scholarly journals Probiotics in the treatment of gastrointestinal diseases: effectiveness from the standpoint of evidence-based medicine

2020 ◽  
Vol 22 (8) ◽  
pp. 57-64
Author(s):  
Marina V. Leonova ◽  
Keyword(s):  
Helicobacter Pylori ◽  
Lactobacillus Rhamnosus ◽  
Gastrointestinal Diseases ◽  
Saccharomyces Boulardii ◽  
Evidence Based ◽  
Lactobacillus Rhamnosus Gg ◽  
Bifidobacterium Lactis ◽  
Clostridioides Difficile ◽  
H Pylori ◽  
Based Medicine

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

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

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masoud Keikha ◽  
Mohsen Karbalaei
Keyword(s):  
Helicobacter Pylori ◽  
Lactobacillus Reuteri ◽  
Competitive Inhibition ◽  
Gastrointestinal Symptoms ◽  
Lactobacillus Rhamnosus ◽  
Saccharomyces Boulardii ◽  
Intestinal Microbiome ◽  
Mucus Production ◽  
Stomach Diseases ◽  
H Pylori

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.

scholarly journals Probiotic Lactobacillus spp. act Against Helicobacter pylori-induced Inflammation

2019 ◽  
Vol 8 (1) ◽  
pp. 90 ◽  
Author(s):  
Yi-Hsing Chen ◽  
Wan-Hua Tsai ◽  
Hui-Yu Wu ◽  
Chun-Ya Chen ◽  
Wen-Ling Yeh ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Bacterial Species ◽  
Lactobacillus Rhamnosus ◽  
Gastrointestinal Diseases ◽  
In Vivo Studies ◽  
Bacterial Strains ◽  
H Pylori ◽  
Lactobacillus Spp

The bacterial species, Helicobacter pylori, is associated with several gastrointestinal diseases, and poses serious health threats owing to its resistance to antibiotics. Lactobacillus spp., on the other hand, possess probiotic activities that have beneficial effects in humans. However, the mechanisms by which Lactobacillus spp. harbor favorable functions and act against H. pylori infection remain to be explored. The aim of this study was to investigate the ability of bacterial strains, Lactobacillus rhamnosus and Lactobacillus acidophilus, termed GMNL-74 and GMNL-185, respectively, to inhibit H. pylori growth and inflammation. Our results showed that GMNL-74 and GMNL-185 possess potent antimicrobial activity against multidrug resistant (MDR)-H. pylori. In addition, an in vitro cell-based model revealed that the inhibition of H. pylori adhesion and invasion of gastric epithelial cells and interleukin-8 production were significantly decreased by treatment with both the Lactobacillus strains. In vivo studies demonstrated that colonization of H. pylori and induced inflammation in the mouse stomach were also alleviated by these Lactobacillus strains. Furthermore, the abundance of beneficial gut bacteria, including Bifidobacterium spp. and Akkermansia muciniphilia, were significantly increased in H. pylori-infected mice treated with GMNL-74 and GMNL-185. These results demonstrate that Lactobacillus spp. ameliorate H. pylori-induced inflammation and supports beneficial gut specific bacteria that act against H. pylori infection.

scholarly journals The correlation between lncRNAs and Helicobacter pylori in gastric cancer

2019 ◽  
Vol 77 (9) ◽  
Author(s):  
Narges Dastmalchi ◽  
Seyed Mahdi Banan Khojasteh ◽  
Mirsaed Miri Nargesi ◽  
Reza Safaralizadeh
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Molecular Mechanisms ◽  
Gastrointestinal Diseases ◽  
Mechanisms Of Action ◽  
Molecular Pathways ◽  
Gastric Diseases ◽  
Non Coding Rnas ◽  
H Pylori ◽  
The Relationship

ABSTRACT Helicobacter pylori infection performs a key role in gastric tumorigenesis. Long non-coding RNAs (lncRNAs) have demonstrated a great potential to be regarded as effective malignancy biomarkers for various gastrointestinal diseases including gastric cancer (GC). The present review highlights the relationship between lncRNAs and H. pylori in GC. Several studies have examined not only the involvement of lncRNAs in H. pylori-associated GC progression but also their molecular mechanisms of action. Among the pertinent studies, some have addressed the effects of H. pylori infection on modulatory networks of lncRNAs, while others have evaluated the effects of changes in the expression level of lncRNAs in H. pylori-associated gastric diseases, especially GC. The relationship between lncRNAs and H. pylori was found to be modulated by various molecular pathways.

scholarly journals Canadian Helicobacter Study Group Consensus Conference: Update on the Approach to Helicobacter Pylori Infection in Children and Adolescents – an Evidence-Based Evaluation

2005 ◽  
Vol 19 (7) ◽  
pp. 399-408 ◽  
Author(s):  
Nicola L Jones ◽  
Philip Sherman ◽  
Carlo A Fallone ◽  
Nigel Flook ◽  
Fiona Smaill ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Consensus Conference ◽  
Helicobacter Pylori Infection ◽  
Diagnostic Tools ◽  
Study Group ◽  
Evidence Based ◽  
H Pylori

As an update to previously published recommendations for the management of Helicobacter pylori infection, an evidence-based appraisal of 14 topics was undertaken in a consensus conference sponsored by the Canadian Helicobacter Study Group. The goal was to update guidelines based on the best available evidence using an established and uniform methodology to address and formulate recommendations for each topic. The degree of consensus for each recommendation is also presented. The clinical issues addressed and recommendations made were: population-based screening for H pylori in asymptomatic children to prevent gastric cancer is not warranted; testing for H pylori in children should be considered if there is a family history of gastric cancer; the goal of diagnostic interventions should be to determine the cause of presenting gastrointestinal symptoms and not the presence of H pylori infection; recurrent abdominal pain of childhood is not an indication to test for H pylori infection; H pylori testing is not required in patients with newly diagnosed gastroesophageal reflux disease; H pylori testing may be considered before the use of long-term proton pump inhibitor therapy; testing for H pylori infection should be considered in children with refractory iron deficiency anemia when no other cause has been found; when investigation of pediatric patients with persistent or severe upper abdominal symptoms is indicated, upper endoscopy with biopsy is the investigation of choice; the 13C-urea breath test is currently the best noninvasive diagnostic test for H pylori infection in children; there is currently insufficient evidence to recommend stool antigen tests as acceptable diagnostic tools for H pylori infection; serological antibody tests are not recommended as diagnostic tools for H pylori infection in children; first-line therapy for H pylori infection in children is a twice-daily, triple-drug regimen comprised of a proton pump inhibitor plus two antibiotics (clarithromycin plus amoxicillin or metronidazole); the optimal treatment period for H pylori infection in children is 14 days; and H pylori culture and antibiotic sensitivity testing should be made available to monitor population antibiotic resistance and manage treatment failures.

scholarly journals Can probiotics improve efficiency and safety profile of triple Helicobacter pylori eradication therapy? A prospective randomized study

2016 ◽  
Vol 73 (11) ◽  
pp. 1044-1049 ◽  
Author(s):  
Sasa Grgov ◽  
Tomislav Tasic ◽  
Biljana Radovanovic-Dinic ◽  
Daniela Benedeto-Stojanov
Keyword(s):  
Helicobacter Pylori ◽  
Randomized Study ◽  
Eradication Therapy ◽  
Saccharomyces Boulardii ◽  
Rapid Urease Test ◽  
Group I ◽  
Urease Test ◽  
Probiotic Strains ◽  
The Difference ◽  
H Pylori

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.

scholarly journals Phenotypic and Genotypic Analysis of Resistant Helicobacter pylori Strains Isolated from Children with Gastrointestinal Diseases

Diagnostics ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 759
Author(s):  
Monika Maria Biernat ◽  
Aldona Bińkowska ◽  
Łukasz Łaczmański ◽  
Paweł Biernat ◽  
Paweł Krzyżek ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Point Mutations ◽  
Gastrointestinal Diseases ◽  
Drug Susceptibility Testing ◽  
Test Method ◽  
Ulcer Disease ◽  
Genotypic Analysis ◽  
Clinical Diagnoses ◽  
H Pylori

Antibiotic resistance of Helicobacter pylori is currently a global issue. The aim of this study was to analyze actual antibiotic resistance rates of H. pylori strains isolated from children with primary infections and to compare the incidence of mutations that determine resistance to clarithromycin (CH) and metronidazole (MET) in children with different clinical diagnoses. A total of 91 H. pylori strains were isolated from 108 children with primary infections. Drug susceptibility testing of the strains was performed using E-test method. Classical sequencing of DNA fragments was used to detect point mutations for CH and MET resistance. Resistance to CH was detected in 31% of isolated strains (28/91), while resistance to MET and CH was detected in 35% (32/91) of strains. A2143G was the most frequently detected mutation and was dominant among strains isolated from children with peptic ulcer disease (80%). Mutations in the rdxA gene were found significantly more frequently among MET-resistant strains than MET-sensitive strains (p = 0.03, Chi2 = 4.3909). In children, a higher frequency of H. pylori multiresistant strains was observed compared with the previous study in the same area. Differences were found in the occurrence of point mutations among H. pylori strains resistant to CH isolated from children with different clinical diagnoses.

Prevalence of Helicobacter pylori cagA and vacA Genes and Their Correlation with Gastrointestinal Diseases

2020 ◽  
Vol EJMM29 (4) ◽  
pp. 151-156
Author(s):  
Amr M. El-Sabbagh ◽  
Ahmed H. Yassen ◽  
Maha M abdelsalam
Keyword(s):  
Helicobacter Pylori ◽  
Gastrointestinal Diseases ◽  
Vital Role ◽  
Gastroduodenal Disease ◽  
Urease Test ◽  
Cytotoxin Associated Gene A ◽  
Gastrointestinal Illnesses ◽  
Clinical Illness ◽  
H Pylori ◽  
Variant Genes

Background: Helicobacter pylori (H. pylori) is a gram-negative bacterium, producing gastric ulcer, mild to severe gastritis, gastric carcinoma and lymphoma to the gastric mucosa-associated lymphoid tissue through many virulence influences. Among the virulence factors identified; vacuolating cytotoxin A (vacA) and cytotoxin-associated gene A (cagA) play an important role. Objective: In this study, we try to discover the relation between vacA variant and cagA genes with the clinical illness occurring in H. pylori patients Methodology: One hundred and forty patients were included in our study. Dual biopsy samples were taken from the stomach; one was examined by the urease test, and the other one was stored at −80°C for DNA extraction followed by PCR. The existence of H. pylori in the tissue was recognized by the existence of glmM gene and its detection by PCR. All the positive samples were additionally tested by PCR for the occurrence of cagA and vacA variant genes. Results: Our study demonstrated that cagA and vacA genes were found among 50% and 57% respectively of H. pylori patients complaining from gastrointestinal illnesses and that vacA s1/s2 was the main genotype found in H. pylori persons with gastroduodenal disease. Significant relation between vacA s1 gene and cagA gene was found. Conclusion: vacA s1 genotype has a vital role in upper gastrointestinal illnesses progress.

scholarly journals Structural basis for the peptidoglycan recognition by Helicobacter pylori Csd4

2014 ◽  
Vol 70 (a1) ◽  
pp. C817-C817
Author(s):  
Hyoun Sook Kim ◽  
Byung Woo Han ◽  
Byung Il Lee ◽  
Se Won Suh
Keyword(s):  
Helicobacter Pylori ◽  
Gastric Mucosa ◽  
Cell Shape ◽  
Gastrointestinal Diseases ◽  
Structural Basis ◽  
Free Form ◽  
Peptic Ulcers ◽  
Carboxypeptidase H ◽  
Ligand Free ◽  
H Pylori

Helicobacter pylori infection causes a variety of gastrointestinal diseases including peptic ulcers and gastric cancer. The colonization of this bacterium in the gastric mucosa is required for the survival in the stomach. Its colonization of the gastric mucosa of human stomach depends on its motility, which is facilitated by the helical cell shape. In H. pylori, crosslinking relaxation or trimming of peptidoglycan muropeptide affects the helical shape. Among several cell shape-determining peptidoglycan hydrolases identified in H. pylori, Csd4 is a Zn2+-dependent D,L-carboxypeptidase that cleaves the bond between the γ-D-Glu and mDAP bond of the uncrosslinked tripeptide of peptidoglycan (L-Ala-γ-D-Glu-mDAP) to produce L-Ala-γ-D-Glu dipeptide and mDAP, promoting the helical cell shape. Inhibition of D,L-carboxypeptidase activity of Csd4 may represent a novel therapeutic approach. We report here the crystal structures of H. pylori Csd4 in three different states: the ligand-free form, the substrate-bound form, and the product-bound form. H. pylori Csd4 consists of three domains: an N-terminal D,L-carboxypeptidase domain, a novel β-barrel domain, and a C-terminal immunoglobulin-like domain. Our ligand-bound structures provide structural basis of peptidoglycan recognition by D,L-carboxypeptidase. H. pylori Csd4 recognizes primarily the terminal mDAP of the tripeptide substrate and undergoes a significant structural change upon binding either mDAP or mDAP-containing tripeptide.

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