Helicobacter spp 1 3 Andrew Lee The Helicobacter

הליקובקטר Helicobacter spp. 1

3 Andrew Lee, The Helicobacter Web Site, concept and design by Andrew Lee, copyright A. Lee 1997

סביבת חיים . המאכסן החיידק נמצא בעיקר בשכבת הריר על פני רירית הקיבה של This is a x 1000 photograph of HP in an antral gland. This picture and more details of the patient's history were published in the NEJM as "picture of the week". Congratulations to Drs. Bob Genta and David Graham of the Veteran's Affairs Hospital in . Houston Texas 5 A silver stain (Warthin Starry) of HP (black wiggly things) on gastric mucus-secreting epithelial cells (x 1000). This picture is notorious because it is of Dr. Marshall's stomach biopsy taken 8 days after he drank a culture of H. pylori. The experiment was published in 1985 (Marshall BJ, Armstrong JA, Mc. Gechie DB, Glancy RJ. Attempt to fulfill Koch's postulates for pyloric . (Campylobacter. Med J Aust 1985; 142: 436 -439

Zoonosis ? - Reverse zoonosis? ? Helicobacter pylori isolated from the domestic cat: public health implications. L K Handt, et al. , University of Pennsylvania, Philadelphia 19104. Infection and Immunity, June 1994, p. 2367 -2374, Vol. 62, No. 6 Detection of Helicobacter in gastric washing of cats Paola Pregel et al. , Journal of Veterinary Diagnostic Investigation Vol. 20 Issue 6, 780 -782, Copyright © 2008 by the American Association of Veterinary Laboratory Diagnosticians Helicobacter felis Infection Is Associated with Lymphoid Follicular Hyperplasia and Mild Gastritis but Normal Gastric Secretory Function in Cats Kenneth W. Simpson et al. , Infection and Immunity, February 2000, p. 779 -790, Vol. 68, No. 2 6

• • mucinase phospholipase hemolysin TNFα : מנגנוני אלימות • Cag Pathogenicity Island Cag. A • Cag (cytotoxin-associated gene) pathogenicity island (PAI) • encodes a type 4 secretion system that mediates translocation of the Cag. A protein into host cells. • Inside the cell the Cag. A is phosphorylated -> resulting in actin rearrangement. • Vac (vacuolating cytotoxin) • Associated with colonization in gastric epithelial cell barrier & stimulates an inflammatory response. 9

10 The Role of Cag. A Protein Signaling in Gastric Carcinogenesis — Cag. A Signaling in Gastric Carcinogenesis, Current Topics in Gastritis – 2012 Stephanie E. Morales-Guerrero, Eduardo Mucito-Varela, Germa n Rube n Aguilar-Gutie rrez, Yolanda Lopez-Vidal and Gonzalo Castillo-Rojas

Mc. Gee, D. J , . F. J. Radcliff, G. L. Mendz, R. L. Ferrero, and H. L. T. Mobley. 1999 . Helicobacter pylori 11 roc. F is required for arginase activity and acid protection in vitro but is not essential for in vivo colonization of mice or for urease activity. J. Bacteriol. , 181: 7314 -7322.

Helicobacter species naturally colonizing the stomachs of animals and their pathogenic significance for humans 14

Gastric Helicobacters in Domestic Animals and Nonhuman Primates and Their Significance for Human Health Freddy Haesebrouck, * Frank Pasmans, Bram Flahou, Koen Chiers, Margo Baele, Tom Meyns, Annemie Decostere, and Richard Ducatelle Clin Microbiol Rev. 2009 April; 22(2): 202– 223. Summary: Helicobacters other than Helicobacter pylori have been associated with gastritis, gastric ulcers, and gastric mucosa-associated lymphoid tissue lymphoma in humans. These very fastidious microorganisms with a typical large spiral-shaped morphology were provisionally designated “H. heilmannii, ” but in fact they comprise at least five different Helicobacter species, all of which are known to colonize the gastric mucosa of animals. H. suis, which has been isolated from the stomachs of pigs, is the most prevalent gastric non-H. pylori Helicobacter species in humans. Other gastric non-H. pylori helicobacters colonizing the human stomach are H. felis, H. salomonis, H. bizzozeronii, and the still-uncultivable “Candidatus Helicobacter heilmannii. ” These microorganisms are often detected in the stomachs of dogs and cats. “Candidatus Helicobacter bovis” is highly prevalent in the abomasums of cattle but has only occasionally been detected in the stomachs of humans. There are clear indications that gastric non-H. pylori Helicobacter infections in humans originate from animals, and it is likely that transmission to humans occurs through direct contact. Little is known about the virulence factors of these microorganisms. The recent successes with in vitro isolation of non-H. pylori helicobacters from domestic animals open new perspectives for studying these microorganisms and their interactions with the host 16 .

: התסמונת reveals severe gastritis with gastrointestinal bleeding Endoscopy 2 large duodenal ulcers 17 Gastric MALT lymphoma

. שדה אפל , צביעה , ביופסיה לתרבית Clotest usually gives a result in a few minutes. The middle test shows a red color around a biopsy which is infected with H. pylori (the urease enzyme of H. pylori organisms causes the red color change). The lower test shows the final appearance of a CLOtest an hour or so after inserting an infected biopsy 22

: טיפול וביזמוט מטרונידזול , אמוקסיצילין של תערובת. 1 (amoxycillin, bismuth – eg “pepto-bismol”, “Kalbeten” and metronidazole) אחד תרופה ו הבאה מהרשימה אנטיביוטיקות 2 של תערובת . 2 : קיבה הפרשות המפחיטה Amoxicillin, azrithromycin, clarithromycin, –. metronidazole, tetracycline Famotidine, Omeprazole, ranitidine, cimetadine – Antisecretory agents (1 with 2 antibiotics). 3 omprazole, famotidine, ranitidine, cimetadine 23