Helicobacter heilmannii-like organism（HHLO）関連胃炎

Gastritis Associated with Helicobacter heilmannii-like Organism

要旨●HHLOと総称される，大型でらせん型を呈するHelicobacter属菌は人獣共通感染症のひとつであり，ヒト胃粘膜に感染した場合は軽度の胃粘膜障害が認められることが多い．しかし，近年鳥肌胃炎や胃MALTリンパ腫との関連が示唆され注目されている．自験例での感染率は0.1％と他の先進国と同程度であり，またHHLO関連胃MALTリンパ腫6症例に対して除菌治療を施行したところ，追加放射線治療を行った症例も含め全例寛解を維持している．H. pyloriに比べて日常診療の場で症例に遭遇する確率は低いが，臨床上注意すべき感染症であり，疑わしい場合には慎重な存在診断を行うとともに必要に応じて治療を検討すべきと考える．今後培養法の確立や分子生物学的手法を用いた解析や分類により，その実態がさらに明らかになるものと期待される．

　Helicobacter spp. hat exhibit a large helical form, collectively referred to as HHLO（Helicobacter heilmannii-like organism）, are a cause of zoonotic infections, and a mild gastric mucosal disorder is often observed. However, in recent years, this organism has attracted attention because of its suggested association with nodular gastritis and gastric MALT（mucosa-associated lymphoid tissue）lymphoma. The infection rate of our cases in Japan is 0.1%, which is approximately the same as in other developed countries. Eradication therapy was performed in six patients with HHLO-associated gastric MALT lymphoma, including one who underwent additional radiation therapy, and all six cases have maintained remission.

　The probability of encountering a case of HHLO infection in everyday clinical practice is low compared with that of Helicobacter pylori infections. However, it may be noteworthy with respect to the development of MALT lymphoma.Thus, the establishment of culture methods as well as analysis and classification using molecular biology techniques are expected.