Potential role of probiotics in the management of gastric ulcer

Abstract

Gastric ulcer is one of the most common chronic gastrointestinal diseases characterized by a significant defect in the mucosal barrier. Helicobacter pylori (H. pylori) infection and the frequent long-term use of non-steroidal anti-inflammatory drugs are major factors involved in gastric ulcer development. Acid inhibitors and antibiotics are commonly used to treat gastric ulcer. However, in the last few decades, the accumulating evidence for resistance to antibiotics and the side effects of antibiotics and acid inhibitors have drawn attention to the possible use of probiotics in the prevention and treatment of gastric ulcer. Probiotics are live microorganisms that when administered in adequate amounts confer health benefits on the host. Currently, the available experimental and clinical studies indicate that probiotics are promising for future applications in the management of gastric ulcers. This review aims to provide an overview of the general health benefits of probiotics on various systemic and gastrointestinal disorders with a special focus on gastric ulcer and the involved cellular and molecular mechanisms: i) Protection of gastric mucosal barrier; ii) upregulation of prostaglandins, mucus, growth factors and anti-inflammatory cytokines; iii) increased cell proliferation to apoptosis ratio; and iv) induction of angiogenesis. Finally, some of the available data on the possible use of probiotics in H. pylori eradication are discussed.

Amelioration of Alcohol Induced Gastric Ulcers Through the Administration of Lactobacillus plantarum APSulloc 331261 Isolated From Green Tea

“…Different strains of the lactic acid bacteria (LAB), and particularly some Lactobacillus spp., are representing some of the most commonly used probiotics, defined as "live microorganisms which, when administered in adequate amounts, confer a health benefit on the host" (Food and Agriculture Organization [FAO], and World Health Organization [WHO], 2002). Extensive research has been performed on the efficacy of various Lactobacillus strains on gastric ulcers (Dharmani et al, 2013;Khoder et al, 2016) either as single therapeutic agents or in combination with antibiotics (Boltin, 2016;Goderska et al, 2018). The majority of the investigated strains have been shown to inhibit or protect the gastric mucosal barrier through the up-regulation of prostaglandin E2 (Uchida and Kurakazu, 2004;Gotteland et al, 2006;Lam et al, 2007;Uchida et al, 2010), enhancement of mucus secretion (Gomi et al, 2013) or the regulation of inflammatory responses (Konturek et al, 2009;Şenol et al, 2014).…”

The effect of Lactobacillus reuteri supplementation in Helicobacter pylori infection: a placebo-controlled, single-blind study

“…Mechanisms by which probiotics work in this application include suppressive effects against gastrointestinal inflammation and against H. pylori [9]. Probiotics might enhance the production of prostaglandin, mucins, growth factors and anti-inflammatory cytokines, and can stabilize or strengthen the gut mucosal barrier [10][11][12].…”

Antiplatelet drug ticagrelor delays gastric ulcer healing in rats

“…Ulcer healing is a complex process of tissue regeneration, which involves cell proliferation and angiogenesis, ultimately leading to scar formation (13). All these processes are controlled by various growth factors (14).…”