Review: Other Helicobacter Species
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DOI: 10.1111/hel.12645 SUPPLEMENT ARTICLE Review: Other Helicobacter species Armelle Ménard1 | Annemieke Smet2 1INSERM, UMR1053, Bordeaux Research in Translational Oncology, BaRITOn, Université Abstract de Bordeaux, Bordeaux, France This article is a review of the most important, accessible, and relevant literature pub‐ 2 Laboratorium of Experimental lished between April 2018 and April 2019 in the field of Helicobacter species other than Medicine and Pediatrics, Department of Translational Research in Immunology and Helicobacter pylori. The initial part of the review covers new insights regarding the pres‐ Inflammation, Faculty of Medicine and ence of gastric and enterohepatic non‐H. pylori Helicobacter species (NHPH) in humans Health Sciences, University of Antwerp, Wilrijk (Antwerp), Belgium and animals, while the subsequent section focuses on the progress in our understand‐ ing of the pathogenicity and evolution of these species. Over the last year, relatively Correspondence Armelle Ménard, Laboratoire de few cases of gastric NHPH infections in humans were published, with most NHPH in‐ Bactériologie, INSERM U1053, Campus de fections being attributed to enterohepatic Helicobacters. A novel species, designated Carreire, Université de Bordeaux, Bâtiment 2B RDC ‐ Case 76, 146 rue Léo Saignat, “Helicobacter caesarodunensis,” was isolated from the blood of a febrile patient and F33076 Bordeaux, France. numerous cases of human Helicobacter cinaedi infections underlined this species as a Email: Armelle.Menard@u‐bordeaux.fr true emerging pathogen. With regard to NHPH in animals, canine/feline gastric NHPH cause little or no harm in their natural host; however they can become opportunistic when translocated to the hepatobiliary tract. The role of enterohepatic Helicobacter species in colorectal tumors in pets has also been highlighted. Several studies in rodent models have further elucidated the mechanisms underlying the development of NHPH‐ related disease, and the extra‐gastric effects of a Helicobacter suis infection on brain homeostasis was also studied. Comparative genomics facilitated a breakthrough in the evolutionary history of Helicobacter in general and NHPH in particular. Investigation of the genome of Helicobacter apodemus revealed particular traits with regard to its viru‐ lence factors. A range of compounds including mulberries, dietary fiber, ginseng, and avian eggs which target the gut microbiota have also been shown to affect Helicobacter growth, with a potential therapeutic utilization and increase in survival. KEYWORDS non‐Helicobacter pylori Helicobacter, human and animal disease, animal studies, pathogenesis, genomics and evolution 1 | PRESENCE OF NON‐HELICOBACTER lesions which differ from the less active and less severe gastritis PYLORI HELICOBACTER SPECIES IN HUMANS usually associated with NHPH infections in humans. The patient was successfully treated with a combination of amoxicillin, clari‐ 1 A limited number of cases of gastric non‐Helicobacter pylori thromycin, and a proton pump inhibitor. Another case report de‐ Helicobacter (NHPH) infections in humans were reported this year. scribed a reddish depression lesion in the corpus of the stomach of An atypical presentation of an acute Helicobacter felis infection was a 56‐year‐old man. Gastric biopsy analysis identified a Helicobacter 2 described in a 39‐year‐old male suffering from acute abdominal pain, suis infection which was eradicated after 10 days of triple therapy. nausea, and vomiting. Gastroscopic examination revealed necrotic The presence of gastric NHPH was also reported for the first time in Helicobacter. 2019;24(Suppl. 1):e12645. wileyonlinelibrary.com/journal/hel © 2019 John Wiley & Sons Ltd | 1 of 8 https://doi.org/10.1111/hel.12645 2 of 8 | MÉNARD and SMET 2.7% of children suffering from gastric disorders in Southern Turkey, reported cases include a secondary infection following a vascular with H. suis being the most prevalent species.3 access device placement,13 chemotherapy (rituximab plus cyclo‐ Human NHPH infections reported over the last year were mostly phosphamide, doxorubicin, vincristine, and prednisone),10 or ceph‐ associated with enterohepatic Helicobacters. A proposed novel alosporin treatment (ceftriaxone).22 In the latter case, high plasma Helicobacter species “Helicobacter caesarodunensis” was isolated and cerebrospinal fluid ceftriaxone concentrations induced an from the blood of a febrile patient. This curved, rod‐shaped entero‐ encephalopathy in the hemodialysis patient.22 Anti‐cancer che‐ hepatic Helicobacter was shown to be closely related to Helicobacter motherapy and systemic steroids have been shown to be inde‐ equorum and harbors two sheathed amphitrichous flagella.4 Whole pendent risk factors for recurrent H. cinaedi‐induced bacteremia; genome sequencing revealed a genome of 1 708 265 base pairs (bp) however, evidence would suggest that selective digestive decon‐ with a G+C content of 37.80% and a total of 1697 predicted coding tamination with kanamycin could potentially be a strategy to pre‐ sequences. vent recurrence of infectious bacteremia.23 H. cinaedi is difficult to An umbrella review of 53 meta‐analyses identified 9 environ‐ identify at the species level. H. cinaedi infections can be diagnosed mental factors that increase the risk of inflammatory bowel diseases using the VersaTREKTM blood culture system.24 A multi‐step ge‐ (IBD), including infection with enterohepatic Helicobacter species.5 nome‐wide phylogenetic analysis of isolates from an intra‐hospital In contrast, H. pylori infection was shown to reduce the risk of IBD.5 outbreak of H. cinaedi‐associated bacteremia highlighted the role However, further studies are required to determine whether an en‐ of asymptomatic carriers or environmental contamination as well terohepatic Helicobacter infection is the cause or consequence of as the emergence of a subclone with increased resistance to flu‐ IBD. Analysis of microbiota in human colorectal cancer (CRC) tis‐ oroquinolones.25 Finally, H. cinaedi was also found in small sludge sues revealed that the number of Helicobacter species in patients flocs in wastewater treatment plants, indicating the human and with poorly differentiated right colon cancers was higher than in environmental health risks of activated sludge.26 Another draft well‐differentiated left colon cancers. In addition, Helicobacter bilis genome sequence of H. cinaedi isolated from a blood culture re‐ was overrepresented in poorly differentiated cancers as compared vealed a 1 995 911 bp chromosome with 39.1% G+C content.27 to well‐differentiated cancers, suggesting that H. bilis is potentially associated with a poorer differentiation and more negative progno‐ sis in patients with CRC.6 In another study, PCR‐based investigation 2 | PRESENCE OF NON‐HELICOBACTER failed to show any correlation between enterohepatic Helicobacter PYLORI HELICOBACTER SPECIES IN species (H. bilis, Helicobacter hepaticus and Helicobacter pullorum) and ANIMALS cholelithiasis, while the presence of H. pylori DNA was associated with acute gallstone cholecystitis.7 Using NGS‐based 16S rRNA se‐ In 2018, Sousa et al28 investigated the presence of NHPH in the quencing, Helicobacter species were not detected either in bile col‐ gastric mucosa of cats. They showed that all animals were predomi‐ lected from Chilean patients with gallbladder cancer,8 contradicting nantly infected with Helicobacter heilmannii, the most prevalent fe‐ previous studies. line Helicobacter species.28,29 Despite the observation of a histologic Helicobacter fennelliae was isolated from a non‐diarrheal stool mild gastritis, all animals were clinically healthy.28 This suggests that sample in a child from Cambodia. The infecting strain showed re‐ pet‐associated gastric Helicobacters cause little or no harm in their sistance to macrolides and quinolones which represent the first‐line natural host, which is in contrast to other members of the NHPH antibiotic therapy for Campylobacter‐like infections.9 group.29 However, Takemura et al30 identified gastric Helicobacters New cases of Helicobacter cinaedi‐related bacteremia have been in hepatobiliary samples from dogs with lesions in the liver. These reported in immunocompromised patients, patients with rheuma‐ authors stated that pet‐associated NHPH can become opportunistic toid arthritis and malignant lymphoma,10 a prosthetic joint infec‐ pathogens in the biliary tract when translocated from the stomach tion in an HIV‐infected man,11 X‐linked agammaglobulinemia,12 to the liver.30 De Witte et al31 analyzed fecal samples from marine and acute gastroenteritis.13 H. cinaedi was also isolated from the and terrestrial mammals in zoos for the presence of gastric and en‐ blood and peritoneal fluid of a patient undergoing peritoneal di‐ terohepatic Helicobacter species. Helicobacter cetorum was the only alysis who presented with autosomal dominant polycystic kidney gastric species that could be detected in the majority of dolphins. disease and a cyst infection, showing that H. cinaedi cyst infection Furthermore, novel enterohepatic Helicobacter species were identi‐ had spread to the peritoneal fluid.14 A further study demonstrated fied in both marine and terrestrial zoo mammals.31 Another study that bacterial translocation from the intestinal tract could repre‐ also reported Helicobacter species in the stomach of aquatic marine sent one route of H. cinaedi‐induced bacteremia.15 H. cinaedi‐re‐ mammals, for example, East Asian finless porpoises (Neophocaena lated bacteremia