Eradication of Helicobacter pylori: the power of nanosized formulations

Nanomedicine ◽  
2020 ◽  
Vol 15 (5) ◽  
pp. 527-542
Author(s):  
Qianyu Zhang ◽  
Wen Wu ◽  
Jinqiang Zhang ◽  
Xuefeng Xia
Keyword(s):  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Peptic Ulcer ◽  
Gastric Carcinoma ◽  
Antibacterial Agents ◽  
Antimicrobial Agents ◽  
Mucosal Barrier ◽  
Harsh Environment ◽  
H Pylori ◽  
Cure Rates

Helicobacter pylori is a pathogen that is considered to cause several gastric disorders such as chronic gastritis, peptic ulcer and even gastric carcinoma. The current therapeutic regimens mainly constitute of a combination of several antimicrobial agents and proton pump inhibitors. However, the prevalence of antibiotic resistance has been significantly lowering the cure rates over the years. Nanocarriers possess unique strengths in this regard owing to the fact that they can protect the drugs (such as antibiotics) from the harsh environment in the stomach, penetrate the mucosal barrier and deliver drugs to the desired site. In this review we summarized recent studies of different antibacterial agents orally delivered by nanosized carriers for the eradication of H. pylori.

scholarly journals Eradication Therapy Should Be Different for Dyspeptic Patients than for Ulcer Patients

2003 ◽  
Vol 17 (suppl b) ◽  
pp. 41B-45B ◽  
Author(s):  
Wink A de Boer
Keyword(s):  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Eradication Therapy ◽  
Cure Rate ◽  
Ulcer Disease ◽  
Biological Explanation ◽  
Choice Of Treatment ◽  
H Pylori ◽  
Different Strains ◽  
Cure Rates

Physicians should try to achieve an optimal cure rate with their initialHelicobacter pylorieradication therapy. Most physicians use the same treatment in all their patients.H pyloriinfection in patients with peptic ulcer disease (PUD) is more likely to be cured than that in patients with functional dyspepsia (FD). Differences in cure rates of 5% to 15% are usually reported, which is considered to be clinically relevant. A plausible biological explanation for this finding suggests that different strains (virulent [cagA+,vacAtype s1] compared with nonvirulent strains [cagA–,vacAtype s2]) in PUD and FD induce different changes in the gastric mucosa, and this facilitates or impairs antimicrobial efficacy. Physicians should be aware that most published treatment studies have included only PUD patients. This means that in clinical practice cure rates obtained in patients with FD or perhaps uninvestigated dyspepsia are usually lower than those reported in the literature. This has implications for the choice of treatment. Physicians should consider prolonging the duration of initialHelicobactereradication therapy from seven to 10 to 14 days in patients without ulcers.

scholarly journals Effectiveness ofCitrusFruits onHelicobacter pylori

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Giuseppina Mandalari ◽  
Carlo Bisignano ◽  
Santa Cirmi ◽  
Michele Navarra
Keyword(s):  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Side Effects ◽  
Gastric Carcinoma ◽  
Current Knowledge ◽  
Therapeutic Strategies ◽  
Treatment Regimens ◽  
H Pylori ◽  
Novel Therapeutic Strategies ◽  
Novel Therapeutic

It is known thatHelicobacter pyloriinfection is associated with chronic gastritis, peptic ulcer, and gastric carcinoma. Due to the increased side effects of the treatment regimens and the development of antimicrobial resistance, a number of natural compounds have been tested as potential alternatives. In this review, we will examine the current knowledge on the effect ofCitrusfruits and their derivatives againstH. pylori, highlighting the remaining outstanding questions on the development of novel therapeutic strategies.

scholarly journals Application of Visual Gene Clip-Based Tailored Therapy for the Eradication of Helicobacter pylori

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Lili Yang ◽  
Ao Zou ◽  
Huihua Wu ◽  
Hai Guo ◽  
Fangting Zhang ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Confidence Interval ◽  
Acid Secretion ◽  
Antimicrobial Agents ◽  
Point Mutations ◽  
Eradication Therapy ◽  
23S Rrna ◽  
Tailored Therapy ◽  
H Pylori

Background. Helicobacter pylori eradication with therapies employing a proton pump inhibitor (PPI) and antimicrobial agents is mainly achieved via bacterial susceptibility to antimicrobial agents and the magnitude of acid secretion inhibition. However, annual eradication rates have greatly declined in Mainland China, and therefore, tailored H. pylori eradication regimens that inhibit acid secretion and employ optimal antimicrobial agents determined based on gene clip testing may improve eradication rates. This study was aimed at evaluating the efficacy of tailored H. pylori eradication therapy guided by visual gene clip testing for antibiotic resistance and PPI metabolism genotypes. Methods. This prospective study included 244 patients (141 men and 103 women aged 20–79 years) receiving initial treatment for H. pylori infection. Visual gene clip testing using gastric mucosal specimens was performed to detect antibiotic resistance to clarithromycin conferred by the A2142G and A2143G point mutations of the H. pylori 23S rRNA gene and to levofloxacin conferred by the Asn87 and Asp91 point mutations of the H. pylori gyrA gene. Patients received a 14-day bismuth quadruple therapy regimen guided by testing for antibiotic resistance and CYP2C19 polymorphisms, and primary H. pylori eradication was assessed at least 4 weeks after therapy. Results. H. pylori strains were successfully isolated from the gastric mucosa tissues of 244 patients. Antibiotic resistant isolates were identified in 63 patients, with clarithromycin resistance observed in 50 patients, levofloxacin resistance in 7 patients, and dual resistance in 6 patients. The PPI metabolic genotype of CYP2C19 was detected in 242 of 244 cases, and 97 cases were categorized as extensive metabolizers, 141 as intermediate metabolizers, and 4 as poor metabolizers. Among the 242 patients who received tailored therapy, the H. pylori eradication rate was 90.9% (95% confidence interval 87.3%~94.6%) in the intention-to-treat analysis and 96.9% (95% confidence interval 94.7%~99.2%) in the per protocol analysis. Conclusions. Tailored therapy for H. pylori infection guided by determination of antibiotic resistance and CYP2C19 polymorphism using visual gene chip technology may provide high clinical effectiveness as initial H. pylori eradication therapy.

scholarly journals Gastric Microenvironment—A Partnership between Innate Immunity and Gastric Microbiota Tricks Helicobacter pylori

2021 ◽  
Vol 10 (15) ◽  
pp. 3258
Author(s):  
Cristina Oana Mărginean ◽  
Lorena Elena Meliț ◽  
Maria Oana Săsăran
Keyword(s):  
Helicobacter Pylori ◽  
Immune System ◽  
Pathogenic Bacteria ◽  
T Regulatory Cells ◽  
Inflammatory Responses ◽  
Mucosal Barrier ◽  
Pathogen Recognition ◽  
Microenvironmental Factors ◽  
H Pylori ◽  
Major Factors

Helicobacter pylori (H. pylori) carcinogenicity depends on three major factors: bacterial virulence constituents, environmental factors and host’s genetic susceptibility. The relationship between microenvironmental factors and H. pylori virulence factors are incontestable. H. pylori infection has a major impact on both gastric and colonic microbiota. The presence of non-H. pylori bacteria within the gastric ecosystem is particularly important since they might persistently act as an antigenic stimulus or establish a partnership with H. pylori in order to augment the subsequent inflammatory responses. The gastric ecosystem, i.e., microbiota composition in children with H. pylori infection is dominated by Streptoccocus, Neisseria, Rothia and Staphylococcus. The impairment of this ecosystem enhances growth and invasion of different pathogenic bacteria, further impairing the balance between the immune system and mucosal barrier. Moreover, altered microbiota due to H. pylori infection is involved in increasing the gastric T regulatory cells response in children. Since gastric homeostasis is defined by the partnership between commensal bacteria and host’s immune system, this review is focused on how pathogen recognition through toll-like receptors (TLRs—an essential class of pathogen recognition receptors—PRRs) on the surface of macrophages and dendritic cells impact the immune response in the setting of H. pylori infection. Further studies are required for delineate precise role of bacterial community features and of immune system components.

Culture and Susceptibility of Levofloxacin Resistant H.pylori

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Sameh Mohamed Fahiem Ghaly ◽  
Hany Ali Hussien Abd El-Rahman ◽  
Mohamed Osama Aly Aly ◽  
Ahmed Medhat Youssef Ibrahim Youssef
Keyword(s):  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Proper Time ◽  
Wide Spectrum ◽  
Signs And Symptoms ◽  
Line Treatment ◽  
Clarithromycin Resistance ◽  
Prior Use ◽  
H Pylori ◽  
Main Factor

Abstract Background Antibiotic resistance in Helicobacter pylori is the major cause of eradication failure. Prevalence of H.pylori antibiotic resistance is increasing worldwide, and it is the main factor affecting efficacy of current therapeutic regimens. Our aim is to investigate H.pylori resistant patients toward Levofloxacin and detect the most effective antibiotic in eradication of H.pylori. Objective To investigate H.pylori resistant patients toward Levofloxacin including regimens and to detect the most effective antibiotic in H.pylori eradication. Patients and Methods The present study aimed to investigate the Susceptibility of Levofloxacin Resistant H.pylori in patients who had been diagnosed and received any regimen including Levofloxacin and still signs and symptoms of H.pylori infection not releaved and after proper time of stoppage of PPI and antibiotics H.pylori Ag in stool still positive at the period from January 2019 to February 2020. Results In the present study we found a wide spectrum of resistance to rates of H. pylori, from nearly negligible rates of Rifampicin (0%), Imipenem (0%), Cefotaxime (2%), Tetracycline (6%), Doxycycline(10%), and Amoxicillin(38%). To high rates resistance to Metronidazole (100%), Erythromycin (72%), Clarithromycin (68%), Azithromycin (60%), Ciprofloxacin (52%), and Levofloxacin (48%). Conclusion Helicobacter pylori is the most common chronic bacterial infection in humans. Antibiotic resistance is a major issue nowadays. Prior use of macrolide antibiotics or metronidazole appears to increase the risk of H. pylori resistance. Clarithromycin resistance appears to be an "absolute" condition that can not be overcome by increasing the macrolide dose. Levofloxacin resistance seems to be increasing. Culture and susceptibility should be done before starting second line treatment.

scholarly journals Helicobacter pyloriAnti-CagA Antibodies: Prevalence in Symptomatic and Asymptomatic Subjects in Turkey

2002 ◽  
Vol 16 (8) ◽  
pp. 527-532 ◽  
Author(s):  
M Fatih Abasiyanik ◽  
Ersan Sander ◽  
Barik A Salih
Keyword(s):  
Gastric Cancer ◽  
Duodenal Ulcer ◽  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Chronic Gastritis ◽  
Molecular Weights ◽  
Cancer Antigens ◽  
Gastroduodenal Disease ◽  
H Pylori ◽  
Asymptomatic Subjects

BACKGROUND: Several reports have shown the prevalence of anti-CagA antibodies to be associated with the development of peptic ulcer diseases, while others have indicated that there is no such association.AIM: To examine the prevalence of antibodies to CagA and otherHelicobacter pyloriantigens in symptomatic and asymptomatic subjects in Turkey.SUBJECTS AND METHODS: Sixty-six symptomatic subjects, 16 to 74 years of age, were examined forH pyloriby biopsy-based tests and ELISA. One hundred nineteen asymptomatic subjects, 20 to 65 years of age, were also tested serologically for the presence ofH pylori. Samples from both groups that were found to be positive forH pyloriby ELISA were then tested by immunoblotting.RESULTS: Fifty-four (82%) symptomatic subjects and 76 (64%) asymptomatic subjects were found to beH pylori-positive by ELISA. Samples from 30 symptomatic subjects who were found to beH pylori-positive by ELISA were analyzed by immunoblotting. Antibodies to CagA (116 kDa) antigen were detected in immunoblots of 11 of 14 (79%) with chronic gastritis, 12 of 13 (92%) with duodenal ulcer and three of three (100%) with gastric cancer. Antigens of the following molecular weights were also detected in these 30 subjects: 89 kDa (VacA) in 21 (70%), 37 kDa in 21 (70%), 35 kDa in 19 (63%), 30 kDa in 27 (90%) and 19.5 kDa in 19 (63%). Immunoblots of 40 ELISA-positive asymptomatic subjects showed that 33 (83%) had antibodies to CagA antigen, 26 (65%) to VacA antigen, 30 (75%) to a 37 kDa antigen, 30 (75%) to a 35 kDa antigen, 39 (98%) to a 30 kDa antigen and 36 (90%) to a 19.5 kDa antigen.CONCLUSIONS: Antibodies to CagA antigen were prevalent in both groups, regardless of the presence of gastroduodenal disease.

scholarly journals Epidemiology of upper gastrointestinal bleeding and Helicobacter pylori infection: review of 3,488 Thai patients

2017 ◽  
Vol 9 (1) ◽  
pp. 87-93
Author(s):  
Sakolwan Suchartlikitwong ◽  
Kamolyut Lapumnuaypol ◽  
Rungsun Rerknimitr ◽  
Duangporn Werawatganon
Keyword(s):  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Helicobacter Pylori Infection ◽  
Exclusion Criteria ◽  
Common Causes ◽  
Mucosal Lesions ◽  
H Pylori ◽  
Upper Gastrointestinal

Abstract Background The current epidemiology of upper gastrointestinal bleeding (UGIB) in Thailand is poorly understood and the reported prevalence of Helicobacter pylori infection is outdated. Objectives To investigate the etiologies of UGIB and prevalence of H. pylori infection in Thailand, including its association with UGIB. Methods We retrieved information regarding patients attending the endoscopic unit of King Chulalongkorn Memorial Hospital from June 2007 to January 2013. A database search using keywords “upper gastrointestinal bleeding” and “iron deficiency” was used. From 4,454 diagnoses, after exclusion criteria, 3,488 patients (2,042 male (58.5%) and 1,446 female (41.5%); mean age 63.3 ± 15.94 years, range 13–103 years) were included. Results The three most common causes of UGIB were peptic ulcer (38.2%), nonulcer-mucosal lesions (23.4%), and esophageal-related causes (20.4%). The 5 year-incidence of H. pylori was 25%–30%. The overall prevalence was 27%. The prevalence of H. pylori infection was found to decrease with age from 43.8% at <40 years to 21.7% at >79 years old. H. pylori infection was significantly associated with duodenal and gastroduodenal ulcers. Cirrhosis and nonulcer-mucosal lesions were significantly unrelated to H. pylori infection. Patients with concurrent cirrhosis with peptic ulcer were found to be negative for H. pylori infection. Conclusion Peptic ulcer is the leading cause of UGIB in Thailand. However, its incidence is declining. Patients who presented to hospital with UGIB were older, compared with those a decade ago. H. pylori infection plays an important role in UGIB and its incidence was stable during the past 5 years.

scholarly journals Identification of Markers for Helicobacter pylori Strains Isolated from Children with Peptic Ulcer Disease by Suppressive Subtractive Hybridization

2006 ◽  
Vol 74 (7) ◽  
pp. 4064-4074 ◽  
Author(s):  
Mónica Oleastro ◽  
Lurdes Monteiro ◽  
Philippe Lehours ◽  
Francis Mégraud ◽  
Armelle Ménard
Keyword(s):  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Subtractive Hybridization ◽  
Suppressive Subtractive Hybridization ◽  
Ulcer Disease ◽  
Lipopolysaccharide Biosynthesis ◽  
The Difference ◽  
H Pylori

ABSTRACT Peptic ulcer disease (PUD) occurs after a long-term Helicobacter pylori infection. However, the disease can develop earlier, and rare cases have been observed in children, suggesting that these H. pylori strains may be more virulent. We used suppressive subtractive hybridization for comparative genomics between H. pylori strains isolated from a 5-year-old child with duodenal ulcer and from a sex- and age-matched child with gastritis only. The prevalence of the 30 tester-specific subtracted sequences was determined on a collection of H. pylori strains from children (15 ulcers and 30 gastritis) and from adults (46 ulcers and 44 gastritis). Two of these sequences, jhp0562 (80.0% versus 33.3%, P = 0.008) and jhp0870 (80.0% versus 36.7%, P = 0.015), were highly associated with PUD in children and a third sequence, jhp0828, was less associated (40.0% versus 10.0%, P = 0.048). Among adult strains, none of the 30 sequences was associated with PUD. However, both jhp0562 and jhp0870 were less prevalent in adenocarcinoma strains than in PUD strains from children and adults, the difference being statistically significant for jhp0870. In conclusion, two H. pylori genes were identified as being strongly associated with PUD in children, and their putative roles as an outer membrane protein for jhp0870 and in lipopolysaccharide biosynthesis for jhp0562, suggest that they may be novel virulence factors of H. pylori.

scholarly journals Antibiotic Resistance Prevalence and Trends in Patients Infected with Helicobacter pylori in the Period 2013–2020: Results of the European Registry on H. pylori Management (Hp-EuReg)

Antibiotics ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 1058
Author(s):  
Luis Bujanda ◽  
Olga P. Nyssen ◽  
Dino Vaira ◽  
Ilaria M. Saracino ◽  
Giulia Fiorini ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Antimicrobial Susceptibility ◽  
Susceptibility Testing ◽  
Resistance Rate ◽  
Antimicrobial Susceptibility Testing ◽  
Metronidazole Resistance ◽  
Infected Adult ◽  
H Pylori ◽  
European Registry

Background: Bacterial antibiotic resistance changes over time depending on multiple factors; therefore, it is essential to monitor the susceptibility trends to reduce the resistance impact on the effectiveness of various treatments. Objective: To conduct a time-trend analysis of Helicobacter pylori resistance to antibiotics in Europe. Methods: The international prospective European Registry on Helicobacter pylori Management (Hp-EuReg) collected data on all infected adult patients diagnosed with culture and antimicrobial susceptibility testing positive results that were registered at AEG-REDCap e-CRF until December 2020. Results: Overall, 41,562 patients were included in the Hp-EuReg. Culture and antimicrobial susceptibility testing were performed on gastric biopsies of 3974 (9.5%) patients, of whom 2852 (7%) were naive cases included for analysis. The number of positive cultures decreased by 35% from the period 2013–2016 to 2017–2020. Concerning naïve patients, no antibiotic resistance was found in 48% of the cases. The most frequent resistances were reported against metronidazole (30%), clarithromycin (25%), and levofloxacin (20%), whereas resistances to tetracycline and amoxicillin were below 1%. Dual and triple resistances were found in 13% and 6% of the cases, respectively. A decrease (p < 0.001) in the metronidazole resistance rate was observed between the 2013–2016 (33%) and 2017–2020 (24%) periods. Conclusion: Culture and antimicrobial susceptibility testing for Helicobacter pylori are scarcely performed (<10%) in Europe. In naïve patients, Helicobacter pylori resistance to clarithromycin remained above 15% throughout the period 2013–2020 and resistance to levofloxacin, as well as dual or triple resistances, were high. A progressive decrease in metronidazole resistance was observed.

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