Faecal microbiota transplantation for eradicating Helicobacter pylori infection: clinical practice and theoretical postulation

Abstract

The sustained increase in antibiotic resistance leads to a declining trend in the eradication rate of Helicobacter pylori (H. pylori) infection with antibiotic-based eradication regimens. Administration of a single probiotic shows limited efficacy in eradicating H. pylori infection. This review indicates that faecal microbiota transplantation (FMT), a novel therapeutic approach, either as a monotherapy or adjunctive therapy, exhibits beneficial effects in terms of the eradication of H. pylori infection and the prevention of adverse events. The role of FMT in H. pylori eradication may be associated directly or indirectly with some therapeutic constituents within the faecal suspension, including bacteria, viruses, antimicrobial peptides and metabolites. In addition, variations in donor selection, faecal suspension preparation and delivery methods are believed to be the main factors determining the effectiveness of FMT for the treatment of H. pylori infection. Future research should refine the operational procedures of FMT to achieve optimal efficacy for H. pylori infection and explore the mechanisms by which FMT acts against H. pylori.

Keywords: Digestive System Diseases; Gastrointestinal Microbiome; Helicobacter pylori; Infections.

Figure 1. Mechanisms of faecal microbiota transplantation (FMT) in the treatment of Helicobacter pylori infection. There is dense colonisation of Helicobacter pylori (H. pylori) in the gastric mucosa before FMT (left). FMT is performed using either catheter or capsule administration. Faecal suspension rich in probiotics, phages or microbial metabolites are infused into the gut through the above ways, leading to the reduction in the H. pylori load within the stomach (right) and alleviation of gastritis induced by H. pylori infection.