Extragastric manifestations ofHelicobacter pyloriinfection: Possible role of bacterium in liver and pancreas diseases

Abstract

Helicobacter pylori (H. pylori) is an ancient microorganism that has co-evolved with humans for over 60000 years. This bacterium typically colonizes the human stomach and it is currently recognized as the most common infectious pathogen of the gastroduodenal tract. Although its chronic infection is associated with gastritis, peptic ulcer, dysplasia, neoplasia, MALT lymphoma and gastric adenocarcinoma, it has been suggested the possible association of H. pylori infection with several extragastric effects including hepatobiliary and pancreatic diseases. Since a microorganism resembling H. pylori was detected in samples from patients with hepatobiliary disorders, several reports have been discussed the possible role of bacteria in hepatic diseases as hepatocellular carcinoma, cirrhosis and hepatic encephalopathy, nonalcoholic fatty liver disease and fibrosis. Additionally, studies have reported the possible association between H. pylori infection and pancreatic diseases, especially because it has been suggested that this infection could change the pancreatic physiology. Some of them have related a possible association between the microorganism and pancreatic cancer. H. pylori infection has also been suggested to play a role in the acute and chronic pancreatitis pathogenesis, autoimmune pancreatitis, diabetes mellitus and metabolic syndrome. Considering that association of H. pylori to liver and pancreas diseases needs further clarification, our work offers a review about the results of some investigations related to the potential pathogenicity of H. pylori in these extragastric diseases.

Co-infections with liver fluke and Helicobacter species: A paradigm change in pathogenesis of opisthorchiasis and cholangiocarcinoma?

“…Virulence factors of H. pylori including cytotoxin-associated gene A (CagA) and vacuolating cytotoxin A (VacA) contribute to the pathogenesis of H. pylori -associated disease [18, 19]. Although chronic H. pylori infection is associated with the stomach possible association with several extragastric complications including hepatobiliary and pancreatic diseases have been proposed [20, 21]. There is strong evidence that H. pylori seropositivity and biliary tract cancer with overall OR 5.47 and, specifically, for extrahepatic (OR 7.01) and intrahepatic cancer (OR 10.67) but not for hepatocellular carcinoma in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) cohort [22].…”

Metformin and risk of hepatocellular carcinoma in patients with type 2 diabetes

“…Viral hepatitis B and C are the main causes of HCC in countries with a high incidence, but alcohol, obesity and type 2 diabetes mellitus may be responsible in more developed countries . Risk factors that have not yet been confirmed include Helicobacter pylori infection, gallstones and fibrate use …”

Fatty pancreas: A possible risk factor for pancreatic cancer in animals and humans

“…Infection and autoimmune diseases are also involved in the development of fatty pancreas . Infection by Helicobacter pylori in humans and infection by Coxsackie B viruses in mice have been reported to cause severe pancreatitis and lead to the replacement of damaged acinar cells with adipocytes . Human immunodeficiency virus‐1 infection and/or antiretroviral therapy are also known to cause lipomatosis …”