Drug-resistant strains of Helicobacter pylori and poor treatment response are the main reasons for the failure in eradicating it in patients. Polyunsaturated fatty acids (PUFA) have an inhibitory effect on bacterial growth. The aim of this study was to investigate the effect of PUFA in combination with standard triple therapy on apoptosis in H. pylori infected subjects with dyspeptic symptoms. This study was a double-blind clinical trial in which 34 H. pylori infected subjects with dyspeptic symptoms were randomly divided into two groups of 17 patients. The control group received standard triple therapy (amoxicillin, clarithromycin and omeprazole) and the experimental group received the standard therapy and PUFA for two weeks. Gene expression levels of caspase-3, BCL-2 and Bad proteins were studied with real-time PCR, while protein levels were quantified in frozen sections and using immunohistochemistry. Compared with the control group, a significant increase (p < 0.01) was observed in the expression of caspase-3 and Bad genes and a significant reduction (p < 0.05) in the expression of Bcl-2 gene. The protein level of active caspase-3 and Bad protein was significantly increased and the level of Bcl-2 protein was significantly decreased (p < 0.05). The results of this study show that oral administration of PUFA in combination with the standard triple therapy increased apoptosis in H. pylori-infected patients with dyspeptic symptoms. This increase in apoptosis may partly reduce drug resistance in these patients. Our results suggest inclusion of a dietary PUFA containing fatty acid supplement may improve treatment of patients that are refractory to the standard triple therapy.
Objective: Helicobacter pylori is a main etiological parameter in chronic active gastritis, gastric duodenal ulcers and gastric malignancy. Particular polyunsaturated fatty acids (PUFA) play roles in inhibitory effect on bacterial propagation. Therefore, this study investigated the protective effects of PUFAs against oxidative stress in patient infected with H. pylori with dyspeptic symptom.
Methods:This study is a double blind clinical trial whose target population was 34 patients infected with H. pylori with dyspeptic symptom. Patients were divided into two groups. The first group was treated with standard therapy without supplement (control), and the second group was treated with Standard Therapy and PUFAs supplement, ω-3, ω-6 and ω-9 (case group) for 2 weeks. Two biopsies from Antrum and body of stomach of all patients were collected before and after the treatment. The biopsy samples were used for quick urease test and measurement of Superoxide Dismutase, Glutathione Peroxidase, and total antioxidant capacity.
Results:In gastric mucosa mean levels of total capacity antioxidant were significantly increased in case group comparing with control group. Also, the mean of superoxide dismutase enzyme activity and glutathione peroxidase activity increased significantly in case group compared with control group (p value <0.001).
Conclusion:The findings revealed that administration of PUFAs supplement can increase total antioxidant capacity and activity of antioxidant enzymes in patients infected with H. pylori.
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