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幽门螺杆菌感染的胃外表现:该细菌在肝脏和胰腺疾病中的可能作用。

Extragastric manifestations of Helicobacter pylori infection: Possible role of bacterium in liver and pancreas diseases.

作者信息

Rabelo-Gonçalves Elizabeth Ma, Roesler Bruna M, Zeitune José Mr

机构信息

Elizabeth MA Rabelo-Gonçalves, Bruna M Roesler, Laboratory of Gastroenterology and Hepatology, Center of Diagnosis of Digestive Diseases, State University of Campinas, Campinas, São Paulo 13083-878, Brazil.

出版信息

World J Hepatol. 2015 Dec 28;7(30):2968-79. doi: 10.4254/wjh.v7.i30.2968.

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.

摘要

幽门螺杆菌(H. pylori)是一种古老的微生物,与人类共同进化了6万多年。这种细菌通常定植于人的胃部,目前被认为是胃十二指肠最常见的感染病原体。尽管其慢性感染与胃炎、消化性溃疡、发育异常、肿瘤形成、黏膜相关淋巴组织淋巴瘤和胃腺癌有关,但有人提出幽门螺杆菌感染可能与包括肝胆和胰腺疾病在内的几种胃外效应有关。自从在肝胆疾病患者的样本中检测到一种类似幽门螺杆菌的微生物以来,已有几份报告讨论了该细菌在肝病如肝细胞癌、肝硬化和肝性脑病、非酒精性脂肪性肝病和肝纤维化中的可能作用。此外,研究报告了幽门螺杆菌感染与胰腺疾病之间的可能关联,特别是因为有人提出这种感染可能会改变胰腺生理。其中一些研究将该微生物与胰腺癌之间的可能关联联系起来。幽门螺杆菌感染也被认为在急性和慢性胰腺炎发病机制、自身免疫性胰腺炎、糖尿病和代谢综合征中起作用。鉴于幽门螺杆菌与肝脏和胰腺疾病之间的关联需要进一步阐明,我们的工作对一些与幽门螺杆菌在这些胃外疾病中的潜在致病性相关的研究结果进行了综述。

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