Editorial: Helicobacter pylori and its mechanisms of antibiotic survival

Abstract

Editorial on the Research TopicHelicobacter pylori and its mechanisms of antibiotic survival Helicobacter pylori is one of the most common human pathogens that, in the absence of therapeutic intervention, is able to remain in the gastric environment for an individual's entire life (Salama et al., 2013). Unfortunately, over time, situations in which treatment does not bring the desired effect are becoming more frequent (Boyanova et al., 2023). In the case of this bacterium, therapeutic failures are very often associated with the presence of genetic mutations at the target sites of antibiotics (Corteś et al., 2021; Roberts et al., 2022). It is increasingly postulated, however, that a variety of physiological processes may also affect the antibiotic tolerance or resistance of H. pylori, including biofilm formation Hou et al., 2022), morphological transformation (Gladyshev et al., 2020, and secretion of membrane vesicles (Jarzab et al., 2020). With reference to the above, the main purpose of this Research Topic was to draw attention to the importance of resistance and tolerance mechanisms promoting the survival of H. pylori under stressogenic conditions, especially antibiotic pressure.The basis for effectively counteracting antibiotic resistance is a thorough understanding of the factors responsible for the development and spreading of this phenomenon. In a comprehensive review, Liang et al. described strategies for the prevention and effective control of H. pylori infections. Attention was drawn to changes in treatment protocols over the last number of decades, including the switch from triple to quadruple therapies, extension of treatment length, and the use of new antibiotics or proton pump inhibitors. The limited effectiveness of these modifications and the need to search for alternative solutions, particularly the inclusion of probiotics in the treatment of H. pylori infections, were also highlighted.Referring to the urgency of applying novel procedures to treat H. pylori, in the original article by Wang et al., the effectiveness of liposomal linolenic acid (LipoLLA) against 30 clinical strains of H. pylori with different antibiotic resistance profiles was determined. This formulation was found to present a high bactericidal effect (MIC = 3.75-15 µg/mL), with activity dependent on both concentration and incubation time. It was observed that LipoLLA showed synergism or additivity with all four tested antibiotics (amoxicillin, clarithromycin, metronidazole, and levofloxacin), which was most likely related to the ability of LipoLLA to disrupt the continuity of bacterial cell structures and to stimulate Frontiers in Cellular and Infection Microbiology frontiersin.org 01