Possibilities of using probiotics in Helicobacter pylori eradication
E.A. Kornienko1, N.I. Parolova1, S.V. Ivanov2, D.S. Polev3, P.A. Zykin3, Yu.D. Kondratenko3
1 St. Petersburg State Pediatric Medical University
2 Pavlov First St. Petersburg State Medical University
3 St. Petersburg State University
A gastric microbiota is diverse. Helicobacter pylori (HP) infection changes its composition as a whole, which may contribute to the more rapid progression of chronic gastritis. Probiotics can be effective in correcting the gastric microbiome.
Aim: to study the effectiveness of the use of Lactobacillus reuteri DSMZ17648 (Lr) in the treatment of HP-associated gastritis in children and HP eradication.
Patients and Methods: a double-blind, randomized, placebo-controlled study of the effectiveness of treatment with killed Lr both as monotherapy and on the background of the eradication scheme (omeprazole + amoxicillin + metronidazole + bismuth —
10 days) in 103 patients from 9 to 17 years old with HP(+), Lr course in subgroups A was 28 days, in subgroups B — 56 days.
For the control, endoscopic, histological studies, rapid urease test, ammonia breath test (ABT) were performed, the number of HP
in the biopsy, inflammatory and atrophic indices were calculated.
Results: with significant HP contamination in the stomach, there was a decrease in microbial diversity, the suppression of other microbes. This was accompanied by a more pronounced inflammation, focal atrophy of the mucous membrane. With low HP contamination, the surrounding microbiota preserved diversity, inflammation was minimal. HP eradication was achieved with Lr monotherapy in 50% of children after 28 days and 60% — after 56 days, with adjuvant Lr prescribing, in 60% — after 28 days and 77.8% — after 56 days, in the placebo group 68.8% — after 28 days and 56 days.
Conclusion: clinical improvement on the background of Lr was earlier, the decline in ABT indications was stable, inflammatory and atrophic changes in the gastric mucosa decreased significantly. According to the effectiveness, Lr monotherapy
is comparable to the standard dual antibiotic regimen, probiotics can be an alternative to traditional HP therapy.
Key words: Helicobacter pylori, HP-associated gastritis, non-Helicobacter gastric microbiota, gastric cancer, probiotics, Lactobacillus reuteri.
For citation: Kornienko E.A., Parolova N.I., Ivanov S.V. et al. Possibilities of using probiotics in Helicobacter pylori eradication //
RMJ. Medical Review. 2018. № 7(II). P. 51–58.
References
1. Osaki T., Matsuki T., Asahara T. et al. Comparative analysis of gastric bacterial microbiota in Mongolian gerbils after long-term infection with Helicobacter pylori // Microb. Pathog. 2012. Vol. 53. P.12–18.
2. Maldonado-Contreras A., Goldfarb K.C., Godoy-Vitorino F. et al. Structure of the human gastric bacterial community in relation to Helicobacter pylori status // ISME J. 2011. Vol. 5. P.574–579.
3. Yu G., Gail M.H., Shi J. et al. Association between upper digestive tract microbiota and cancer-predisposing states in the esophagus and stomach // Cancer Epidemiol. Biomarkers Prev. 2014. Vol. 23 (5). P.735–741.
4. Dicksved J., Lindberg M., Rosenquist M. et al. Molecular characterization of the stomach microbiota in patients with gastric cancer and in controls // J. Med. Microbiol. 2009. Vol. 58 (Pt 4). P.509–516.
5. Aviles-Jimenez F., Vazquez-Jimenez F., Medrano-Guzman R. et al. Stomach microbiota composition varies between patients with non-atrophic gastritis and patients with intestinal type of gastric cancer // Sci. Rep. 2014. Vol. 4. P.4202.
6. Yang I., Woltemate S., Piazuelo M.B. et al. Different gastric microbiota compositions in two human populations with high and low gastric cancer risk in Colombia // Sci. Rep. 2016. Vol. 6. P.18594.
7. Midolo P.D., Lambert J.R., Hull R. et al. In vitro inhibition of Helicobacter pylori NCTC 11637 by organic acids and lactic acid bacteria // J. Appl. Bacteriol. 1995. Vol. 79. P.475–479.
8. Aiba Y., Suzuki N., Kabir A.M. et al. Lactic acid-mediated suppression of Helicobacter pylori by the oral administration of Lactobacillus salivarius as a probiotic in a gnotobiotic model // Am J. Gastroenterol. 1998. Vol. 93. P.2097–2101.
9. Kim T.S., Hur J.W., Yu M.A. et al. Antagonism of Helicobacter pylori by bacteriocins of lactic acid bacteria // J. Food Prot. 2003. Vol. 66. P.3–12.
10. Lorca G.L., Wadstrom T., Valdez G.F., Ljungh A. Lactobacillus acidophilus autolysins inhibit Helicobacter pylori in vitro // Curr Microbiol 2001. Vol. 42. P.39–44.
11. Michetti P., Dorta G., Wiesel P.H. et al. Effect of whey-based culture supernatant of Lactobacillus acidophilus (johnsonii) La1 on Helicobacter pylori infection in humans // Digestion. 1999. Vol. 60. P.203–209.
12. Coconnier M.H., Lievin V., Hemery E., Servin A.L. Antagonistic activity against Helicobacter infection in vitro and in vivo by the human Lactobacillus acidophilus strain LB // Appl. Environ Microbiol. 1998. Vol. 64. P.4573–4580.
13. Uchida M., Kurakazu K. Yogurt containing Lactobacillus gasseri OLL2716 exerts gastroprotective action against acute gastric lesion and antral ulcer in rats // J. Pharmacol. Sci. 2004. Vol. 96. P.84–90.
14. Nagaoka M., Hasimoto S., Watanabe T. et al. Anti-ulcer effects of lactic acid bacteria and their cell wall polysaccharides // Biol. Pharm. Bull. 1994. Vol. 17. P.1012–1017.
15. Sachdeva A., Nagpal J. Effect of fermented milk-based probiotic preparations on Helicobacter pylori eradication: a systematic review and meta-analysis of randomized-controlled trials // Eur. J. Gastroenterol. Hepatol. 2009. Vol. 21 (1). P. 45–53.
16. Gotteland M., Poliak L., Cruchet S., Brunser O. Effect of regular ingestion of Saccharomyces boulardii plus inulin or Lactobacillus acidophilus in children colonised by Helicobacter pylori // Acta Paediatr. 2005. Vol. 94. P. 1747–1751.
17. Pantoflickova D., Corthesy-Theulaz I., Dorta G. et al. Favourable effect of regular intake of fermented milk containing Lactobacillus johnsonii on Helicobacter pylori associated gastritis // Aliment. Pharmacol. Ther. 2003. Vol. 18. P.805–813.
18. Holz C., Busjahn A., Mehling H. et al. Significant reduction in HP load in humans with non-viable L.reuteri DSM17648: a pilot study // Probiotics Antimicrob Proteins. 2015. Vol. 7 (2). P.91–100. DOI: 10.1007/s12602–014–9181–3.
19. Jones N.L., Koletzko S., Goodman K. et al. Joint ESPGHAN/NASPGHAN guidelines for the management of Helicobacter pylori in children and adolescents (update 2016) // J. Pediatr. Gastroenterol. Nutr. 2017. Vol. 64. P.991–1003.
20. Корниенко Е.А., Милейко В.Е., Гольбиц С.В. О диагностике инфекции Helicobacter pylori у детей // Рос. вестник перинатологии и педиатрии. 1998. Т.5. С.34–38 [Kornienko E.A., Milejko V.E., Gol’bic S.V. O diagnostike infekcii Helicobacter pylori u detej // Ros. vestnik perinatologii i pediatrii. 1998. T.5. S.34–38 (in Russian)].
21. Леонтьева Н.И. Клинико-патогенетические аспекты хеликобактериоза, диагностика и тактика лечения: дис. ... д.м.н. Москва. 2012. С.25 [Leont’eva N.I. Kliniko-patogeneticheskie aspekty helikobakterioza, diagnostika i taktika lecheniya: dis. ... d.m.n. Moskva. 2012. S.25 (in Russian)].
22. Конорев М.Р., Матвеенко М.Е., Крылов Ю.В. и др. Сравнительная оценка эффективности быстрого уреазного теста ХЕЛПИЛ® для диагностики Helicobacter pylori в желудке и двенадцатиперстной кишке // Иммунопатология, аллергология, инфектология. 2012. Т.3. С.63–71 [Konorev M.R., Matveenko M.E., Krylov Yu.V. i dr. Sravnitel’naya ocenka ehffektivnosti bystrogo ureaznogo testa HELPIL® dlya diagnostiki Helicobacter pylori v zheludke i dvenadcatiperstnoj kishke // Immunopatologiya, allergologiya, infektologiya. 2012. T.3. S.63–71 (in Russian)].
23. Konorev M.R., Komleva E.N., Matveenko M.E. Evaluation of efficiency of HELIC ammonia breath test for diagnostics of HP infection in stomach in rheumatoidartritis patients taking NSAIDS // Helicobacter. 2014. Vol. 19 (S.1). Р.123.
24. Baryshnikova N.V., Belousova L.N., Loeva I.A. et al. Comparative Analysis of efficacy of noninvasive ammonium “HELIC-test” and histological method in diagnostic of Helicobacter pylori infection // Helicobacter. 2014. Vol. 19 (S.1). Р.122.
25. Паролова Н.И. Сравнительная оценка эффективности эрадикационной терапии инфекции Helicobacter pylori у детей: дис. … к.м.н. СПб. 2008. 9 с. [Parolova N.I. Sravnitel’naya ocenka ehffektivnosti ehradikacionnoj terapii infekcii Helicobacter pylori u detej: dis. … k.m.n. SPb. 2008. 9 s. (in Russian)].
2. Maldonado-Contreras A., Goldfarb K.C., Godoy-Vitorino F. et al. Structure of the human gastric bacterial community in relation to Helicobacter pylori status // ISME J. 2011. Vol. 5. P.574–579.
3. Yu G., Gail M.H., Shi J. et al. Association between upper digestive tract microbiota and cancer-predisposing states in the esophagus and stomach // Cancer Epidemiol. Biomarkers Prev. 2014. Vol. 23 (5). P.735–741.
4. Dicksved J., Lindberg M., Rosenquist M. et al. Molecular characterization of the stomach microbiota in patients with gastric cancer and in controls // J. Med. Microbiol. 2009. Vol. 58 (Pt 4). P.509–516.
5. Aviles-Jimenez F., Vazquez-Jimenez F., Medrano-Guzman R. et al. Stomach microbiota composition varies between patients with non-atrophic gastritis and patients with intestinal type of gastric cancer // Sci. Rep. 2014. Vol. 4. P.4202.
6. Yang I., Woltemate S., Piazuelo M.B. et al. Different gastric microbiota compositions in two human populations with high and low gastric cancer risk in Colombia // Sci. Rep. 2016. Vol. 6. P.18594.
7. Midolo P.D., Lambert J.R., Hull R. et al. In vitro inhibition of Helicobacter pylori NCTC 11637 by organic acids and lactic acid bacteria // J. Appl. Bacteriol. 1995. Vol. 79. P.475–479.
8. Aiba Y., Suzuki N., Kabir A.M. et al. Lactic acid-mediated suppression of Helicobacter pylori by the oral administration of Lactobacillus salivarius as a probiotic in a gnotobiotic model // Am J. Gastroenterol. 1998. Vol. 93. P.2097–2101.
9. Kim T.S., Hur J.W., Yu M.A. et al. Antagonism of Helicobacter pylori by bacteriocins of lactic acid bacteria // J. Food Prot. 2003. Vol. 66. P.3–12.
10. Lorca G.L., Wadstrom T., Valdez G.F., Ljungh A. Lactobacillus acidophilus autolysins inhibit Helicobacter pylori in vitro // Curr Microbiol 2001. Vol. 42. P.39–44.
11. Michetti P., Dorta G., Wiesel P.H. et al. Effect of whey-based culture supernatant of Lactobacillus acidophilus (johnsonii) La1 on Helicobacter pylori infection in humans // Digestion. 1999. Vol. 60. P.203–209.
12. Coconnier M.H., Lievin V., Hemery E., Servin A.L. Antagonistic activity against Helicobacter infection in vitro and in vivo by the human Lactobacillus acidophilus strain LB // Appl. Environ Microbiol. 1998. Vol. 64. P.4573–4580.
13. Uchida M., Kurakazu K. Yogurt containing Lactobacillus gasseri OLL2716 exerts gastroprotective action against acute gastric lesion and antral ulcer in rats // J. Pharmacol. Sci. 2004. Vol. 96. P.84–90.
14. Nagaoka M., Hasimoto S., Watanabe T. et al. Anti-ulcer effects of lactic acid bacteria and their cell wall polysaccharides // Biol. Pharm. Bull. 1994. Vol. 17. P.1012–1017.
15. Sachdeva A., Nagpal J. Effect of fermented milk-based probiotic preparations on Helicobacter pylori eradication: a systematic review and meta-analysis of randomized-controlled trials // Eur. J. Gastroenterol. Hepatol. 2009. Vol. 21 (1). P. 45–53.
16. Gotteland M., Poliak L., Cruchet S., Brunser O. Effect of regular ingestion of Saccharomyces boulardii plus inulin or Lactobacillus acidophilus in children colonised by Helicobacter pylori // Acta Paediatr. 2005. Vol. 94. P. 1747–1751.
17. Pantoflickova D., Corthesy-Theulaz I., Dorta G. et al. Favourable effect of regular intake of fermented milk containing Lactobacillus johnsonii on Helicobacter pylori associated gastritis // Aliment. Pharmacol. Ther. 2003. Vol. 18. P.805–813.
18. Holz C., Busjahn A., Mehling H. et al. Significant reduction in HP load in humans with non-viable L.reuteri DSM17648: a pilot study // Probiotics Antimicrob Proteins. 2015. Vol. 7 (2). P.91–100. DOI: 10.1007/s12602–014–9181–3.
19. Jones N.L., Koletzko S., Goodman K. et al. Joint ESPGHAN/NASPGHAN guidelines for the management of Helicobacter pylori in children and adolescents (update 2016) // J. Pediatr. Gastroenterol. Nutr. 2017. Vol. 64. P.991–1003.
20. Корниенко Е.А., Милейко В.Е., Гольбиц С.В. О диагностике инфекции Helicobacter pylori у детей // Рос. вестник перинатологии и педиатрии. 1998. Т.5. С.34–38 [Kornienko E.A., Milejko V.E., Gol’bic S.V. O diagnostike infekcii Helicobacter pylori u detej // Ros. vestnik perinatologii i pediatrii. 1998. T.5. S.34–38 (in Russian)].
21. Леонтьева Н.И. Клинико-патогенетические аспекты хеликобактериоза, диагностика и тактика лечения: дис. ... д.м.н. Москва. 2012. С.25 [Leont’eva N.I. Kliniko-patogeneticheskie aspekty helikobakterioza, diagnostika i taktika lecheniya: dis. ... d.m.n. Moskva. 2012. S.25 (in Russian)].
22. Конорев М.Р., Матвеенко М.Е., Крылов Ю.В. и др. Сравнительная оценка эффективности быстрого уреазного теста ХЕЛПИЛ® для диагностики Helicobacter pylori в желудке и двенадцатиперстной кишке // Иммунопатология, аллергология, инфектология. 2012. Т.3. С.63–71 [Konorev M.R., Matveenko M.E., Krylov Yu.V. i dr. Sravnitel’naya ocenka ehffektivnosti bystrogo ureaznogo testa HELPIL® dlya diagnostiki Helicobacter pylori v zheludke i dvenadcatiperstnoj kishke // Immunopatologiya, allergologiya, infektologiya. 2012. T.3. S.63–71 (in Russian)].
23. Konorev M.R., Komleva E.N., Matveenko M.E. Evaluation of efficiency of HELIC ammonia breath test for diagnostics of HP infection in stomach in rheumatoidartritis patients taking NSAIDS // Helicobacter. 2014. Vol. 19 (S.1). Р.123.
24. Baryshnikova N.V., Belousova L.N., Loeva I.A. et al. Comparative Analysis of efficacy of noninvasive ammonium “HELIC-test” and histological method in diagnostic of Helicobacter pylori infection // Helicobacter. 2014. Vol. 19 (S.1). Р.122.
25. Паролова Н.И. Сравнительная оценка эффективности эрадикационной терапии инфекции Helicobacter pylori у детей: дис. … к.м.н. СПб. 2008. 9 с. [Parolova N.I. Sravnitel’naya ocenka ehffektivnosti ehradikacionnoj terapii infekcii Helicobacter pylori u detej: dis. … k.m.n. SPb. 2008. 9 s. (in Russian)].
This work is licensed under a Creative Commons «Attribution» 4.0 License.
Previous article
Next article
Распечатать