Is There a Correlation between Helicobacter Pylori and Enterohepatic Helicobacter Species and Gallstone Cholecystitis?

Abstract

BACKGROUND Cholecystitis is a common surgical condition. Recently, several authors have reported that DNA of bile tolerant Helicobacter spp. has been found in the human bile colonizing the biliary tract. The aim of this study was to evaluate the association between the presence of Helicobacter spp. and gallstone cholecystitis. METHODS In this case-control study, gallstones, bile, and gallbladder mucosa were collected from 25 patients without gallstone disease, 24 with acute cholecystitis, and 28 with chronic cholecystitis. The presence of Helicobacter pylori (H. pylori), Helicobacter bilis (H. bilis), Helicobacter hepaticus (H. hepaticus) , and Helicobacter pullorum (H. pullorum) were investigated by polymerase chain reaction (PCR) using species-specific primers. RESULTS In this study, 77 subjects with acute and chronic cholecystitis and control groups with a mean age of 46.85 ± 14.53 years, including 58 (67.25%) women and 19 (32.75%) men were included. DNA of 10 Helicobacter spp. was detected in the bile of the patients with cholecystitis including eight H. pylori and two H. bilis. However, we could not detect H. hepaticus and H. pullorum DNA in the samples. Moreover, there was an association between H. pylori and acute cholecystitis (p = 0.048), which was found to be stronger in 31-40-year-olds group (p = 0.003). CONCLUSION We found an association between the presence of H. pylori DNA and acute gallstone cholecystitis. There is not statistically significant correlation between three enterohepatic Helicobacter spp. ( H. bilis, H. hepaticus , and H. pullorum) and cholelithiasis. Given the low sample size of the patients, more studies are required to clear the clinical role of Helicobacter spp. in the gallstone disease and cholecystitis.

Gallstone Disease and Microbiome

“…Many studies have shown that H. pylori and enterohepatic strains of Helicobacter contribute to the formation of cholesterol gallstones [ 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 ]. H. pylori is a Gram-negative, spiral-shaped, motile microorganism.…”

“…Helicobacter spp. and Helicobacter pylori in bile samples, gallbladder tissue, and gallstones were detected by several methods: using cultures [ 52 , 59 , 67 , 71 ], by immunohistochemistry [ 46 ], by urease test, Giemsa, and immunohistochemical stain [ 72 ], by 16S rRNA PCR-amplification, by nested and multiplex PCR [ 47 , 54 , 55 , 56 , 59 , 60 , 61 , 62 , 63 , 64 , 67 , 71 , 73 , 74 , 75 , 76 , 77 ], by PCR-DGGE [ 52 ], both by PCR and by an ELISA study of the specific antigen (H. pylori stool antigen) [ 47 ], by ELISA after a preabsorption step using H. pylori antigens [ 46 , 78 ], by a Western blot analysis of Helicobacter antibodies [ 67 ], or by WMS sequencing and 16S rRNA sequencing on bile samples [ 35 ].…”

“…In the case-control study from Iran, 77 patients with (n = 52) and without (n = 25) gallstones were included [ 59 ]. Bile culture samples were all negative for Helicobacter species.…”

“…DNA were detected in the bile of 19.2% of patients with gallstone cholecystitis; of these, eight (15.3%) were H. pylori and two (3.9%) were H. bilis . No Helicobacter species were detected in gallstones by PCR [ 59 ]. Fatemi et al found an association between the presence of H. pylori DNA in the bile and acute gallstone cholecystitis [ 59 ].…”

Association of Clinicopathological features of cholecystitis with H.pylori infection in Gall bladders

“…Hyperlipidemia, sedentary lifestyle, low fiber, high fat diet, metabolic syndrome and diabetes are the commonest causative factors of gallstone formation leading to cholecystitis. 4 In recent years, few studies from Middle East 5 and Asia (China, 4,6,7 , Iran, 8,9, India 10,11 ) have identified a new causative agent "H pylori" which plays a role in gall stone formation leading to cholecystitis. The initial study dates back to 1996 by Kawaguchi et al 12 who incidentally discovered a microorganism resembling H pylori from a cholecystectomy specimen.…”