Detection of Helicobacter DNA in the Bile from the Obstructed Bile Duct / 대한내과학회지

ABSTRACT

OBJECTIVE: Several newly recognized Helicobacter spp. such as H. hepaticus, H. bilis, H. cholecystus, H. rappini, H. pullorum, can cause persistent hepatitis, hepatoma, cholangiopancreatitis, and cholecystitis in animals. Recently some studies have been reported that Helicobacter DNA can be found in the bile from the patients with diseased bile duct, although its clinical significance is still unclear. The aim of this study is to investigate the existence, and character of Helicobacter in the bile from the obstructed bile duct, and the relationship with pH and the other bacteria found in the bile. METHODS: Twenty-eight bile samples (15 from bile duct cancer, 6 from pancreatic head cancer, 7 from bile duct stones) were obtained from the PTBD route. Bile pH measurement, and Helicobacter culture in microaerophil uric and anaerobic conditions were performed. The primers chosen for polymerase chain reaction (PCR) amplification for detection and characterization were ureA (411 bp) and cagA gene (298 bp), respectively. And primer of 16s rRNA for all known bacteria including Helicobacter was used, and the kinds of bacteria were identified by RFLP. RESULTS: Helicobacter DNA was detected in 39.3%. The bile pH was not related with presence of Helicobacter (7.83 +/-0.41 vs 7.78+/-0.48). The prevalence of cagA was 35.7%, and 16s rRNA was found in 46.4%. The specific 16s rRNA band for Helicobacter was observed in 14.3%. All the culture were not successful. CONCLUSION: Although the Helicobacter spp. were not cultured, Helicobacter exists obviously in the bile from the diseased bile duct, and coexist with other bacteria. These results should stimulate studies to ascertain whether these Helicobacter play a role in the pathogenesis of bile duct diseases in human.