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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Dec 28, 2015; 7(30): 2968-2979
Published online Dec 28, 2015. doi: 10.4254/wjh.v7.i30.2968
Extragastric manifestations of Helicobacter pylori infection: Possible role of bacterium in liver and pancreas diseases
Elizabeth MA Rabelo-Gonçalves, Bruna M Roesler, José MR Zeitune
Elizabeth MA Rabelo-Gonçalves, Bruna M Roesler, Laboratory of Gastroenterology and Hepatology, Center of Diagnosis of Digestive Diseases, State University of Campinas, Campinas, São Paulo 13083-878, Brazil
José MR Zeitune, Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas, Campinas, São Paulo13083-887, Brazil
Author contributions: Rabelo-Gonçalves EMA contributed to the study idea, study design, literature search, manuscript writing and final revision of the article; Roesler BM contributed to the literature search, manuscript writing and final revision of the article; Zeitune JMR contributed to study design, manuscript writing and the final version of the article.
Conflict-of-interest statement: The authors declare no conflict of interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Elizabeth MA Rabelo-Gonçalves, BSc, MSc, Laboratory of Gastroenterology and Hepatology, Center of Diagnosis of Digestive Diseases, State University of Campinas, Rua Carlos Chagas 420, Campinas, São Paulo 13083-878, Brazil. elizabeth.goncalves@gc.unicamp.br
Telephone: +55-19-35218557 Fax: +55-19-35218566
Received: April 27, 2015
Peer-review started: May 4, 2015
First decision: July 6, 2015
Revised: November 26, 2015
Accepted: December 13, 2015
Article in press: December 15, 2015
Published online: December 28, 2015
Processing time: 243 Days and 15.7 Hours
Abstract

Helicobacter pylori (H. pylori) is an ancient microorganism that has co-evolved with humans for over 60000 years. This bacterium typically colonizes the human stomach and it is currently recognized as the most common infectious pathogen of the gastroduodenal tract. Although its chronic infection is associated with gastritis, peptic ulcer, dysplasia, neoplasia, MALT lymphoma and gastric adenocarcinoma, it has been suggested the possible association of H. pylori infection with several extragastric effects including hepatobiliary and pancreatic diseases. Since a microorganism resembling H. pylori was detected in samples from patients with hepatobiliary disorders, several reports have been discussed the possible role of bacteria in hepatic diseases as hepatocellular carcinoma, cirrhosis and hepatic encephalopathy, nonalcoholic fatty liver disease and fibrosis. Additionally, studies have reported the possible association between H. pylori infection and pancreatic diseases, especially because it has been suggested that this infection could change the pancreatic physiology. Some of them have related a possible association between the microorganism and pancreatic cancer. H. pylori infection has also been suggested to play a role in the acute and chronic pancreatitis pathogenesis, autoimmune pancreatitis, diabetes mellitus and metabolic syndrome. Considering that association of H. pylori to liver and pancreas diseases needs further clarification, our work offers a review about the results of some investigations related to the potential pathogenicity of H. pylori in these extragastric diseases.

Keywords: Hepatocellular carcinoma; Cirrhosis; Hepatic encephalopathy; Helicobacter pylori; Nonalcoholic fatty liver disease; Fibrosis; Pancreatitis; Pancreatic cancer; Diabetes mellitus; Metabolic syndrome

Core tip:Helicobacter pylori (H. pylori) has been associated with several extragastric manifestations, including liver and pancreas diseases. Evidence for its role in the pathogenesis of chronic liver diseases and liver carcinoma is supported by several clinical and experimental studies. Furthermore, epidemiologic and serology-based works have reported a possible association between the microorganism and pancreatic cancer. H. pylori infection has also been linked to the acute and chronic pancreatitis pathogenesis and it could be related to the development of autoimmune pancreatitis, diabetes mellitus and metabolic syndrome. This review summarizes recent findings on the possible role of H. pylori infection in the etiology of liver and pancreas disorders.