Helicobacter pylori and Probiotics1,

Abstract

Helicobacter pylori infection, a highly prevalent pathogen, is a major cause of chronic gastritis and peptic ulcer and a risk factor for gastric malignancies. Antibiotics-based H. pylori eradication treatment is 90% effective. However, it is expensive and causes side effects and antibiotic resistance. Probiotics could present a low-cost, large-scale alternative solution to prevent or decrease H. pylori colonization. A literature search of the MEDLINE database (1966-2006) has been performed selecting all in vitro, animal, and human fully published English-language studies dealing with H. pylori and probiotics. Probiotics had an in vitro inhibitory effect on H. pylori. Animal studies demonstrated that probiotic treatment is effective in reducing H. pylori-associated gastric inflammation. Seven of 9 human studies showed an improvement of H. pylori gastritis and decrease in H. pylori density after administration of probiotics. The addition of probiotics to standard antibiotic treatment improved H. pylori eradication rates (81% vs. 71%, with combination treatment vs. H. pylori-eradication treatment alone; chi(2)test: P=0.03). Probiotic treatment reduced H. pylori therapy-associated side effects (incidence of side effects: 23% vs. 46%, with combination therapy vs. H. pylori-eradication treatment alone; chi(2)test: P=0.04). No study could demonstrate the eradication of H. pylori infection by probiotic treatment. So long-term intake of products containing probiotic strains of probiotics may have a favorable effect on H. pylori infection in humans, particularly by reducing the risk of developing disorders associated with high degrees of gastric inflammation.

Meta-analysis of the efficacy of probiotics inHelicobacter pylorieradication therapy

“…Probiotics may act as surrogate normal microflora after antibiotic therapy until recovery is achieved, although the mechanism is not completely understood [33] . Lesbros-Pantoflickova et al [34] summarized several putative mechanisms by which probiotics can inhibit H. pylori, including non-immunological mechanisms, antimicrobial substances, and the in vitro inhibitory effects of certain probiotics that are probably related to lactic acid and/or other antibacterial substances yet to be identified. Many clinical trials have suggested that probiotic supplementation is a good strategy to enhance the effectiveness of anti-H. pylori therapy and to reduce antibiotic-associated adverse effects, but this remains controversial.…”

Antibacterial Activity of Lactic Acid Bacteria against Helicobacter pylori Evidence by in vivo and in vitro Studies

“…Probiotics had an in vitro inhibitory effect on H. pylori so, it could present a low-cost alternative solution to prevent or decrease H. pylori colonization (Lesbros-Pantoflickova et al, 2007). Cats et al, (2003) found that culture and supernatants from L. casei grown in MRS medium significantly induced clear inhibition zone of H. pylori.…”

“…There are several possible mechanisms by which probiotic bacteria can inhibit the adhesion of H. pylori (Lesbros-Pantoflickova et al, 2007). Certain lactobacilli such as L. johnsonii La1 (Michetti et al, 1999) or L. acidophilus LB (Coconnier et al, 1998) can exert their antiadhesion activity by secreting antimicrobial substances.…”

Low co-existence rates of Lactobacillus spp. and Helicobacter pylori detected in gastric biopsies from patients with gastrointestinal symptoms

“…Although several studies indicate that Lactobacillus spp. colonisation diminish gastric inflammation, promote mucin regeneration and down-regulate several genes of the cag pathogenicity island (20,21), one study (19) speculates that Lactobacillus spp. might play a role in malignancy as they can be isolated from the gastric mucosa of patients with adenocarcinoma.…”