scholarly journals Probiotics as the live microscopic fighters against Helicobacter pylori gastric infections

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masoud Keikha ◽  
Mohsen Karbalaei

Abstract Background Helicobacter pylori (H. pylori) is the causative agent of stomach diseases such as duodenal ulcer and gastric cancer, in this regard incomplete eradication of this bacterium has become to a serious concern. Probiotics are a group of the beneficial bacteria which increase the cure rate of H. pylori infections through various mechanisms such as competitive inhibition, co-aggregation ability, enhancing mucus production, production of bacteriocins, and modulating immune response. Result In this study, according to the received articles, the anti-H. pylori activities of probiotics were reviewed. Based on studies, administration of standard antibiotic therapy combined with probiotics plays an important role in the effective treatment of H. pylori infection. According to the literature, Lactobacillus casei, Lactobacillus reuteri, Lactobacillus rhamnosus GG, and Saccharomyces boulardii can effectively eradicate H. pylori infection. Our results showed that in addition to decrease gastrointestinal symptoms, probiotics can reduce the side effects of antibiotics (especially diarrhea) by altering the intestinal microbiome. Conclusion Nevertheless, antagonist activities of probiotics are H. pylori strain-specific. In general, these bacteria can be used for therapeutic purposes such as adjuvant therapy, drug-delivery system, as well as enhancing immune system against H. pylori infection.

2020 ◽  
Vol 22 (8) ◽  
pp. 57-64
Author(s):  
Marina V. Leonova ◽  

Пробиотики представляют клинически важные микроорганизмы, имеющие полезные свойства для кишечной микробиоты и способность влиять на заболеваемость желудочно-кишечного тракта (ЖКТ). Приведен научный обзор результатов большого числа метаанализов исследований (с 2004 по 2019 г.) по оценке эффективности применения пробиотиков при лечении острой диареи, антибиотикоассоциированной диареи, эрадикационной те-рапии инфекции Helicobacter pylori, при функциональном запоре. По данным 9 метаанализов (из них 2 Кокрейновских метаанализа), применение про-биотиков для лечения острой диареи у взрослых и детей позволяет достоверно сократить продолжительность диареи более чем на 1 сут и способ-ствовать ускорению излечения через 3–4 дня. Наиболее выраженный эффект пробиотиков при острой диарее отмечен у детей до 5 лет, в связи с чем пробиотики включены в Европейские рекомендации для лечения острого гастроэнтерита у детей. По данным 12 метаанализов (из них 3 Кокрейновских метаанализа) пробиотики показали значимую эффективность в предупреждении и лечении антибиотикоассоциированной диареи, снижая риск раз-вития диареи на 40% и более в разных популяциях пациентов (взрослые, пожилые, дети). В 2 Кокрейновских метаанализах показана эффективность пробиотиков для предупреждения диареи, вызванной инфекцией Clostridioides difficile, снижая риск на 60% и более. В 14 метаанализах установлена эффективность пробиотиков в дополнение к разным схемам эрадикационной терапии H. pylori в увеличении частоты эрадикации и снижении риска развития побочных эффектов антибиотиков на 40–50%, что получило значимость в клинических рекомендациях Маастрихт V (Maastricht V). В 10 ме-таанализах установлена эффективность пробиотиков по влиянию на кишечный транзит при функциональном запоре, кроме того, пробиотики спо-собствовали уменьшению запоров. Наибольшую клиническую значимость для лечения и профилактики заболеваний ЖКТ получили два вида про-биотиков – Lactobacillus и Saccharomyces, а именно штаммы Lactobacillus rhamnosus GG и Saccharomyces boulardii, для лечения функциональных запоров – пробиотики рода Bifidobacterium lactis. Кроме того, установлен дозозависимый эффект пробиотиков, и наибольший эффект проявляется при использовании высоких дозировок – не менее 109–1010 КОЕ/сут. Доказательность применения пробиотиков в лечении заболеваний ЖКТ у взрослых и детей также определена в рекомендациях Всемирной гастроэнтерологической организации 2017 г. Ключевые слова: пробиотики, острая диарея, антибиотикоассоциированная диарея, инфекция Clostridioides difficile, инфекция Helicobacter pylori, функциональный запор. Для цитирования: Леонова М.В. Пробиотики в лечении заболеваний желудочно-кишечного тракта: эффективность с позиции доказательной медицины. Consilium Medicum. 2020; 22 (8): 57–64. DOI: 10.26442/20751753.2020.8.200195


2021 ◽  
Author(s):  
Nooshin Naghibzadeh ◽  
Fatemeh Salmani ◽  
Samira Nomiri ◽  
Tahmine Tavakoli

Abstract Background: The primary goal of this placebo-controlled study was to determine the effect of quadruple treatment with Saccharomyces boulardii or Lactobacillus reuteri on the eradication of Helicobacter pylori and side effects of the treatment.Results: This study was a double-blind, randomized, placebo-controlled trial. And, eradication of helicobacter pylori was reported comparing conventional anti-H. Pylori therapy versus conventional therapy supplemented with S. boulardii and L. reuteri DSMZ 17648. For this aim, a total of 156 patients were included in the current study; and patients positive for H. Pylori infection (n =156) were randomly assigned to 3 groups: 52 patients (Group P) received conventional quadruple therapy plus L. reuteri, 52 patients (Group S) received conventional quadruple therapy plus S. boulardii daily, for 2 weeks, and 52 patients were in the control group (Group C). At the end of the treatment period, all the subjects continued to take proton pump inhibitor (PPI) alone for 14 days, and then, no medication was given for 2 weeks again. During follow-up, gastrointestinal symptoms were assessed using an evaluation scale (Glasgow dyspepsia questionnaire (GDQ)), and adverse events were assessed at 7, 14, 21, and 28 days. As a result, eradication therapy was effective for 94.2% of subjects in Group S, 92.3% of subjects in Group P, and 86.5% of subjects in the control group, with no differences between treatment arms. In Group S, the chance of developing symptoms of nausea (OR=2.74), diarrhea (OR=3.01), headache (OR=10.51), abdominal pain (OR=3.21), and anxiety (OR=3.58) was significantly lower than in the control group (p<0.05).Conclusion: In general, our findings revealed that the use of probiotic supplements containing S. boulardii or Lactobacillus reuteri (DSMZ 17648 strain) improved the eradication rate of H. Pylori infection, but it was not statistically significant. Therefore, it is recommended to conduct future research with a larger sample size to investigate the effect of S. boulardii supplementation on eradicating H. pylori infection and reducing treatment side effects.Trial registration: IRCT20200106046021N1, this trial was registered on Jan 14, 2020.


2021 ◽  
Vol 22 (5) ◽  
pp. 2695
Author(s):  
Paweł Krzyżek ◽  
Paweł Migdał ◽  
Emil Paluch ◽  
Magdalena Karwańska ◽  
Alina Wieliczko ◽  
...  

Helicobacter pylori, a gastric pathogen associated with a broad range of stomach diseases, has a high tendency to become resistant to antibiotics. One of the most important factors related to therapeutic failures is its ability to change from a spiral to a coccoid form. Therefore, the main aim of our original article was to determine the influence of myricetin, a natural compound with an antivirulence action, on the morphological transformation of H. pylori and check the potential of myricetin to increase the activity of antibiotics against this pathogen. We observed that sub-minimal inhibitory concentrations (sub-MICs) of this compound have the ability to slow down the process of transformation into coccoid forms and reduce biofilm formation of this bacterium. Using checkerboard assays, we noticed that the exposure of H. pylori to sub-MICs of myricetin enabled a 4–16-fold reduction in MICs of all classically used antibiotics (amoxicillin, clarithromycin, tetracycline, metronidazole, and levofloxacin). Additionally, RT-qPCR studies of genes related to the H. pylori morphogenesis showed a decrease in their expression during exposure to myricetin. This inhibitory effect was more strongly seen for genes involved in the muropeptide monomers shortening (csd3, csd6, csd4, and amiA), suggesting their significant participation in the spiral-to-coccoid transition. To our knowledge, this is the first research showing the ability of any compound to synergistically interact with all five antibiotics against H. pylori and the first one showing the capacity of a natural substance to interfere with the morphological transition of H. pylori from spiral to coccoid forms.


2016 ◽  
Vol 73 (11) ◽  
pp. 1044-1049 ◽  
Author(s):  
Sasa Grgov ◽  
Tomislav Tasic ◽  
Biljana Radovanovic-Dinic ◽  
Daniela Benedeto-Stojanov

Background/Aim. Some studies suggest the benefit of applying different probiotic strains in combination with antibiotics in the eradication of Helicobacter pylori (H. pylori) infection. The aim of this study was to evaluate the effect of co-administration of multiple probiotic strains with triple H. pylori eradication therapy. Methods. This prospective study included 167 patients with dyspeptic symptoms and chronic gastritis who were diagnosed with H. pylori infection and randomized into two groups. The group I of 77 patients underwent triple eradication therapy, for 7 days, with lansoprazole, 2 ? 30 mg half an hour before the meal, amoxicillin 2 ? 1.000 mg per 12 hours and clarithromycin 2 ? 500 mg per 12 hours. After the 7th day of the therapy, lansoprazole continued at a dose of 30 mg for half an hour before breakfast for 4 weeks. The group II of 90 patients received the same treatment as the patients of the group I, with the addition of the probiotic cultures in the form of a capsule comprising Lactobacillus Rosell-52, Lactobacillus Rosell-11, Bifidobacterium Rosell-1755 and Saccharomyces boulardii, since the beginning of eradication for 4 weeks. Eradication of H. pylori infection control was performed 8 weeks after the therapy by rapid urease test and histopathologic evaluation of endoscopic biopsies or by stool antigen test for H. pylori. Results. Eradication of H. pylori infection was achieved in 93.3% of the patients who received probiotics with eradication therapy and in 81.8% of patients who were only on eradication therapy without probiotics. The difference in eradication success was statistically significant, (p < 0.05). The incidence of adverse effects of eradication therapy was higher in the group of patients who were not on probiotic (28.6%) than in the group that received probiotic (17.7%), but the difference was not statistically significant. Conclusion. Multiple probiotic strains addition to triple eradication therapy of H. pylori achieves a significantly better eradication success, with fewer side effects of antibiotics.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Seyedeh Amineh Hojati ◽  
Sara Kokabpeyk ◽  
Salma Yaghoubi ◽  
Farahnaz Joukar ◽  
Mehrnaz Asgharnezhad ◽  
...  

Abstract Background Helicobacter pylori (H. pylori) infection is the most important risk factor for gastritis and peptic ulcer. However, factors other than H. pylori are involved in its pathogenesis. In the current study, we aimed to compare the clinical manifestations and endoscopic and histopathological findings of patients with and without H. pylori infection. Methods In this cross-sectional study, 233 patients with dyspepsia, referred for endoscopy, were examined regarding the presence of H. pylori infection. During an endoscopic exam, 5 biopsy specimens were taken from the stomach. The criteria for the presence of H. pylori infection was the presence and identification of bacteria in pathology. Two groups of H. pylori-positive and H. pylori-negative patients were compared regarding their demographic, endoscopic, and pathological findings. Results Of 233 patients, 154 (66.1%) were non-smokers, 201 (86.3%) were not alcohol users, and 153 (65.7%) used tap water. The most common symptom, reported in 157 (67.4%) patients, was epigastric pain. There was a significant difference between patients with and without H. pylori infection in terms of the educational status, occupational status, family history of gastrointestinal cancer, and some gastrointestinal symptoms. Also, there was a significant relationship between the endoscopic and pathological findings of patients with H. pylori. Conclusions The results of the present study revealed that H. pylori infection was not associated with sex, alcohol consumption, or non-steroidal anti-inflammatory drug use. The role of H. pylori in the pathophysiology of peptic ulcer was clarified. Also, there was a significant difference in the endoscopic and pathological findings of patients with H. pylori.


Gut ◽  
1997 ◽  
Vol 41 (2) ◽  
pp. 169-176 ◽  
Author(s):  
S Rosenstock ◽  
L Kay ◽  
C Rosenstock ◽  
L P Andersen ◽  
O Bonnevie ◽  
...  

Background—Helicobacter pylori is a human pathogen that colonises the gastric mucosa and causes permanent gastric inflammation.Aims—To assess the symptoms of H pylori infection in an adult unselected population.Subjects—A random sample of 3589 adult Danes who were examined in 1982 and 1987 (n=2987).Methods—Abdominal symptoms within the preceding year were recorded at both attendances. Circulating IgG antibodies against H pylori in serum samples drawn in 1982 were measured by using in-house indirect enzyme linked immunosorbent assays (ELISA).Results—People with increased levels of IgG antibodies to H pylori were more likely than uninfected individuals to report heartburn (odds ratio (OR) = 1.26, 95% confidence interval (CI) 1.03–1.54) and abdominal pain characterised by daily length (OR = 1.33, 95% CI 0.92–1.91), nocturnal occurrence (OR = 1.62, 95% CI 1.19–2.19), spring aggravation (OR = 1.68, 95% CI 0.70–4.05), and no relation to meals (OR = 0.62, 95% CI 0.43–0.91) or stress (OR = 0.69, 95% CI 0.50–0.95). The inclusion of people with increased levels of IgG antibodies to H pylori, but without upper dyspepsia, at study entry significantly increased the likelihood of reporting upper dyspepsia at follow up (OR = 1.71, 95% CI 1.24–2.36). People with epigastric pain and increased levels of IgM antibodies to H pylori only indicative of acute H pylori infection were more likely to report nocturnal pain, heartburn, nausea, and vomiting.Conclusions—H pylori infection may precede the development of dyspepsia and is associated with a variety of gastrointestinal symptoms in people with no history of peptic ulcer disease.


2015 ◽  
Vol 113 (7) ◽  
pp. 1113-1119 ◽  
Author(s):  
Mariana A. Janjetic ◽  
Paula Mantero ◽  
Eduardo Cueto Rua ◽  
Norma Balcarce ◽  
Gerardo Zerbetto de Palma ◽  
...  

It has been postulated that Helicobacter pylori infection could affect growth and appetite, consequently influencing body weight. Therefore, the association between H. pylori infection and the dietary and anthropometric indicators of nutritional status of a paediatric population were investigated. A total of 525 children (aged 4–16 years) who were referred to the gastroenterology unit of the Sor Maria Ludovica Children's Hospital from Buenos Aires, Argentina, were enrolled and completed an epidemiological questionnaire. H. pylori infection was diagnosed using the 13C-urea breath test (13C-UBT). Height and weight were assessed for calculation of anthropometric indicators. Energy and macronutrient intakes were estimated by 24 h dietary recall. Data analysis was performed using a χ2 test, a Student's t test, a Mann–Whitney U test and linear and logistic regressions. The prevalence of H. pylori infection was 25·1 % (with a mean age of 10·1 (sd 3·1) years). A tendency towards lower energy, carbohydrate, protein and fat intakes was observed in infected patients; however, it was not associated with H. pylori infection in any of the evaluated age groups (4–8, 9–13 and 14–16 years). Underweight, stunting, overweight and obesity were also not associated with the infection. Although height-for-age and BMI-for-age Z scores tended to be lower in infected patients, the differences between H. pylori-positive and H. pylori-negative children were not statistically significant. In conclusion, H. pylori infection was not associated with dietary intake or with anthropometric indicators in the present population of children with gastrointestinal symptoms; however, an increased sample size would be needed to confirm the observed tendency towards lower dietary intake and lower anthropometric indicators of nutritional status in H. pylori-infected children.


2020 ◽  
Vol 10 (1) ◽  
pp. 8-14
Author(s):  
Amal A. Mohamed ◽  
Shorouk Moussa ◽  
Mahmoud M. Shaheen ◽  
Sherief Abd-Elsalam ◽  
Rehab Ahmed ◽  
...  

Background & Aims: Human genetic polymorphism has been reported in the susceptibility and clinical development of infection. In this regard, this study aimed to investigate the link between Vitamin D Receptor (VDR) gene polymorphism and H. pylori infection. Materials and Methods: This cross-sectional study was conducted on 224 adult patients with upper gastrointestinal symptoms who underwent an upper gastrointestinal endoscopy between July 2017 and May 2019 in two major university hospitals. All patients were evaluated for helicobacter pylori infection. Two gastric antral biopsy specimens were taken from each patient. One of those Biopsy specimens was evaluated for histopathology examination and the other one was immersed in a saline solution ready for genomic DNA extraction. Results: There were statistically significant differences between different genotypes of VDR rs7975232 polymorphism between H. pylori infected and non-infected groups (CC was higher in H. pylori negative and AC and AA were the most common in H. pylori positive group). There were statistical differences between different genotypes of VDR rs2228570 between H. pylori infected and non-infected groups (TT was higher in H. pylori negative and CT and CC were the most common in H. pylori positive group). Regarding VDR rs 7975232 gene polymorphisms; the (A) allele was significantly higher H. pylori infected, while (C) allele was significantly higher in uninfected patients. Regarding VDR rs 2228570 gene polymorphisms; the (C) allele was significantly higher H. pylori infected, while (T) allele was significantly higher in uninfected patients. Conclusion: There is a possible association between the FokI and Apal VDR polymorphism and H. pylori infection.


2021 ◽  
Author(s):  
Yun Zhang ◽  
Xinyi Feng ◽  
Lijun Bian ◽  
Yan Zhang ◽  
Qian Li ◽  
...  

Abstract Background: The Helicobacter pylori (H. pylori) antibiotic resistance pattern differs geographically, knowledge of local antimicrobial resistance pattern is key to successful eradication. The current study was performed to investigate the resistance of H. pylori to 5 commonly used antibiotics in Yangzhou.Methods: A total of 461 H. pylori strains were collected from April 2018 to September 2019 in Yangzhou and tested for their susceptibility to clarithromycin, levofloxacin, metronidazole, amoxicillin, tetracycline using gene chip technology.Results: The resistance rates of H. pylori to clarithromycin, levofloxacin, metronidazole, amoxicillin and tetracycline were 41.0%, 44.9%, 38.8%, 6.3% and 1.1%. In addition, sixteen multiple resistance patterns were detected, and fortunately there were no strains resistant to all five antibiotics. The vacA s1 allele was detected in each strain, 64.0% of the isolates were s1/m2 genotype, 36.0% s1/m1 genotype. In multivariate analysis, history of chronic superficial gastritis was significantly associated with clarithromycin resistance, strains isolated from subjects with gastrointestinal symptoms had a significantly higher likelihood of metronidazole resistance, and antibiotic resistance of H. pylori was independent of both sex and age.Conclusion: The resistance rate of H. pylori to clarithromycin, levofloxacin and metronidazole were very high in Yangzhou, the results will help in selecting effective eradication regimens.


2020 ◽  
Vol 57 (1) ◽  
pp. 74-78 ◽  
Author(s):  
Carine LEITE ◽  
Luiz Edmundo MAZZOLENI ◽  
Diego de Mendonça UCHOA ◽  
Juliana Araújo CASTANHO ◽  
Felipe MAZZOLENI ◽  
...  

ABSTRACT BACKGROUND: The role of Helicobacter pylori infection on eosinophilic infiltration in duodenal mucosa is poorly studied. An increase in the number of eosinophils in duodenum has been associated with functional dyspepsia. OBJECTIVE: To evaluate the influence of H. pylori infection on duodenal eosinophil count and the role of eosinophilic infiltrate of duodenum in functional dyspepsia. METHODS: Positive and negative H. pylori individuals were included. Both functional dyspeptic patients according to Rome III criteria (cases) and individuals without gastrointestinal symptoms (controls) were enrolled. They were submitted to upper endoscopy and H. pylori infection was verified by gastric histopathology and urease test. Eosinophils in the duodenal mucosa were counted in five high-power fields, randomly selected on slides of endoscopic biopsies. RESULTS: Thirty-nine H. pylori positive (mean age 40.5 and 69.2% women) and 24 negative patients (mean age 37.3 and 75% women) were included. The influence of the infection was observed in the duodenal eosinophil count, which was higher in infected individuals: median 13.2 vs 8.1 in non-infected individuals (P=0.005). When we analyzed patients according to symptoms, cases - mean age 39.6; 71.4% women - and controls - mean age 38.7; 71.4% women - had similar duodenal eosinophil count: median 11.9 and 12.6 respectively (P=0.19). CONCLUSIONS: We did not demonstrate association of duodenal eosinophil count with functional dyspepsia but found association with H. pylori infection.


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