Silva Cíntia Presser, Pereira-Lima Júlio Carlos, Oliveira Adriana Gonçalves, Guerra Juliana Becattini, Marques Daniela Lemos, Sarmanho Letícia, Cabral Mônica Maria Demas Alvares, Queiroz Dulciene Maria Magalhães
Fundação Faculdade Federal de Ciências Médicas de Porto Alegre, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
J Clin Microbiol. 2003 Dec;41(12):5615-8. doi: 10.1128/JCM.41.12.5615-5618.2003.
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.
在患有胆道疾病患者的胆管上皮中，已对幽门螺杆菌DNA种类的存在情况进行了研究。然而，观察到的结果相互矛盾，这可能是由于研究对象数量较少、难以获得健康对照组、未对混杂因素进行控制或人群之间存在差异所致。因此，我们通过对46例患有胆结石和18例未患胆结石的巴西受试者的胆囊组织和胆汁进行培养及16S rRNA基因巢式PCR，来研究幽门螺杆菌种类的存在情况。对照组主要由肝脏供体以及作为病态肥胖手术治疗一部分而接受胆囊切除术的患者组成。在胆汁或胆囊组织中未培养出幽门螺杆菌种类。分别在31.3%的患者胆囊组织和42.9%的患者胆汁中检测到幽门螺杆菌DNA。在逻辑回归模型中，胆结石与女性性别（P = 0.02）、年龄增长（P = 0.002）以及胆囊组织中幽门螺杆菌DNA的存在（P = 0.009）呈正相关且独立相关。胆汁中幽门螺杆菌DNA的存在与胆结石无关（P = 0.8）。即使在对性别和年龄进行调整后（P = 0.002），也观察到胆囊上皮中幽门螺杆菌DNA的存在与组织学胆囊炎之间存在显著关联。16S rRNA基因序列与幽门螺杆菌的序列相似度>99%。总之，我们的结果支持幽门螺杆菌与人类胆结石和胆囊炎发病机制相关的假说。
