Helicobacter species DNA in liver and gastric tissues in children and adolescents with chronic liver disease.
OBJECTIVE
Enterohepatic Helicobacter species (EHS) have previously been found in adults with hepatobiliary diseases. Here, we report the prevalence of Helicobacter pylori and EHS in liver and gastric tissue in children and adolescents with chronic liver disease (CLD).


METHODS
Seventy-seven consecutive children and adolescents with CLD with or without ulcerative colitis or Crohn's disease (UC/CD) were investigated. Tissue samples were analysed using a Helicobacter genus-specific 16S rDNA polymerase chain reaction (PCR) assay and DNA-sequence analysis. Sera from 61 subjects were also analysed using enzyme immunoassay and immunoblotting.


RESULTS
The Helicobacter PCR was positive in 3/23 (13%) livers from patients with primary sclerosing cholangitis and UC, and in 1/2 livers from patients with autoimmune hepatitis (AIH) and UC. Sequenced PCR products matched the 16S rDNA of H. hepaticus, H. muridarum, H. canis, and H. pylori, respectively. H. ganmani and H. bilis were detected in gastric tissues from two AIH patients. H. hepaticus and H. pullorum were found in livers from two patients with acute liver failure and intrahepatic cholestasis. Antibody reactivity to Helicobacter cell-surface proteins was negative.


CONCLUSIONS
H. pylori and EHS can be detected in the livers of some patients with UC and concomitant liver disease, as well as in other children with liver diseases. Multicentre studies from different locations are needed to find out whether these bacteria play a pathogenetic role or whether their presence is an epiphenomenon.
Casswall
Thomas H
TH
Department of Pediatric Gastroenterology, Hepatology and Nutrition, Astrid Lindgren's Children's Hospital at Karolinska University Hospital, CLINTEC, Karolinska Institutet, Stockholm, Sweden. thomas.casswall@ki.se
Németh
Antal
A
Nilsson
Ingrid
I
Wadström
Torkel
T
Nilsson
Hans-Olof
HO
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015209:Cholangitis, Sclerosing / Q000382:microbiology; D002908:Chronic Disease; D004269:DNA, Bacterial / Q000302:isolation & purification*; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology*; D016998:Helicobacter / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D019693:Hepatitis, Autoimmune / Q000382:microbiology; D006801:Humans; D007223:Infant; D008099:Liver / Q000382:microbiology*; D008107:Liver Diseases / Q000382:microbiology*; D008297:Male; D012336:RNA, Ribosomal, 16S / Q000302:isolation & purification; D013270:Stomach / Q000382:microbiology
D004269:DNA, Bacterial; D012336:RNA, Ribosomal, 16S