Pesquisa de Helicobacter spp. no fígado de pacientes submetidosà biópsia hepática para esclarecimento diagnóstico

• Ano de defesa: 2006
• Autor(a) principal: Luciana Diniz Silva
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Minas Gerais; UFMG
• Palavras-chave em Português: isolamento & purificação; DNA/uso diagnóstico; Hepatopatias/; complicações; Infecções por helicobacter/diganóstico; Pancreatopatias/; Vírus da hepatite b/patogenicidade; Helicobacter pylori/; Gastropatias/complicações; Gastropatias; Helicobacter pylori; Hepatopatias/complicações; DNA; Biópsia; Infecções por Helicobater; Pancreatopatias
• Link de acesso: http://hdl.handle.net/1843/ECJS-7K2J37

Helicobacter DNA has been detected in the liver of patients with cirrhosis and hepatocellular carcinoma. These findings indicate a possible causal role of these bacteria in the development of chronic liver diseases. However, in the majority of these studies, only patients infected with hepatitis B or C virus have been evaluated. We investigated prospectively the presence of Helicobacter species in the liver of patients with hepatic diseases of different etiologies as alcohol and auto-immune hepatitis. From March, 2000 to December, 2004, we enrolled 125consecutive patients (65 males; mean age of 52.4 + 15.7 years; range 18 to 93 years) with primary or secondary hepatic diseases. Liver tissue specimens were obtained by laparoscopical or percutaneous biopsy. Helicobacter was investigated in the liver tissue samples by culture andnested-PCR, using specific primers for ureA and gene that codes for the 16S rRNA. H. pylori status was determined by 13C urea breath test and serology. On the basis of the sorological studies associating chronic B virus hepatitis (HBV) and high prevalence of H. pylori gastric infection, HBV markers had also been investigated in the serum samples of all patients. For the first time, Helicobacter strains were isolated from the human liver of three patients and were identified in species by ultra microscopy, immunohistochemistry, biochemical tests andsequencing analysis of amplified PCR products of the gene that codes for the 16S rRNA. Helicobacter DNA was detected in 51 (40.8%) liver tissue specimens. All 16S rDNA amplicons were sequenced and the sequences were more than 99.0% similar to that of H pylori. Inmultivariate analysis, the presence of the bacterium in the liver was associated with pancreatic diseases (especially pancreatic tumors) and with last or current HBV infection, but was not with alcoholic hepatopathy. The presence of Helicobacter DNA in the liver was associated with H.pylori gastric infection, which strongly suggests that the liver is colonized by bacteria arising from the stomach. The presence of the microorganism in the liver was not associated with the presence of hepatic lesions at histology. However, the gastric infection with the bacterium associated with hepatic necroinflammatory lesions. Therefore, these findings suggest that the liver may be colonized by the H. pylori, confirm previous retrospective results and demonstrate associations with other diseases. However, if the presence of the microorganism in the liver is primary or secondary or contributes to the hepatic damage, it will deserve further studies.