Mucoadhesive and muco-penetrating delivery systems for eradication of helicobacter pylori

Abstract

H elicobacter pylori (H. pylori), the major culprit for peptic ulcer, has a unique way of survival in harsh acidic environment of the stomach by colonizing deep in the gastric mucosal layer. Failure of conventional therapies against H. pylori for complete eradication has major limitations like low residence time of delivery system in stomach, poor penetration of drug in gastric mucosa, acidic degradation of antibiotics, and development of antibiotics resistance. The poor penetration of antibiotics through thick viscoelastic mucosal gel results in incomplete eradication of H. pylori. Various investigators have formulated novel gastro-retentive drug delivery systems such as floating systems, mucoadhesive systems, pH-sensitive gel systems, and muco-penetrating delivery systems for increasing the concentration of antibiotic in close proximity to the site of H. pylori infection. This review summarizes the novel drug delivery approaches investigated during the last few years and suggests that a high eradication rate can be achieved by therapy comprising of muco-penetrating delivery systems of antibiotics against H. pylori.

The Potential Use of Antibiotics Against Helicobacter pylori Infection: Biopharmaceutical Implications

“…It should be pointed out that non-motile flagellated or non-flagellated H. pylori bacteria are less able (or even unable) to initiate cellular infection (Skene et al, 2007). In general, H. pylori colonization occurs in the gastric mucus layer close to the epithelial cells of the stomach, but the bacteria usually do not directly colonize the epithelial cells themselves (Arora et al, 2012;Zhao et al, 2014). However, it has been proposed that H. pylori bacteria can be localized within the intracellular or intercellular space of gastric epithelial cells (Necchi et al, 2007;Chu et al, 2010;Arora et al, 2012;Kao et al, 2016;Sit et al, 2020).…”

“…In general, H. pylori colonization occurs in the gastric mucus layer close to the epithelial cells of the stomach, but the bacteria usually do not directly colonize the epithelial cells themselves (Arora et al, 2012;Zhao et al, 2014). However, it has been proposed that H. pylori bacteria can be localized within the intracellular or intercellular space of gastric epithelial cells (Necchi et al, 2007;Chu et al, 2010;Arora et al, 2012;Kao et al, 2016;Sit et al, 2020). The epithelial cells are shielded by a thick layer of mucus as a barrier against foreign invasion, therefore H. pylori has to employ its flagellae to penetrate towards the underlying epithelial cells (Walton, 2016;Charitos et al, 2021).…”

“…The Nobel Prize in medicine or physiology 2005 was jointly awarded to the Australian-born scientists, Robin Warren and Barry J. Marshall, for the discovery of Helicobacter pylori (H. pylori), as a fastidious Gram-negative microaerophilic spiral bacterium (Warren and Marshall, 1983;Arora et al, 2012). This germ is 2.5-5 μm long and 0.5-1.0 μm wide, with six unipolar sheathed flagella visible under electron microscopy (Goodwin and Armstrong, 1990;Geis et al, 1993;Zhao et al, 2014).…”

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“…H. pylori are a motile pathogen which lives in the gastric mucus layer and penetrates deep in the mucous membrane close to the epithelial cells 6 . The eradication of H. pylori infection is the main troubles antibiotic resistance, patient's compliance and intolerance to therapeutic regimens 7,8,9 .…”

Preparation of Sterculia foetida - pullulan based semi-interpenetrating polymer network gastroretentive microspheres of amoxicillin trihydrate and optimization by response surface methodology

“…Study reported that H. pylori infection is responsible for causing 90-100% duodenal ulcer and 60-90% of gastric ulcer in patients infected with H. pylori. Literature survey reported that H. pylori infection increases possibility of developing peptic ulcers and 10-15% of individuals infected with H. pylori will have more chance of peptic ulcer disease throughout out their life 3 .…”