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Panminerva Medica 2001 December;43(4):279-82

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

The journey from hepatitis to hepatocellular carcinoma. Bridging role of Helicobacter species

Fagoonee S., Pellicano R., Rizzetto M., Ponzetto A.

From the Department of Biology Biochemistry and Genetics, University of Turin, Turin, Italy *Department of Gastro-Hepatology Molinette Hospital, Turin, Italy


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Hepatocellular car­ci­no­ma (HCC) is a ­long-­term con­se­quence of chron­ic liv­er dis­ease, ­whose aetio­lo­gy ­could ­result ­from ­viral, envi­ron­men­tal and hered­i­tary caus­es. Viral infec­tion, by ­itself, ­could ­only par­tial­ly ­explain the path­o­gen­e­sis of cir­rho­sis and HCC. A new aet­io­log­ic ­agent ­capable of induc­ing chron­ic ­active hep­a­titis and hepat­o­cel­lu­lar ­tumours was dis­cov­ered: it is a bac­te­ri­um belong­ing to the ­genus Helicobacter, and ­named H. hepat­i­cus. Presence of sequenc­es belong­ing to the 16S rRNA of Helicobacter species (spp.) has ­been dem­on­strat­ed in liv­er of ­most ­patients ­with cir­rho­sis and HCC. H. pylo­ri and relat­ed bac­te­ria, ­such as H. hepat­i­cus, pro­duce tox­ins ­that ­kill hepat­o­cyte by a gran­u­lat­ing ­effect on liv­er ­cell ­lines. In ­vivo, ­such tox­ins ­might ­reach the liv­er ­through the por­tal ­tract, there­by caus­ing hepat­o­cel­lu­lar dam­age. The rec­og­ni­tion of Helicobacter spp. as a pos­sible ­risk fac­tor for cir­rho­sis and HCC ­might ­have a prac­ti­cal ­impact on the gen­er­al pop­u­la­tion: the treat­ment of ­this infec­tion is ­easy and far ­less expen­sive ­than liv­er trans­plan­ta­tion or any ­long ­term treat­ment for the oth­er ­risk fac­tors of HCC. Any con­fir­ma­tion of the involve­ment of Helicobacter in liv­er dis­ease ­would even­tu­al­ly ­come ­from the suc­cess of cul­tur­ing the bac­te­ri­um ­from liv­er tis­sues. Future ­research is need­ed to clar­i­fy the impor­tance of Helicobacter spp. in ­respect to the oth­er patho­gens ­already ­known as caus­a­tive ­agents of chron­ic inflam­ma­tion of the liv­er and its ­long ­term seque­lae, name­ly cir­rho­sis and HCC.

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