In contrast to H. pylori infection the rare colonization of the gastric mucosa with H. heilmannii, mainly circumscribed and mostly in the antrum, induces a very much milder form of gastritis in the antrum and corpus, which may also be the reason for the rarity of concurrent erosions and ulcers. Whether the observed relatively frequent association of H. heilmannii infection and gastric MALT lymphoma is coincidental, and whether H. heilmannii gastritis is more commonly associated with MALT lymphoma than is H. pylori gastritis must be investigated in further studies.
Our analysis indicates that H. heilmannii gastritis is due to its transmission to humans by domestic animals or pets. Concomitant infections by H. heilmannii and H. pylori are very rare, and it is possible that H. heilmannii might protect from infection with H. pylori. However, the results of our retrospective analysis will have to be tested against those of a prospective study investigating the day-to-day situation of the individual patients in greater detail and also be compared with patients not infected with H. heilmannii.
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