Correlation between liver damage and degree of gastric mucose colonization by Helicobacter pylori in subjects with parenchymatous liver damage.
BACKGROUND
Helicobacter pylori (H. pylori) is an important factor responsible for chronic inflammatory conditions of the gastric mucosa. It has been demonstrated in numerous animal studies that some Helicobacter species may cause parenchymatous liver damage. The aim of the study was to investigate whether there is any correlation between the incidence of parenchymatous liver damage, and the incidence and degree of colonization of the gastric mucosa by H. pylori.


METHODS
The study was carried out in the group of 30 patients (14 females, 16 males) whose mean age was 37 years, hospitalized because of parenchymatous liver damage without clinical symptoms of cirrhosis. All the patients had gastroscopy and urease tests performed, and mucosal biopsies were taken for immunomorphological investigations. The patients were divided into groups, group I comprising those with positive, and group II with negative urease test results.


RESULTS
Positive urease tests were obtained in 26/30 patients (group I), 18/26 of whom demonstrated macroscopic changes of the gastric mucosa visible in gastroscopy. Group II with negative urease test results comprised 4/30 patients, 2/4 of whom had detectable changes in the gastric mucosa. The presence of H. pylori antigens was demonstrated by gastric mucosa immunomorphology in all 30 patients. The degree of invasion of H. pylori was visualized by immunofluorescence, which allowed to differentiate deep mucosal invasion of H. pylori (bacterial antigens present in lymph follicles and at the base of muciferous glands) observed in group I in 14/26 and in group II in 1/4 cases and superficial invasion (epithelium and mucosal surface) observed in group I in 12/26, in group II in 3/4.


CONCLUSIONS
The obtained results may suggest more frequent H. pylori infections in subjects with parenchymatous liver damage than in the population without liver damage. Immunofluorescence seems to be a highly sensitive method allowing for detection of even small degrees of gastric mucosa colonization by H. pylori.
Stalke
P
P
Clinic of Infection Diseases, Medical University of Gdańsk, ul. Smoluchowskiego 18, 80-214 Gdańsk, Poland. pstalke@amedec.amg.gda.pl
Zółtowska
A
A
Orłowski
M
M
Ellert-Zygadłowska
J
J
Witczak-Malinowska
K
K
Michalska
Z
Z
Lakomy
E A
EA
Trocha
H
H
Stepiński
J
J
D000328:Adult; D000818:Animals; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology*; D016480:Helicobacter pylori / Q000378:metabolism*; D006801:Humans; D008099:Liver / Q000293:injuries* / Q000382:microbiology* / Q000473:pathology*; D008297:Male; D008856:Microscopy, Fluorescence; D008875:Middle Aged; D014510:Urease / Q000378:metabolism
D014510:Urease