA in the gallbladder tissue (P ‫؍‬ 0.009). The presence of Helicobacter DNA in the bile was not associated with cholelithiasis (P ‫؍‬ 0.8). A significant association between the presence of Helicobacter DNA in the gallbladder epithelium and histological cholecystitis, even after adjusting for gender and age (P ‫؍‬ 0.002), was also observed. The sequences of the 16S rRNA genes were >99% similar to that of Helicobacter pylori. In conclusion, our results support the hypothesis that Helicobacter is associated with the pathogenesis of human cholelithiasis and cholecystitis.

Molecular detection of Helicobacter species in the bile and histopathological evaluation of gall bladders of patients with calculus cholycystitis in Duhok province, Kurdistan region of Iraq

“…13 The results of current study revealed a higher figure for the presence of Helicobacter DNA in bile compared to the studies of Ghazal et al, 14 and Lee et al, 15 who reported values of 18% and 25%, respectively. However, our results came in line with those of other researchers 11,16 as high percentages of 42.9% and 96.7%, respectively were recorded for the presence of Helicobacter DNA for patients with different hepatobiliary diseases. Furthermore, it has been declared that 65% bile sample contained DNA of Helicobacter spp.…”

“…are bileresistant, a property that may confer protection against the deleterious effects of bile in vivo and allow them to adapt better to the hepatobiliary surroundings. 11 Interestingly, the first and largestNorth American investigation addressing the issue of Helicobacter in bile revealed that Helicobacter DNA hadn't been detected in all samples involved. This suggests that Helicobacter is not a significant cause of biliary problems in general and this observation came in line with that of the current study as far as H. pylori DNA is looked for but when Helicobacter genus DNA is generally considered, the results of the two studied are contradictory; the discrepancy of results can be argued as it is possible that the organisms preferentially live in the bile canaliculi, as the biochemical nature of bile in this location is distinct from that in the common bile duct.…”

Prevalence of Helicobacter spp in chronic cholecystitis and correlation with changes on the histological pattern of the gallbladder

“…It is a similar prevalence when compared to data from the Chilean and Asian population, higher than previous data from our environment 4,9,10,15 . Perhaps the findings may be related to the fact that the population studied includes only patients with chronic inflammatory processes, which further selected the sample.…”

“…It is a rate of extraction of genetic material considered to be low, a finding that this made us question the efficiency of the method used. But several factors such viscosity and ph of the bile may have hindered the process of dilution and membrane filtration 15 . We found that eventually the amount of bile collected (2 to 3ml) was not enough.…”

“…From reports in literature 9,15,16 referring about the isolation of helicobacter species in bile from the liver and particularly of the gallbladder and its implications in the pathogenesis of diseases, we became interested to assess the prevalence of Helicobacter spp in patients operated on for chronic cholecystitis .…”