DNA sequences and proteic antigens of H. pylori in cholecystic bile and tissue of patients with gallstones.
BACKGROUND
Although Helicobacter pylori DNA sequences have been detected in cholecystic bile and tissue of patients with gallstones, controversial results are reported from different geographic areas.


OBJECTIVE
To detect H. pylori in cholecystic bile and tissue of patients with gallstones from a previously uninvestigated geographic area, southern Italy. Detection included both the bacterial DNA and the specific antigen (H. pylori stool antigen) identified in the stools of infected patients for diagnostic purposes.


METHODS
The study enclosed 33 consecutive patients undergoing laparoscopic cholecystectomy for gallstones. DNA sequences of H. pylori were detected by polymerase chain reaction in both cholecystic bile and tissue homogenate. Moreover, we assayed H.pylori stool antigen on gall-bladder cytosolic and biliary proteins after their extraction. Bacterial presence in the stomach was assessed by urea breath test in all patients and Deltadelta13CPDB value assumed as marker of intragastric load. Fisher's exact probability and Student's t-tests were used for statistical analysis.


RESULTS
DNA sequences of H. pylori in bile were found in 51.5% and significantly correlated with its presence in cholecystic tissue homogenate (P<0.005), H. pylori stool antigen in gall-bladder (P=0.0013) and bile (P=0.04) proteins, gastric infection (P<0.01) and intragastric bacterial load (P<0.001). No correlation was found, however, with sex and age of the patients.


CONCLUSIONS
Our prevalence value of bacterial DNA in bile and gall-bladder of patients with gallstones agreed with that of the only other Italian study. The simultaneous presence of both bacterial DNA and proteic antigen suggests that the same prototype of bacterium could be located at both intestinal and cholecystic level and, therefore, the intestine represents the source of biliary contagion.
Neri
V
V
Section of General Surgery, Department of Surgical Sciences, University of Foggia, Foggia, Italy.
Margiotta
M
M
de Francesco
V
V
Ambrosi
A
A
Valle
N Della
ND
Fersini
A
A
Tartaglia
N
N
Minenna
M F
MF
Ricciardelli
C
C
Giorgio
F
F
Panella
C
C
Ierardi
E
E
D000368:Aged; D000942:Antigens, Bacterial / Q000032:analysis; D001646:Bile / Q000382:microbiology*; D001944:Breath Tests; D017081:Cholecystectomy, Laparoscopic; D041761:Cholecystolithiasis / Q000382:microbiology* / Q000601:surgery; D004269:DNA, Bacterial / Q000032:analysis; D005260:Female; D005704:Gallbladder / Q000382:microbiology; D042882:Gallstones / Q000382:microbiology* / Q000601:surgery; D016481:Helicobacter Infections / Q000150:complications* / Q000175:diagnosis; D016480:Helicobacter pylori / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods; D013270:Stomach / Q000382:microbiology
D000942:Antigens, Bacterial; D004269:DNA, Bacterial