School of Pharmacy, Kitasato University, Tokyo, Japan.
Center of Education in Kongsvinger, Kongsvinger, Norway.
Helicobacter. 2020 Oct;25(5):e12700. doi: 10.1111/hel.12700. Epub 2020 Aug 13.
The clinical significance of non-Helicobacter pylori Helicobacter (NHPH) is still unknown. There are many reports of NHPH-infected patients suffering from gastric diseases. Here, we investigated the polymerase chain reaction (PCR) positivity of NHPH infection in gastric disease patients who were negative for H. pylori (Hp) by the rapid urease test and by pathological observation.
We collected the 296 endoscopically obtained gastric mucosal samples of Hp-negative gastric disease patients diagnosed based on a rapid urease test and pathology from 17 hospitals in Japan from September 2013 to June 2019, and we analyzed the existence of Hp and NHPH by PCR. The samples were also treated by indirect immunohistochemistry using an anti-Helicobacter suis VacA paralog antibody and were observed by confocal laser microscopy.
Among the 236 non-Hp-eradicated cases, 49 cases (20.8%) were positive for NHPH. Among them, 20 cases were positive for Helicobacter suis, 7 cases were positive for Helicobacter heilmannii sensu stricto/ Helicobacter ailurogastricus (Hhss/Ha), and the other 22 cases could not be identified. The regional differences in the infection rates were significant. Forty percent of the nodular gastritis cases, 24% of the MALT lymphoma, 17% of the chronic gastritis cases, and 33% of the gastroduodenal ulcer cases were NHPH positive. Forty-five patients had been treated with one of the four types of combinations of a proton pump inhibitor and two antibiotics, and in all of these cases, the NHPH diagnosed by PCR was successfully eradicated. Immunohistochemistry using the Helicobacter suis-specific HsvA antibody coincided well with the PCR results. Among the 29 post-Hp eradication cases, three were NHPH positive, including one Hhss/Ha-positive case. Thus, approx. 20% of the Hp-negative non-Hp-eradicated gastric disease patients treated at 17 hospitals in Japan were infected with NHPH.
非幽门螺杆菌 Helicobacter（NHPH）的临床意义尚不清楚。有许多报道称，NHPH 感染患者患有胃部疾病。在这里，我们通过快速尿素酶试验和病理观察，调查了经快速尿素酶试验和病理检查诊断为 H. pylori（Hp）阴性的胃部疾病患者中 NHPH 感染的聚合酶链反应（PCR）阳性率。
我们收集了 2013 年 9 月至 2019 年 6 月，来自日本 17 家医院的 296 例经内镜获得的 Hp 阴性胃部疾病患者的胃黏膜标本，通过 PCR 分析 Hp 和 NHPH 的存在。还使用抗 Helicobacter suis VacA 同工型抗体通过间接免疫组织化学处理这些样本，并通过共聚焦激光显微镜进行观察。
在 236 例非 Hp 根除病例中，49 例（20.8%）NHPH 阳性。其中，20 例为 Helicobacter suis 阳性，7 例为 Helicobacter heilmannii sensu stricto/ Helicobacter ailurogastricus（Hhss/Ha）阳性，其余 22 例无法鉴定。感染率的区域差异显著。结节性胃炎病例中 40%、黏膜相关淋巴组织淋巴瘤病例中 24%、慢性胃炎病例中 17%、胃十二指肠溃疡病例中 33%为 NHPH 阳性。45 例患者接受了质子泵抑制剂加两种抗生素的四种组合之一的治疗，PCR 诊断的 NHPH 在所有这些病例中均成功根除。使用 Helicobacter suis 特异性 HsvA 抗体的免疫组织化学与 PCR 结果吻合良好。在 29 例 Hp 根除后病例中，有 3 例 NHPH 阳性，其中 1 例为 Hhss/Ha 阳性。因此，在日本 17 家医院接受治疗的 Hp 阴性非 Hp 根除的胃部疾病患者中，约 20%感染了 NHPH。
