Association between entero-hepatic Helicobacter species and Crohn’s disease: a prospective cross-sectional study


Dr D. Laharie, CHU Bordeaux, Haut-Leveque Hospital, Gastroenterology department, Pessac, F-33600 France.


Background  The pathogenesis of Crohn’s disease (CD) involved microbial factors. Some Helicobacter species, the so-called entero-hepatic Helicobacters (EHH), can naturally colonize the intestinal surface and have been detected in humans.

Aim  To look for an association between CD and the presence of EHH DNA in intestinal biopsies.

Methods  Two groups of patients were included prospectively in a multicentre cross-sectional study: CD patients with an endoscopic post-operative recurrence within 2 years following a surgical resection and controls screened for colorectal polyps or cancer. Intestinal biopsies were taken for Helicobacter culture and Helicobacter 16S DNA detection. If positive, the EHH species were identified with specific PCRs, sequencing and denaturing gradient gel electrophoresis.

Results  In the 165 included patients (73 CD and 92 controls), Helicobacter cultures were negative. PCR was positive in 44% of CD and 47% of controls. After age-adjustment, CD was significantly associated with EHH in intestinal biopsies (OR = 2.58; 95%CI: 1.04–6.67). All EHH species detected were identified as Helicobacter pullorum and the closely related species Helicobacter canadensis.

Conclusion  Crohn’s disease is associated with the presence of EHH species DNA in intestinal biopsies after adjustment for age. Whether these species play a role in the pathophysiology of CD remains to be determined.