Current and future perspectives for Helicobacter pylori treatment and management: From antibiotics to probiotics

Liang, Bing; Yang, Yuan; Peng, Xiaojin; Liu, Xinlin; Xing, Dongming

doi:10.3389/fcimb.2022.1042070

Cited by 29 publications

(26 citation statements)

References 77 publications

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“…H. pylori is a microaerobic organism and susceptible to increased oxygen levels, thus, the delivery of nanoparticles that include oxygen into the gastric mucus layer could render the bacterium vulnerable. In addition, multiple aspects of the interaction of H. pylori with the gastrointestinal microbiome are addressed by current research and will influence future research [360][361][362][363][364] . The exclusive property of H. pylori to colonize and infect the gastric mucosa affects the biodiversity of other gastric bacteria and their role in either enhancing or mitigating H. pylori-induced gastric inflammation; this needs to be further explored.…”

Section: Discussionmentioning

confidence: 99%

Helicobacter pylori infection

Malfertheiner

Camargo

El-Omar

et al. 2023

Nat Rev Dis Primers

235

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Helicobacter pylori infection causes chronic gastritis, which can progress to severe gastroduodenal pathologies, including peptic ulcer, gastric cancer and gastric mucosa-associated lymphoid tissue lymphoma. H. pylori is usually transmitted in childhood and persists for life if untreated. The infection affects around half of the population in the world but prevalence varies according to location and sanitation standards. H. pylori has unique properties to colonize gastric epithelium in an acidic environment. The pathophysiology of H. pylori infection is dependent on complex bacterial virulence mechanisms and their interaction with the host immune system and environmental factors, resulting in distinct gastritis phenotypes that determine possible progression to different gastroduodenal pathologies. The causative role of H. pylori infection in gastric cancer development presents the opportunity for preventive screen-and-treat strategies. Invasive, endoscopy-based and non-invasive methods, including breath, stool and serological tests, are used in the diagnosis of H. pylori infection. Their use depends on the specific individual patient history and local availability. H. pylori treatment consists of a strong acid suppressant in various combinations with antibiotics and/or bismuth. The dramatic increase in resistance to key antibiotics used in H. pylori eradication demands antibiotic susceptibility testing, surveillance of resistance and antibiotic stewardship.

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Section: Discussionmentioning

confidence: 99%

Helicobacter pylori infection

Malfertheiner

Camargo

El-Omar

et al. 2023

Nat Rev Dis Primers

235

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“…17 Twelve clinical trials in six countries (Germany, Ireland, Russia, Romania, China, and India) investigating the efficacy and safety of L. reuteri showed improved eradication rates and reduced antibiotic side effects. 18 The eradication rate ranged between 9% and 20%, with the highest rate reported by Parth et al in India. 19 To our knowledge, the efficacy of a Lactobacillus reuteri DSM 17648 probiotic as an adjunct treatment in H. pylori management has yet to be studied in Malaysian and South East Asian cohorts.…”

Section: Introductionmentioning

confidence: 95%

“…Among all 11 randomized controlled trials, five involving Lactobacillus reuteri have shown successful results 17 . Twelve clinical trials in six countries (Germany, Ireland, Russia, Romania, China, and India) investigating the efficacy and safety of L. reuteri showed improved eradication rates and reduced antibiotic side effects 18 . The eradication rate ranged between 9% and 20%, with the highest rate reported by Parth et al in India 19 …”

Section: Introductionmentioning

confidence: 99%

Probiotic containing Lactobacillus reuteri DSM 17648 as an adjunct treatment for Helicobacter pylori infection: A randomized, double‐blind, placebo‐controlled trial

Ismail,

Nawawi,

Hsin

et al. 2023

Helicobacter

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BackgroundDespite multiple therapy regimens, the decline in the Helicobacter pylori eradication rate poses a significant challenge to the medical community. Adding Lactobacillus reuteri probiotic as an adjunct treatment has shown some promising results. This study aims to investigate the efficacy of Lactobacillus reuteri DSM 17648 in H. pylori eradication and its effect in ameliorating gastrointestinal symptoms and adverse treatment effects.Materials and MethodsThis randomized, double‐blinded, placebo‐controlled trial involved treatment‐naïve H. pylori‐positive patients. Ninety patients received standard triple therapy for 2 weeks before receiving either a probiotic or placebo for 4 weeks. The posttreatment eradication rate was assessed via a 14C urea breath test in Week 8. The Gastrointestinal Symptom Rating Scale (GSRS) questionnaire and an interview on treatment adverse effects were conducted during this study.ResultsThe eradication rate was higher in the probiotic group than in the placebo group, with a 22.2% difference in the intention‐to‐treat analysis (91.1% vs. 68.9%; p = 0.007) and 24.3% difference in the per‐protocol analysis (93.2% vs. 68.9%; p = 0.007). The probiotic group showed significant pre‐ to post‐treatment reductions in indigestion, constipation, abdominal pain, and total GSRS scores. The probiotic group showed significantly greater reductions in GSRS scores than the placebo group: indigestion (4.34 ± 5.00 vs. 1.78 ± 5.64; p = 0.026), abdominal pain (2.64 ± 2.88 vs. 0.89 ± 3.11; p = 0.007), constipation (2.34 ± 3.91 vs. 0.64 ± 2.92; p = 0.023), and total score (12.41 ± 12.19 vs. 4.24 ± 13.72; p = 0.004). The probiotic group reported significantly fewer adverse headache (0% vs. 15.6%; p = 0.012) and abdominal pain (0% vs. 13.3%; p = 0.026) effects.ConclusionsThere was a significant increase in H. pylori eradication rate and attenuation of symptoms and adverse treatment effects when L. reuteri was given as an adjunct treatment.

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“…With around 50% of the world's population infected, H. pylori is the most widespread infection. 1,2 It is well recognized that H. pylori is the primary cause of chronic gastritis, peptic ulcer, gastric cancer, and gastric mucosaassociated lymphoid tissue (MALT) lymphoma, and is linked to various extra-intestinal disorders. 3,4 Most of the time, bacterial colonization lasts the entirety of a person's life, and it can have a variety of clinical symptoms, ranging from asymptomatic people to those who have serious outcomes.…”

Section: Introductionmentioning

confidence: 99%