Nitazoxanide in Treatment of Helicobacter
pylori: a Clinical and In Vitro
Study

ABSTRACT Nitazoxanide (NTZ) is an antibiotic with microbiological characteristics similar to those of metronidazole but without an apparent problem of resistance. The aim of this study was the prospective evaluation of NTZ given as a single agent in the treatment of Helicobacter pylori infection. Twenty culture-positive patients with dyspepsia who had previously failed at least one course of H. pylori eradication therapy were enrolled. Subjects received 1 g of NTZ twice daily for 10 days. The safety and tolerability of the drug were assessed by physical examination, monitoring of adverse events, and clinical laboratory evaluation. Urea breath tests (UBTs) were performed 6 weeks posttreatment. H. pylori was isolated from UBT-positive patients by the string test or endoscopy with biopsy, and the MICs for these isolates were compared to those for isolates obtained pretherapy. The levels of tizoxanide, the active deacylated derivative of NTZ, were measured in blood, saliva, and tissue from two patients during treatment. The UBT results were positive for all 20 patients after completion of NTZ therapy. The MIC results demonstrated that the NTZ susceptibilities of none of the strains isolated from the patients posttherapy had changed significantly. No major adverse reactions were observed, but frequent minor side effects were observed. In conclusion, NTZ did not eradicate H. pylori when it was given as a single agent.

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Effect of Glycine on Helicobacter pylori In Vitro

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.48.10.3782-3788.2004 ◽

2004 ◽

Vol 48 (10) ◽

pp. 3782-3788 ◽

Cited By ~ 15

Author(s):

Masaaki Minami ◽

Takafumi Ando ◽

Shin-nosuke Hashikawa ◽

Keizo Torii ◽

Tadao Hasegawa ◽

...

Keyword(s):

Helicobacter Pylori ◽

Eradication Therapy ◽

Resistant Mutant ◽

Synergistic Activity ◽

Wild Type ◽

Mutant Strains ◽

The Difference ◽

H Pylori ◽

Isogenic Mutants

ABSTRACT Glycine is the simplest amino acid and is used as a metabolic product in some bacteria. However, an excess of glycine inhibits the growth of many bacteria, and it is used as a nonspecific antiseptic agent due to its low level of toxicity in animals. The effect of glycine on Helicobacter pylori is not precisely known. The present study was conducted to investigate (i) the effect of glycine on clarithromycin (CLR)-resistant and -susceptible strains of H. pylori, (ii) the effect of glycine in combination with amoxicillin (AMX), and (iii) the postantibiotic effect (PAE). The MIC at which 90% of strains are inhibited for glycine was almost 2.5 mg/ml for 31 strains of H. pylori, including CLR-resistant strains. We constructed isogenic CLR-resistant mutant strains by natural transformation and investigated the difference between clinical wild-type strains and isogenic mutants. There were no differences in the MICs between CLR-resistant and -susceptible strains or between clinical wild-type and mutant strains. The combination of AMX and glycine showed synergistic activity, with the minimum bactericidal concentration of AMX with glycine decreasing to 1/10 that of AMX alone. Glycine showed no PAE against H. pylori. These results suggest that glycine may be a useful antimicrobial agent against H. pylori not only alone but also in combination with antibacterial drugs for the treatment of H. pylori-associated diseases. Glycine may represent a component of a new type of eradication therapy for CLR-resistant H. pylori.

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In Vitro Probiotic Potential of Lactic Acid Bacteria Isolated from Aguamiel and Pulque and Antibacterial Activity Against Pathogens

Applied Sciences ◽

10.3390/app9030601 ◽

2019 ◽

Vol 9 (3) ◽

pp. 601 ◽

Cited By ~ 4

Author(s):

Alicia Cervantes-Elizarrarás ◽

Nelly Cruz-Cansino ◽

Esther Ramírez-Moreno ◽

Vicente Vega-Sánchez ◽

Norma Velázquez-Guadarrama ◽

...

Keyword(s):

Antimicrobial Activity ◽

Helicobacter Pylori ◽

Lactic Acid ◽

Lactic Acid Bacteria ◽

Eradication Therapy ◽

Antimicrobial Effect ◽

E Coli ◽

Probiotic Potential ◽

H Pylori

Probiotics can act as a natural barrier against several pathogens, such Helicobacter pylori, a bacterium linked to stomach cancer. The aim of the present study was to isolate and identify lactic acid bacteria (LAB) from pulque and aguamiel, and evaluate their probiotic potential and antimicrobial effect on Escherichia coli, Staphylococcus aureus, and Helicobacter pylori. Ten isolates were selected and evaluated for in vitro resistance to antibiotics and gastrointestinal conditions, and antimicrobial activity against E. coli and S. aureus and the effect on H. pylori strains. 16S rRNA identification was performed. Ten potential probiotic isolates were confirmed as belonging to the genera Lactobacillus and Pediococcus. All the strains were susceptible to clinical antibiotics, except to vancomycin. Sixty percent of the isolates exhibited antimicrobial activity against E. coli and S. aureus. The growth of H. pylori ATCC 43504 was suppressed by all the LAB, and the urease activity from all the H. pylori strains was inhibited, which may decrease its chances for survival in the stomach. The results suggest that LAB isolated from pulque and aguamiel could be an option to establish a harmless relationship between the host and H. pylori, helping in their eradication therapy.

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Potential Association of EEF1A Dimethylation at Lysine 55 in the Basal Area of Helicobacter Pylori-Eradicated Gastric Mucosa with the Risk of Gastric Cancer: A Retrospective Observational Study

10.21203/rs.3.rs-1072695/v1 ◽

2021 ◽

Author(s):

Yuka Hirashita ◽

Masahide Fukuda ◽

Masaaki Kodama ◽

Yoshiyuki Tsukamoto ◽

Tadayoshi Okimoto ◽

...

Keyword(s):

Gastric Cancer ◽

Helicobacter Pylori ◽

Gastric Mucosa ◽

Eradication Therapy ◽

Basal Area ◽

Immunofluorescent Staining ◽

Upper Gastrointestinal Endoscopy ◽

H Pylori ◽

The Relationship

Abstract Background Although eradication therapy for chronic Helicobacter pylori reduces the risk of gastric cancer (GC), its effectiveness is incomplete. Therefore, it is critically important to identify those patients who remain at high risk after H. pylori eradication therapy. Accumulation of protein methylation is strongly implicated in cancer, and a recent study showed that dimethylation of eEF1A lysine 55 (eEF1AK55me2) promotes carcinogenesis in vivo. We aimed to investigate the relationship between eEF1A dimethylation and H. pylori status in gastric mucosa and to reveal potential downstream molecules of eEF1A dimethylation in H. pylori-eradicated mucosa. Methods Records of 115 patients (11 H. pylori-negative, 29 H. pylori-positive, 75 post-eradication patients) who underwent upper gastrointestinal endoscopy were retrospectively reviewed. The eEF1A dimethyl level was evaluated in each functional cell type of gastric mucosa by immunofluorescent staining. We also investigated the relationship between eEF1AK55me2 downregulation by CRISPR/Cas9-mediated deletion of Mettl13, which is known as a dimethyltransferase of eEF1AK55me2. Results The level of eEF1A dimethylation significantly increased in the surface and basal areas of H. pylori-positive mucosa compared with -negative mucosa (surface, p=0.0031; basal, p<0.0001). The eEF1A dimethyl levels in the surface area were significantly reduced by eradication therapy (p=0.005), but those in the basal area were maintained even after eradication therapy. Multivariate analysis revealed that high dimethylation of eEF1A in the basal area of the mucosa was the independent factor related to GC incidence (odds ratio=3.6611, 95% confidence interval=1.0350–12.949, p=0.0441). We also showed the relationship between eEF1A dimethylation and expressions of reprogramming factors Oct4 and Nanog by immunohistochemistry and in vitro genome editing experiments. Conclusions The results indicated that H. pylori infection potently induced eEF1A dimethylation in gastric mucosa. The accumulation of dimethyl-eEF1A in the basal area of the mucosa might contribute to GC risk via regulation of reprograming factors in H. pylori-eradicated gastric mucosa.

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Is The Theoretical Knowledge Reflected in Current Practice: Histopathological Helicobacter Pylori Research?

National Journal of Health Sciences ◽

10.21089/njhs.61.0022 ◽

2021 ◽

Vol 6 (1) ◽

pp. 22-25

Author(s):

Mehmet Ali Kosekli ◽

Keyword(s):

Helicobacter Pylori ◽

Public Health Problem ◽

Clinical Trial Data ◽

In Vitro Study ◽

Control Group ◽

Study Group ◽

Optimal Test ◽

Study Results ◽

H Pylori

Abstract: Objective: Helicobacter pylori (H. pylori) is considered in the category of biological agent directly responsible for cancer. Guidelines recommend discontinuing suppressive conditions prior to histopathological helicobacter pylori testing, but there is little clinical trial data on how outcome is affected if this is not done. Optimal test recommendations in the guidelines are based on in vitro study results. In present study, we aimed to observe whether there was a difference in the prevalence of H. pylori histopathologically in patients who met the necessary prerequisites before Esophago-Gastro-Duodenoscopy (EGD) compared to the subjects group who did not meet the PPI discontinuation condition. Materials & Methods: This retrospective study was conducted between October 2015 and August 2016 in a reference hospital with 1.5 million hinterlands. Patients who underwent EGD by meeting all the prerequisites recommended by the guidelines for the H. pylori test were included in the study group (n=213), and those who discontinued other suppressive drugs except PPI were included in the control group (n=193). Results: While H. pylori was found to be 74.6% positive in the study group that provided all the prerequisites for histopathological H. pylori detection, H. pylori was found to be 64.9% positive in the control group continuing to receive PPI treatment (p=0.02). Conclusion: In conclusion, we suggest that it is necessary to proceed with the guidance of classical knowledge in determining the presence of H. pylori, which is a common public health problem that is up-to-date. Keywords: Helicobacter pylori, Suppressive condition, Proton pump inhibitor, Histopathology, Cancer, Guideline.

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The rod-to-coccoid body transformation in cultures of Helicobacter pylori

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100160686 ◽

1990 ◽

Vol 48 (3) ◽

pp. 626-627

Author(s):

A. R. Crooker ◽

W. G. Kraft ◽

T. L. Beard ◽

M. C. Myers

Keyword(s):

Helicobacter Pylori ◽

Growth Cycle ◽

Negative Bacterium ◽

Body Formation ◽

Coccoid Form ◽

Spiral Form ◽

Prolonged Culture ◽

H Pylori ◽

Upper Gastrointestinal

Helicobacter pylori is a microaerophilic, gram-negative bacterium found in the upper gastrointestinal tract of humans. There is strong evidence that H. pylori is important in the etiology of gastritis; the bacterium may also be a major predisposing cause of peptic ulceration. On the gastric mucosa, the organism exists as a spiral form with one to seven sheathed flagella at one (usually) or both poles. Short spirals were seen in the first successful culture of the organism in 1983. In 1984, Marshall and Warren reported a coccoid form in older cultures. Since that time, other workers have observed rod and coccal forms in vitro; coccoid forms predominate in cultures 3-7 days old. We sought to examine the growth cycle of H. pylori in prolonged culture and the mode of coccoid body formation.

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Synthesis and In Vitro Enzymatic Studies of New 3-Aryldiazenyl Indoles as Promising Helicobacter pylori IMPDH Inhibitors

Current Topics in Medicinal Chemistry ◽

10.2174/1568026619666190227212334 ◽

2019 ◽

Vol 19 (5) ◽

pp. 376-382 ◽

Cited By ~ 4

Author(s):

Sachin Jangra ◽

Gayathri Purushothaman ◽

Kapil Juvale ◽

Srimadhavi Ravi ◽

Aishwarya Menon ◽

...

Keyword(s):

Helicobacter Pylori ◽

Bacterial Infections ◽

Immunosuppressive Drugs ◽

Multi Drug Resistance ◽

Metabolic Enzyme ◽

World Population ◽

Inhibitor Molecule ◽

Nucleotide Synthesis ◽

H Pylori

Background & Objective:Helicobacter pylori infection is one of the primary causes of peptic ulcer followed by gastric cancer in the world population. Due to increased occurrences of multi-drug resistance to the currently available antibiotics, there is an urgent need for a new class of drugs against H. pylori. Inosine 5′-monophosphate dehydrogenase (IMPDH), a metabolic enzyme plays a significant role in cell proliferation and cell growth. It catalyses guanine nucleotide synthesis. IMPDH enzyme has been exploited as a target for antiviral, anticancer and immunosuppressive drugs. Recently, bacterial IMPDH has been studied as a potential target for treating bacterial infections. Differences in the structural and kinetic parameters of the eukaryotic and prokaryotic IMPDH make it possible to target bacterial enzyme selectively.Methods:In the current work, we have synthesised and studied the effect of substituted 3-aryldiazenyl indoles on Helicobacter pylori IMPDH (HpIMPDH) activity. The synthesised molecules were examined for their inhibitory potential against recombinant HpIMPDH.Results:In this study, compounds 1 and 2 were found to be the most potent inhibitors amongst the database with IC50 of 0.8 ± 0.02µM and 1 ± 0.03 µM, respectively.Conclusion:When compared to the most potent known HpIMPDH inhibitor molecule C91, 1 was only four-fold less potent and can be a good lead for further development of selective and potent inhibitors of HpIMPDH.

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Synthesis, Molecular Modelling and Antibacterial Activity Against Helicobacter pylori of Novel Diflunisal Derivatives as Urease Enzyme Inhibitors

Letters in Drug Design & Discovery ◽

10.2174/1570180815666180627130208 ◽

2019 ◽

Vol 16 (4) ◽

pp. 392-400 ◽

Cited By ~ 2

Author(s):

Göknil Pelin Coşkun ◽

Teodora Djikic ◽

Sadık Kalaycı ◽

Kemal Yelekçi ◽

Fikrettin Şahin ◽

...

Keyword(s):

Helicobacter Pylori ◽

Antibacterial Activity ◽

Enzyme Inhibitors ◽

Binding Modes ◽

Bacterial Strains ◽

Urease Enzyme ◽

H Pylori ◽

Ulcer Treatment ◽

Main Factor

Background:The main factor for the prolongation of the ulcer treatment in the gastrointestinal system would be Helicobacter pylori infection, which can possibly lead to gastrointestinal cancer. Triple therapy is the treatment of choice by today's standards. However, observed resistance among the bacterial strains can make the situation even worse. Therefore, there is a need to discover new targeted antibacterial therapy in order to make success in the eradication of H. pylori infections.Methods:The targeted therapy rule is to identify the related macromolecules that are responsible for the survival of the bacteria. Thus, 2-[(2',4'-difluoro-4-hydroxybiphenyl-3-yl)carbonyl]-N- (substituted)hydrazinocarbothioamide (3-13) and 5-(2',4'-difluoro-4-hydroxybiphenyl-3-yl)-4- (substituted)-2,4-dihydro-3H-1,2,4-triazole-3-thiones (14-17) were synthesized and evaluated for antibacterial activity in vitro against H. pylori.Results:All of the tested compounds showed remarkable antibacterial activity compared to the standard drugs (Ornidazole, Metronidazole, Nitrimidazin and Clarithromycin). Compounds 4 and 13 showed activity as 2µg/ml MIC value.Conclusion:In addition, we have investigated binding modes and energy of the compounds 4 and 13 on urease enzyme active by using the molecular docking tools.

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Nutrient Deficiency Promotes the Entry of Helicobacter pylori Cells into Candida Yeast Cells

Biology ◽

10.3390/biology10050426 ◽

2021 ◽

Vol 10 (5) ◽

pp. 426

Author(s):

Kimberly Sánchez-Alonzo ◽

Fabiola Silva-Mieres ◽

Luciano Arellano-Arriagada ◽

Cristian Parra-Sepúlveda ◽

Humberto Bernasconi ◽

...

Keyword(s):

Helicobacter Pylori ◽

Nutrient Deficiency ◽

Gastric Epithelium ◽

Yeast Cells ◽

Nutrient Concentrations ◽

Fetal Bovine ◽

H Pylori ◽

Pcr Techniques ◽

Strain Dependent

Helicobacter pylori, a Gram-negative bacterium, has as a natural niche the human gastric epithelium. This pathogen has been reported to enter into Candida yeast cells; however, factors triggering this endosymbiotic relationship remain unknown. The aim of this work was to evaluate in vitro if variations in nutrient concentration in the cultured medium trigger the internalization of H. pylori within Candida cells. We used H. pylori–Candida co-cultures in Brucella broth supplemented with 1%, 5% or 20% fetal bovine serum or in saline solution. Intra-yeast bacteria-like bodies (BLBs) were observed using optical microscopy, while intra-yeast BLBs were identified as H. pylori using FISH and PCR techniques. Intra-yeast H. pylori (BLBs) viability was confirmed using the LIVE/DEAD BacLight Bacterial Viability kit. Intra-yeast H. pylori was present in all combinations of bacteria–yeast strains co-cultured. However, the percentages of yeast cells harboring bacteria (Y-BLBs) varied according to nutrient concentrations and also were strain-dependent. In conclusion, reduced nutrients stresses H. pylori, promoting its entry into Candida cells. The starvation of both H. pylori and Candida strains reduced the percentages of Y-BLBs, suggesting that starving yeast cells may be less capable of harboring stressed H. pylori cells. Moreover, the endosymbiotic relationship between H. pylori and Candida is dependent on the strains co-cultured.

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Putative Cooperative ATP–DnaA Binding to Double-Stranded DnaA Box and Single-Stranded DnaA-Trio Motif upon Helicobacter pylori Replication Initiation Complex Assembly

International Journal of Molecular Sciences ◽

10.3390/ijms22126643 ◽

2021 ◽

Vol 22 (12) ◽

pp. 6643

Author(s):

Pawel Jaworski ◽

Dorota Zyla-Uklejewicz ◽

Malgorzata Nowaczyk-Cieszewska ◽

Rafal Donczew ◽

Thorsten Mielke ◽

...

Keyword(s):

Helicobacter Pylori ◽

Replication Initiation ◽

Dna Unwinding ◽

Rich Region ◽

Initiator Protein ◽

New Class ◽

H Pylori ◽

General Architecture ◽

Dnaa Box

oriC is a region of the bacterial chromosome at which the initiator protein DnaA interacts with specific sequences, leading to DNA unwinding and the initiation of chromosome replication. The general architecture of oriCs is universal; however, the structure of oriC and the mode of orisome assembly differ in distantly related bacteria. In this work, we characterized oriC of Helicobacter pylori, which consists of two DnaA box clusters and a DNA unwinding element (DUE); the latter can be subdivided into a GC-rich region, a DnaA-trio and an AT-rich region. We show that the DnaA-trio submodule is crucial for DNA unwinding, possibly because it enables proper DnaA oligomerization on ssDNA. However, we also observed the reverse effect: DNA unwinding, enabling subsequent DnaA–ssDNA oligomer formation—stabilized DnaA binding to box ts1. This suggests the interplay between DnaA binding to ssDNA and dsDNA upon DNA unwinding. Further investigation of the ts1 DnaA box revealed that this box, together with the newly identified c-ATP DnaA box in oriC1, constitute a new class of ATP–DnaA boxes. Indeed, in vitro ATP–DnaA unwinds H. pylori oriC more efficiently than ADP–DnaA. Our results expand the understanding of H. pylori orisome formation, indicating another regulatory pathway of H. pylori orisome assembly.

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Shedding Light on the African Enigma: In Vitro Testing of Homo sapiens-Helicobacter pylori Coevolution

Microorganisms ◽

10.3390/microorganisms9020240 ◽

2021 ◽

Vol 9 (2) ◽

pp. 240

Author(s):

Bruno Cavadas ◽

Marina Leite ◽

Nicole Pedro ◽

Ana C. Magalhães ◽

Joana Melo ◽

...

Keyword(s):

Gene Expression ◽

Helicobacter Pylori ◽

Host Response ◽

Homo Sapiens ◽

European Ancestry ◽

Genome Wide ◽

Expression Host ◽

H Pylori ◽

Human Ancestry

The continuous characterization of genome-wide diversity in population and case–cohort samples, allied to the development of new algorithms, are shedding light on host ancestry impact and selection events on various infectious diseases. Especially interesting are the long-standing associations between humans and certain bacteria, such as the case of Helicobacter pylori, which could have been strong drivers of adaptation leading to coevolution. Some evidence on admixed gastric cancer cohorts have been suggested as supporting Homo-Helicobacter coevolution, but reliable experimental data that control both the bacterium and the host ancestries are lacking. Here, we conducted the first in vitro coinfection assays with dual human- and bacterium-matched and -mismatched ancestries, in African and European backgrounds, to evaluate the genome wide gene expression host response to H. pylori. Our results showed that: (1) the host response to H. pylori infection was greatly shaped by the human ancestry, with variability on innate immune system and metabolism; (2) African human ancestry showed signs of coevolution with H. pylori while European ancestry appeared to be maladapted; and (3) mismatched ancestry did not seem to be an important differentiator of gene expression at the initial stages of infection as assayed here.

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