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Review
. 2022 Nov 25:12:1042070.
doi: 10.3389/fcimb.2022.1042070. eCollection 2022.

Current and future perspectives for Helicobacter pylori treatment and management: From antibiotics to probiotics

Bing Liang  1 , Yang Yuan  1 , Xiao-Jin Peng  1 , Xin-Lin Liu  1 , Xiao-Kun Hu  2 , Dong-Ming Xing  1   3
Affiliations
Review

Current and future perspectives for Helicobacter pylori treatment and management: From antibiotics to probiotics

Bing Liang et al. Front Cell Infect Microbiol. .

Abstract

Helicobacter pylori (H. pylori) is a Gram-negative anaerobic bacterium that colonizes the human stomach and is the leading cause of gastric diseases such as chronic gastritis and peptic ulcers, as well as the most definite and controllable risk factor for the development of gastric cancer. Currently, the regimen for H. pylori eradication has changed from triple to quadruple, the course of treatment has been extended, and the type and dose of antibiotics have been adjusted, with limited improvement in efficacy but gradually increasing side effects and repeated treatment failures in an increasing number of patients. In recent years, probiotics have become one of the most important tools for supporting intestinal health and immunity. Numerous in vitro studies, animal studies, and clinical observations have demonstrated that probiotics have the advantage of reducing side effects and increasing eradication rates in adjuvant anti-H. pylori therapy and are a valuable supplement to conventional therapy. However, many different types of probiotics are used as adjuncts against H. pylori, in various combinations, with different doses and timing, and the quality of clinical studies varies, making it difficult to standardize the results. In this paper, we focus on the risk, status, prevention, control, and treatment of H. pylori infection and review international consensus guidelines. We also summarize the available scientific evidence on using Limosilactobacillus reuteri (L. reuteri) as a critical probiotic for H. pylori treatment and discuss its clinical research and application from an evidence-based perspective.

Keywords: Helicobacter pylori; Limosilactobacillus reuteri DSM 17648; antibiotic resistance; eradication therapy; probiotics.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Gastrointestinal disease outcomes of H. pylori infection.
Figure 2
Figure 2
Disease progression pattern of H. pylori infection promoting gastric cancer: chronic active gastritis occurs after infection of normal gastric mucosa with H. pylori, through progressive development of atrophic gastritis, intestinal chemosis, heterogeneous hyperplasia, and finally gastric cancer.
Figure 3
Figure 3
A schematic diagram of the potential mechanism of action of probiotics against H. pylori infection.
See this image and copyright information in PMC

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