The clinical effectiveness of probiotics and autoprobiotics in treatment of <i>Helicobacter pylori</i>-associated dyspepsia

Abstract

The aim of our study was to evaluate the clinical performance of a monotherapy by Enterococcus faecium-based probiotics and indigenous autoprobiotics against H. pylori associated dyspepsia.&#x0D; Materials and methods. There were examined 95 patients with dyspepsia. The entire patient cohort underwent clinical evaluation including filling out the questionnaire to assess dyspepsia symptoms before and after treatment, gastric endoscopy as well as gastric multi-focal biopsy (gastric body and gastric antrum) and verification of H. pylori infection with the three clinical laboratory methods (biochemical, bacteriological and molecular detection). An antagonistic in vitro activity of probiotics against H. pylori was detected by drop plate method for probiotic strains Enterococcus faecium SF68 and Bifidobacterium bifidum (Bifiform), Enterococcus faecium L3 (Laminolact), and autoprobiotic strains combined with indigenous Enterococcus faecium. To examine an antagonistic activity of probiotics and autoprobiotics in clinical trials, we used a starter culture based on the Enterococcus faecium L3 strain and an autoprobiotic based on indigenous Enterococcus faecium. The probiotic or autoprobiotic were administered orally to patients with gastritis twice a day at dose of 50 ml (8.0 lgCFU/ml) for 20 days. H. pylori eradication was assessed by stool antigen test 1.52 months after the end of treatment.&#x0D; Results. Initially the H. pylori infection was confirmed with 49.4% of patients. The sensitivity of H. pylori to the probiotics was detected in 81% of individuals for indigenous Enterococci (the autoprobiotic), 76% for Laminolact, and in 62% for Bifiform. 22 patients with previous history of allergic reactions to antibiotics used in routine H. pylori eradication regimens were divided in two cohorts. One cohort (10 patients) received the autoprobiotic only, another cohort (12 patients) received only probiotic. Monotherapy with autoprobiotic resulted in 100% H. pylori eradication, single-agent therapy with probiotic led to 60% eradication of H. pylori. Dyspepsia symptoms were completely resolved in both groups of patients.&#x0D; Conclusion. Our research demonstrated the sensitivity of examined H. pylori strains to be similar for traditional eradication treatment agents (antibiotics) and the proposed intervention agents (probiotics and autoprobiotics). An autoprobiotic monotherapy with indigenous enterococci led to higher levels of H. pylori eradication than with E. faecium L3-based probiotic agent. Our work demonstrated advantage for application of probiotics in patients with antibiotic allergies or other obstacles for the standard eradication therapy. Nonetheless, further investigation to better understand underlying mechanisms of action, as well as larger observational and randomized studies, are necessary to determine the scope of therapeutic application for probiotics and autoprobitics to eradicate H. pylori infection.

Probiotics and autoprobiotics for treatment of Helicobacter pylori infection

“…Autoprobiotics can be prepared by culturing individual clones of indigenous bacteria (such as bifidobacteria, lactobacilli, or enterococci) on nutrient cultural media outside the body, or by culturing a complex of indigenous bacteria under anaerobic conditions[ 86 ]. Initially, the selection of autoprobiotic strains involved the addition of blood serum[ 87 ], but later it was replaced by molecular genetic testing of the strains of interest[ 88 , 89 ].…”

“…in restoring and stabilizing the levels of key representatives of the normal intestinal microbiota (such as Bifidobacterium spp., Lactobacillus spp., and E. coli ) in dysbiotic disorders caused by antibiotic usage[ 91 - 93 ], as well as in infection and inflammatory diseases[ 86 , 90 , 94 ]. The efficacy of monotherapy using autoprobiotics based on indigenous non-pathogenic enterococci has been demonstrated in the treatment of chronic gastritis associated with H. pylori : The eradication rate was 80%, and there was 100% relief of symptoms after a 20-d autoprobiotic treatment[ 95 ].…”

Anti‑Helicobacter pylori activity of Lactobacillus plantarum LZU-J-Q21, LZU-J-Q25 and LZU-J-QA85 in vitro evaluation

“…Currently, a variety of probiotic preparations have been clinically applied in the treatment of diseases caused by gastrointestinal pathogenic bacterial infections [8,9]. Several studies have demonstrated the effectiveness of various probiotics in the treatment of diseases resulting from H. pylori infections, such as L. acidophilus [10,11], L. rhamnosus GG [12,13], L. casei [14][15][16], L. gasseri OLL2716 [17], L. reuteri [18][19][20], L. salivarius [21], L. plantarum [22,23], E. faecium [24,25], Bacillus subtilis [26,27],…”