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

lingua: Inglese

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


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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