Lactobacillus plantarum associated with antimicrobial therapy in the eradication of Helicobacter pylori: a randomized clinical trial
Lactobacillus plantarum associado à terapia antimicrobiana na erradicação do Helicobacter pylori: um ensaio clínico
Palavras-chave:
Helicobacter pylori, Probiotics, Lactobacillus plantarumResumo
Background: Helicobacter pylori infection affects nearly 50% of the world's population, and 1 to 3% of patients infected with H. pylori have a risk of developing gastric cancer. Probiotics can inhibit the proliferation and adhesion of H. pylori. This study aimed to test Lactobacillus plantarum as an adjuvant therapy in treating H. pylori. Methods: Dyspeptic patients (18-74 years) with gastric infection documented and untreated were randomized into two groups: probiotic group (amoxicillin and clarithromycin for one week, esomeprazole for three weeks and Lactobacillus plantarum 5 x 108 CFU for four weeks) and placebo group (amoxicillin, clarithromycin, and esomeprazole for the same period). Four weeks after therapy, a re-endoscopy was performed. Results: Fifty patients were randomized, and 47 (mean 42.7 SD 14.8 years) concluded the study. The total eradication rate was 78.7% (p = 0.73). Further analyses by age group showed that in patients up to 45 years, the eradication rate in patients who received probiotics was 93.8% against 70.0% in the placebo group (p = 0.046). Conclusion: The results indicate the potential of using probiotics as an adjuvant in eliminating H. pylori, and the greater potential of probiotics use in younger age groups.
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Bernardini, G.; Figura, N.; Ponzetto, A.; Marzocchi, B.; Santucci, A. (2017). Application of proteomics to the study of Helicobacter pylori and implications for the clinic. Expert Rev. Proteom., 14, 477–490.
Bruno, G.; Rocco, G.; Zaccari, P.; Porowska, B.; Mascellino, M.T.; Severi, C. (2018). Helicobacter pylori infection and gastric dysbiosis: can probiotics administration be useful to treat this condition? Can J Infect Dis Med Microbiol, 2018: 6237239.
Canducci F, Armuzzi A, Cremonini F, Cammarota G, Bartolozzi F, Pola P, Gasbarrini G, Gasbarrini A. (2000). A lyophilized and inactivated culture of Lactobacillus acidophilus increases Helicobacter pylori eradication rates. Aliment Pharmacol Ther, 14(12):1625-9.
Foligne, B.; Nutten, S.; Grangette, C.; Dennin, V.; Goudercourt, D.; Poiret, S. (2007). Correlation between in vitro and in vivo immunomodulatory properties of lactic acid bacteria. World J Gastroenterol, 13: 236-43.
Fortes PM, Teles Filho RV, Azevêdo LHS, Queiroz VCJ, Costa PSSD. (2020). Inflammatory cytokines and lipid profile in children and adolescents with nephrotic syndrome receiving L. Plantarum: a randomized, controlled feasibility trial. Rev Assoc Med Bras, 66(11):1487-1492.
Goderska, K.; Agudo Pena, S.; Alarcon, T. (2018). Helicobacter pylori treatment: antibiotics or probiotics. Appl Microbiol Biotechnol; 102: 1-7
Gomez-Ramirez U, Valencia-Mayoral P, Mendoza-Elizalde S, Murillo-Eliosa JR, Solórzano Santos F, Contreras-Rodríguez A, Zúñiga G, Aguilar-Rodea P, Jiménez-Rojas VL, Vigueras Galindo JC, Salazar-García M, Velázquez-Guadarrama N. (2021). Role of Helicobacter pylori and Other Environmental Factors in the Development of Gastric Dysbiosis. Pathogens, 10(9):1203.
Homan M. & Orel R. (2015). Are probiotics useful in Helicobacter pylori erradication? World J Gastrenterol, 21(37):10.644-10.653.
Isolauri, E, Sütas Y, Kankaanpää P, Arvilommi H, Salminen S. (2001). Probiotics: effects on immunity. Am J Clin Nutr, 73, S444-S450.
Kamarehei F, Saidijam M, Taherkhani A. (2023). Prognostic biomarkers and molecular pathways mediating Helicobacter pylori-induced gastric cancer: a network- biology approach. Genomics Inform.21(1):e8. doi: 10.5808/gi.22072.
Kodaira MS, Escobar AM, Grisi S. (2002). Epidemiological aspects of Helicobacter pylori infection in childhood and adolescence. Rev Saude Publica, 36(3):356-69.
Kusters, J.G.; Van Vliet, A.H.; Kuipers, E.J. (2006). Pathogenesis of Helicobacter pylori infection. Clin Microbiol Rev 2006; 19: 449-90
Mukai, T.; Asasaka, T.; Sato, E.; Mori, K.; Matsumoto, M.; Ohori, H. (2002). Inhibition of binding of Helicobacter pylori to the glycolipid receptors by probiotic Lactobacillus reuteri. Fems Immunol Med Microbiol, 32, 105–110.
Noorbakhsh N, Nikpour S, Salehi M. (2022). The efficacy and safety of furazolidone-bismuth quadruple therapy for Helicobacter pylori eradication with or without probiotic supplementation. Gastroenterol Hepatol Bed Bench, 15(2):146-152.
O'Connor A, Fischbach W, Gisbert JP, O'Morain C. Treatment of Helicobacter pylori infection 2016. Helicobacter. 2016 Sep;21 Suppl 1:55-61.
Pan, M.; Wan, C.; Xie, Q.; Huanag, R.; Tao, X.; Shah, N.P.; Wei, H. (2016). Changes in gastric microbiota induced by Helicobacter pylori infection and preventive effects of Lactobacillus plantarum ZDY 2013 against such infection. J Dairy Sci, 99(2):970-981.
Pantoflickova, D., Corthesy-Theulaz, I., Dorta, G., Stolte, M., Isler, P., Rochat, F. (2003) Favorable effect of long-term intake of fermented milk containing Lactobacillus johnsonii on H. pylori associated gastritis, Aliment Pharmacol Ther 18: 805–813.
Parsonnet, J.; Hansen, S.; Rodriguez, L.; Gelb, A.B.; Wamke, R.A.; Jellum, E.; Orentreich, N.; Vogelman, J. H.; Friedman G.D. (1994). Helicobacter pylori infection and gastric lynphoma. N Engl J Med, 330: 1267-1271.
Price, A. & Misiewicz, J. (1991). Sydney classification for gastritis. Lancet 337: 174.
Qinggingi Z.; Bingyao X.; Rongcheng G.; Ping L.; Qing G. (2021). Lactobacillus plantarum ZJ316 Attenuates Helicobacter pylori-Induced Gastritis in C57BL/6 Mice. J Agric Food Chem, 69(23):6510-6523.
Rask, C.; Adlerberth, I., Berggren, A.; Ahren, I.L.; Wold, A.E. (2012). Differential effect on cell-mediated immunity in human volunteers after intake of different lactobacilli. Clinical and Experimental Immunology, 172, 321-332.
Saracino Im, Matteo Pavoni M, Saccomanno L, Fiorini G, Pesci V, Foschi C, Piccirilli G, Bernardini G, Holton J, Figura N. (2020). Antimicrobial Efficacy of Five Probiotic Strains Against Helicobacter Pylori. Antibiotics (Basel), 9(5): E244.
Savilahti, E.; Kukkonen, K.; Kuitunem, M. (2009). Probiotics in the treatment and prevention of allergy in children. World Allergy Organ J, 2(5), 69-76.
Sini, K.; Yaqing, G.; Junhui, R. Hui, J.; Hyun, J.Y.; Geun, E.J. (2021). In vitro and in vivo inhibition of Helicobacter pylori by Lactobacillus plantarum pH3A, monolaurin, and grapefruit seed extract. Food Funct, 12(21):11024-11032.
Sipponen P, Maaroos HI. (2015). Chronic gastritis. Scand J Gastroenterol, 50(6):657-67.
Stolte, M., Batz, C., Bayerdorffer, E. And Eidt, S. (1995) Helicobacter pylori eradication in the treatment and differential diagnosis of giant folds in the corpus and fundus of the stomach. Z Gastroenterol, 33: 198–201.
Viazis, N.; Argyriou, K.; Kotzampassi, K.; Christodoulou, D.K.; Apostolopoulos, P.; Georgopoulos, S.D.; Liatsos, C.; Giouleme, O.; Koustenis, K.; Veretanos, C.; Stogiannou, D.; Moutzoukis, M.; Poutakidis, C.; Mylonas, I.I.; Tseti, I.; Mantzaris, G.J. (2022). A Four-Probiotics Regimen Combined with A Standard Helicobacter pylori-Eradication Treatment Reduces Side Effects and Increases Eradication Rates. Nutrients, 14(3):632.
Yang L, Zhang J, Xu J, Wei X, Yang J, Liu Y, Li H, Zhao C, Wang Y, Zhang L, Gai Z. (2019). Helicobacter pylori Infection Aggravates Dysbiosis of Gut Microbiome in Children With Gastritis. Front Cell Infect Microbiol, 9:375.
Yu B, Xiang L, Peppelenbosch MP, Fuhler GM. (2023). Overlapping cytokines in H. pylori infection and gastric cancer: A tandem meta-analysis. Front Immunol, 14:1125658.
Zhou, Q.; Xue, B.; Gu, R.; Li, P.; Gu, Q. (2021). Lactobacillus plantarum ZJ316 Attenuates Helicobacter pylori-Induced Gastritis in C57BL/6 Mice. J Agric Food Chem, 69(23):6510-6523.
