To the Editor

Sir,

We read with great interest the recent article by Murakami et al. [1]. The study reported in the article evaluated the pathological relationship between Helicobacter hepaticus infection and gastrointestinal diseases, by measurements of serum anti-H. hepaticus antibody levels in patients with various gastrointestinal diseases. In the literature it has been reported that the presence of abnormal intestinal permeability in patients with chronic liver disease can result in the increased exposure of gut-derived antigens, including microbial antigens, to the immune system and specifically to the liver [2]. In this way Helicobacter species have also been proposed to be implicated in the pathogenesis of primary biliary cirrhosis (PBC), because their DNA has been found in liver tissue, and antibodies to the microbe have been found in the serum and the bile of patients with PBC [3]. In addition, PBC is frequently associated with other autoimmune disorders; in particular, with celiac disease (CD). There are several common pathogenetic mechanisms that occur in these diseases and they include increased intestinal permeability, which is an early abnormality in CD and has also been demonstrated in PBC. Did Murakami et al. [1]detect CD blood markers in their PBC patients?