Immunohistochemical detection of Helicobacter pylori vacuolating cytotoxinin the hepatocytes of patients with isolated hypertransaminasaemia

Background and aim, Even if different Helicobacter species can colonise ani mal livers and induce hepatitis, there is no evidence that Helicobacter pyl ori can damage this organ and only a potential capacity of cytotoxic strain s to increase transaminases in humans has been suggested. We have, therefor e, carried out an immunohistochemical study on vacuolating cytotoxin in the hepatocytes of subjects with isolated hypertransaminasaemia. Patients, Methods and Results. Five male patients with isolated hypertransa minasaemia without signs of known causes of liver diseases were studied. En doscopy demonstrated diffuse mucosal hyperaemia in 3 patients and duodenal ulcer in one. Histology revealed active chronic pangastritis in all. Helico bacter pylori was assessed by histology and culture and its cytotoxity, dem onstrated by positive immunoblotting for both anti-CagA and VacA. Percutane ous liver biopsy Showed minimal changes. Hepatic and gastric sections were tested either with autologous serum and rabbit antibody to VacA toxin. Immu ne reaction was revealed by immunoperoxidase. Both autologous sera and anti -VacA toxin antibody showed a reaction with a similar pattern which involve d 60% of hepatocytes. Anti-VacA toxin showed a reaction to gastric epitheli al cells and autologous sera to parietal cells in 4/5 patients. All patient s received triple therapy and eradication of Helicobacter pylori was assess ed by urea breath test. Serum transaminase levels 3 months after eradicatio n, are still abnormal. Conclusions, Our immunohistochemical findings suggest that vacuolating cyto toxin could reach the hepatocytes of patients suffering from both isolated hypertransaminasaemia and infection by cytotoxic strains of Helicobacter py lori. Nevertheless, a clear relationship between these two condition remain s uncertain.