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Abdoh Q, Alnees M, Kharraz L, Ayoub K, Darwish A, Awwad M, Najajra D, Khraim J, Awad W, Sbaih A, Turman S, Abu Hamdeh N. Prevalence of Helicobacter pylori resistance to certain antibiotics at An-Najah University Hospital: a cross-sectional study. Sci Rep 2024; 14:14542. [PMID: 38914675 PMCID: PMC11196700 DOI: 10.1038/s41598-024-63982-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 06/04/2024] [Indexed: 06/26/2024] Open
Abstract
Antibiotic resistance among bacteria is recognized as the primary factor contributing to the failure of treatment. In this research, our objective was to examine the prevalence of antibiotic resistance in H. pylori bacteria in Palestine. We enlisted 91 individuals suffering from dyspepsia, comprising 49 females and 42 males. These participants underwent esophagogastroduodenoscopy procedures with gastric biopsies. These biopsies were subsequently subjected to microbiological assessments and tested for their susceptibility to various antimicrobial drugs. Among the 91 patients, 38 (41.7%) exhibited the presence of H. pylori. Notably, Ciprofloxacin displayed the highest efficacy against H. pylori, followed by Levofloxacin, Moxifloxacin, and Amoxicillin, with resistance rates of 0%, 0%, 2.6%, and 18.4%, respectively. On the contrary, Metronidazole and Clarithromycin demonstrated the lowest effectiveness, with resistance percentages of 100% and 47.4%, respectively. The outcomes of this investigation emphasize that H. pylori strains within the Palestinian patient group exhibit substantial resistance to conventional first-line antibiotics like clarithromycin and metronidazole. However, alternative agents such as fluoroquinolones and amoxicillin remain efficacious choices. Consequently, we recommend favoring quinolone-based treatment regimens for H. pylori infections and adopting a more judicious approach to antibiotic usage among the Palestinian population.
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Affiliation(s)
- Qusay Abdoh
- Faculty of Medicine, An-Najah National University, Nablus, Palestine.
- Division of Gastroenterology, An-Najah National University Hospital, Nablus, Palestine.
| | - Mohammad Alnees
- Faculty of Medicine, An-Najah National University, Nablus, Palestine.
- Global Clinical Scholars Research Training Program, Harvard Medical School Postgraduate Medical Education, Boston, USA.
- Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
| | - Lubna Kharraz
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | - Khubaib Ayoub
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
- Department of Internal Medicine, Specialized Araby Hospital, Nablus, Palestine
| | - Abdalaziz Darwish
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | - Mahdi Awwad
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | - Duha Najajra
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | - Jana Khraim
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | - Wafaa Awad
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | - Aesha Sbaih
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | - Safaa Turman
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
| | - Nizar Abu Hamdeh
- Faculty of Medicine, An-Najah National University, Nablus, Palestine
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Zhang Y, Lu B, Dong Y, Zhang Y, Du Q, Chen Y, Zhang Z. Saccharomyces boulardii combined with triple therapy alter the microbiota in the eradication of Helicobacter pylori infection. Sci Rep 2024; 14:13152. [PMID: 38849408 PMCID: PMC11161611 DOI: 10.1038/s41598-024-63894-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 06/03/2024] [Indexed: 06/09/2024] Open
Abstract
To assess the effectiveness and safety of combining Saccharomyces boulardii powder with triple therapy as a primary approach for eradicating H. pylori infection, a total of 144 patients who tested positive for H. pylori and diagnosed with non-ulcer dyspepsia underwent endoscopy at two national centers between June 2017 and March 2019 were included. The patients were categorized into three groups using a subsection randomization method and received initial H. pylori eradication treatments. Microbial composition, eradication rates, symptom alleviation, and adverse reactions were monitored on the 14th and 44th days post-treatment. According to PP analysis showed the eradication rates for the SRAC group was 75%, BRAC was 93.18% and RAC was 65.2%. Group BRAC exhibited a marginally higher eradication rate compared to other groups. However, patients receiving Saccharomyces boulardii treatment exhibited an overall reduction in initial dyspepsia symptoms by the end of the treatment period. When employed as a primary strategy, the combination of Saccharomyces boulardii powder with triple therapy displayed notable efficacy and smaller gastrointestinal side effects in eradicating initial H. pylori infections among non-ulcer dyspepsia patients. Moreover, this approach demonstrated advantages in alleviating symptoms, exhibited favorable tolerance, and maintained a high level of clinical safety.
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Affiliation(s)
- Yan Zhang
- Department of Gastroenterology, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing, 210006, People's Republic of China
| | - Bingyun Lu
- Department of Gastroenterology, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, People's Republic of China
| | - Yu Dong
- Department of Gastroenterology, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing, 210006, People's Republic of China
| | - Yifeng Zhang
- Department of Gastroenterology, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing, 210006, People's Republic of China
| | - Qianming Du
- Department of Gastroenterology, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing, 210006, People's Republic of China
| | - Ye Chen
- Department of Gastroenterology, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, People's Republic of China.
- Integrative Microecology Clinical Center, Shenzhen Key Laboratory of Gastrointestinal Microbiota and Disease, Shenzhen Clinical Research Center for Digestive Disease, Shenzhen Technology Research Center of Gut Microbiota Transplantation, Shenzhen Hospital, Southern Medical University, 1333 Xinhu Road, Bao'an District, Shenzhen, 518101, People's Republic of China.
| | - Zhenyu Zhang
- Department of Gastroenterology, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing, 210006, People's Republic of China.
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Tsukadaira T, Hayashi S, Ota H, Kobayashi N, Agawa H, Kodaira H, Sekiguchi Y, Matsumoto T, Horiuchi K, Negishi T, Tada T. Triple-drug combination therapy versus six-month proton pump inhibitor monotherapy in non-Helicobacter pylori Helicobacter eradication, and hyperacid environment preference of Helicobacter suis: a clinical study. BMC Gastroenterol 2024; 24:157. [PMID: 38720287 PMCID: PMC11080111 DOI: 10.1186/s12876-024-03252-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 04/30/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND At present, eradication regimens for non-Helicobacter pylori Helicobacter (NHPH) have not been established yet. We investigated effectiveness of the standard triple-drug combination therapy for Helicobacter pylori eradication and of a proton pump inhibitor (PPI) monotherapy in eradication of NHPH. METHODS Subjects were the patients who were diagnosed with NHPH-infected gastritis based on microscopic findings, helical-shaped organisms obviously larger than Helicobacter pylori, in the gastric mucosal specimens using Giemsa staining at Kenwakai Hospital between November 2010 and September 2021, whose NHPH species were identified by polymerase chain reaction (PCR) analysis of urease genes in endoscopically-biopsied samples, and who consented to NHPH eradication with either the triple-drug combination therapy for one week or a PPI monotherapy for six months. Six months after the completion of eradication, its result was determined with esophagogastroduodenoscopy, microscopic examination, and PCR analysis. In cases of unsuccessful eradication, a second eradication with the other therapy was suggested to the patient. RESULTS PCR analysis detected NHPH in 38 patients: 36 as Helicobacter suis and two as Helicobacter heilmannii/Helicobacter ailurogastricus. Fourteen Helicobacter suis-infected and one Helicobacter heilmannii/Helicobacter ailurogastricus-infected patients requested eradication therapy. The triple-drug combination therapy succeeded in four of five patients, while the PPI monotherapy succeeded in five of 10 patients. Three of five patients who had been unsuccessful with the latter therapy requested the triple-drug combination therapy as the second eradication and all three were successful. In total, the triple-drug combination therapy succeeded in seven out of eight (87.5%) attempted cases, while the PPI monotherapy in five out of 10 (50%) attempted cases. CONCLUSIONS In NHPH eradication, the triple-drug combination therapy was considered to be effective to some extent and to become the first-line therapy. While, although less successful, PPI monotherapy appeared to be a potentially promising option particularly for patients with allergy or resistance to antibiotics. Effectiveness of PPI monotherapy may be attributed to hyperacid environment preference of Helicobacter suis and PPI's acid-suppressive effect. Additionally, male predominance in NHPH-infected gastritis patients may be explained by gender difference in gastric acid secretory capacity. However, further evidence needs to be accumulated. STUDY REGISTRATION This study was approved by the Research Ethics Committee of Kenwakai Hospital (No. 2,017,024).
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Affiliation(s)
- Toshihisa Tsukadaira
- Department of Internal Medicine, Kenwakai Hospital, Kanaenakadaira, Iida, 1936, 395-0801, Japan.
| | - Seiichi Hayashi
- Department of Pathology, Kenwakai Hospital, Kanaenakadaira, Iida, 1936, 395-0801, Japan
| | - Hiroyoshi Ota
- Department of Biomedical Laboratory Sciences, Shinshu University School of Medicine, 3-1-1, Asahi, 390-8621, Matsumoto, Japan
| | - Natsuko Kobayashi
- Department of Internal Medicine, Kenwakai Hospital, Kanaenakadaira, Iida, 1936, 395-0801, Japan
| | - Hiroyuki Agawa
- Department of Internal Medicine, Kenwakai Hospital, Kanaenakadaira, Iida, 1936, 395-0801, Japan
| | - Himiko Kodaira
- Department of Pathology, Kenwakai Hospital, Kanaenakadaira, Iida, 1936, 395-0801, Japan
| | - Yasuhiro Sekiguchi
- Department of Internal Medicine, Kenwakai Hospital, Kanaenakadaira, Iida, 1936, 395-0801, Japan
| | - Takehisa Matsumoto
- Department of Laboratory Sciences, Gumma University Graduate School of Health, 3-39-22 Showa-cho, Maebashi, 371-8511, Japan
| | - Kazuki Horiuchi
- Department of Laboratory Medicine, Shinshu University Hospital, 3-1-1, Asahi, 390-8621, Matsumoto, Japan
| | - Tatsuya Negishi
- Department of Laboratory Medicine, Shinshu University Hospital, 3-1-1, Asahi, 390-8621, Matsumoto, Japan
| | - Toshifumi Tada
- Department of Internal Medicine, Japanese Red Cross Society Himeji Hospital, 1-12-1 Shimoteno, 670-8540, Himeji, Japan
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Zhou J, Zhang M, Wang H, Zhong X, Yang X. Role of Helicobacter pylori virulence factors and alteration of the Tumor Immune Microenvironment: challenges and opportunities for Cancer Immunotherapy. Arch Microbiol 2024; 206:167. [PMID: 38485861 DOI: 10.1007/s00203-024-03908-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 02/19/2024] [Accepted: 02/22/2024] [Indexed: 03/19/2024]
Abstract
Various forms of malignancies have been linked to Helicobacter pylori. Despite advancements in chemotherapeutic and surgical approaches, the management of cancer, particularly at advanced stages, increasingly relies on the integration of immunotherapy. As a novel, safe therapeutic modality, immunotherapy harnesses the immune system of the patient to treat cancer, thereby broadening treatment options. However, there is evidence that H. pylori infection may influence the effectiveness of immunotherapy in various types of cancer. This association is related to H. pylori virulence factors and the tumor microenvironment. This review discusses the influence of H. pylori infection on immunotherapy in non-gastrointestinal and gastrointestinal tumors, the mechanisms underlying this relationship, and directions for the development of improved immunotherapy strategies.
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Affiliation(s)
- Junyi Zhou
- Department of Oncology, The Huai'an Clinical College of Xuzhou Medical University, Huai'an, Jiangsu, China
| | - Minna Zhang
- Department of Gastroenterology, The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University, Huai'an, Jiangsu, China
| | - HongGang Wang
- Department of Gastroenterology, The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University, Huai'an, Jiangsu, China
| | - Xiaomin Zhong
- Department of Oncology, The Huai'an Clinical College of Xuzhou Medical University, Huai'an, Jiangsu, China.
| | - XiaoZhong Yang
- Department of Gastroenterology, The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University, Huai'an, Jiangsu, China.
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Lara Icaza JD, Tapia RL, Triana CTC, Ramírez LCR. Refractoriness to anti-Helicobacter pylori treatment attributed to phenotypic resistance patterns in patients with gastroduodenopathy in Guayaquil-Ecuador. Helicobacter 2024; 29:e13060. [PMID: 38581134 DOI: 10.1111/hel.13060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 01/13/2024] [Accepted: 02/13/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Treatment of Helicobacter pylori gastric infection is complex and associated with increased rates of therapeutic failure. This research aimed to characterize the H. pylori infection status, strain resistance to antimicrobial agents, and the predominant lesion pattern in the gastroduodenal mucosa of patients with clinical suspicion of refractoriness to first- and second-line treatment who were diagnosed and treated in a health center in Guayaquil, Ecuador. METHODS A total of 374 patients with upper gastrointestinal symptoms and H. pylori infection were preselected and prescribed one of three triple therapy regimens for primary infection, as judged by the treating physician. Subsequently, 121 patients who returned to the follow-up visit with persistent symptoms after treatment were studied. RESULTS All patients had H. pylori infection. Histopathological examination diagnosed chronic active gastritis in 91.7% of cases; premalignant lesions were observed in 15.8%. The three triple therapy schemes applied showed suboptimal efficacy (between 47.6% and 77.2%), with the best performance corresponding to the scheme consisting of a proton pump inhibitor + amoxicillin + levofloxacin. Bacterial strains showed very high phenotypic resistance to all five antimicrobials tested: clarithromycin, 82.9%; metronidazole, 69.7%; amoxicillin and levofloxacin, almost 50%; tetracycline, 38.2%. Concurrent resistance to clarithromycin-amoxicillin was 43.4%, to tetracycline-metronidazole 30.3%, to amoxicillin-levofloxacin 27.6%, and to clarithromycin-metronidazole 59.2%. CONCLUSIONS In vitro testing revealed resistance to all five antibiotics, indicating that H. pylori exhibited resistance phenotypes to these antibiotics. Consequently, the effectiveness of triple treatments may be compromised, and further studies are needed to assess refractoriness in quadruple and concomitant therapies.
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Affiliation(s)
- Javier David Lara Icaza
- Centro Clínico Quirúrgico Ambulatorio (Hospital del Día) Efrén Jurado López, Guayaquil, Ecuador
- Universidad del Zulia (LUZ), Maracaibo, Venezuela
| | - Rosalina Lara Tapia
- Centro Clínico Quirúrgico Ambulatorio (Hospital del Día) Efrén Jurado López, Guayaquil, Ecuador
| | - Cástula Tania Castro Triana
- Centro Clínico Quirúrgico Ambulatorio (Hospital del Día) Efrén Jurado López, Guayaquil, Ecuador
- Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
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Tran VH, Nguyen TMN, Le PTQ, Nguyen THT, Nguyen TCL, Ha TMT. Current status of Helicobacter pylori resistance to clarithromycin and levofloxacin in Vietnam: Results from molecular analysis of gastric biopsy specimens. J Glob Antimicrob Resist 2024; 36:76-82. [PMID: 38160708 DOI: 10.1016/j.jgar.2023.12.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 10/13/2023] [Accepted: 12/21/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVES The management of Helicobacter pylori in Vietnam is becoming progressively more difficult due to increasing antibiotic resistance, particularly to clarithromycin (CLR) and levofloxaxin (LVX). In Vietnam, the selection of an H. pylori eradication regimen is predominantly based on empirical evidence. However, molecular analysis aimed at identifying H. pylori antibiotic-resistant genotypes is a promising method in antibiotic susceptibility testing. In this study, we aimed to determine the rates of genotypic H. pylori resistance to CLR and LVX by using DNA strip technology in Vietnam. METHODS We performed DNA-strip technology-based testing on 112 patients with H. pylori-positive gastroduodenal diseases to detect 23S rRNA and gyrA mutations. RESULTS Helicobacter pylori genotypic resistance to CLR and LVX was evident in 81.3% and 53.6% of the patients, respectively, and dual resistance was observed in 48.2%. The 23S rRNA A2142G and A2143G mutations accounted for 1.8% and 79.5% of cases, respectively. The gyrA N87K, D91N, D91G, and D91Y mutations were present in 37.5%, 11.6%, 5.4%, and 5.4% of patients, respectively. All four gyrA mutations were observed in both the naïve and failure patients. We further found an association between the 23S rRNA A2143G mutation and a history of CLR use as well as between the gyrA N87K mutation and a history of LVX use. CONCLUSIONS We found a very high prevalence of H. pylori resistance to CLR and LVX and dual resistance to these antibiotics in Vietnam. The application of molecular assays is feasible and may improve the management of H. pylori infection in Vietnam.
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Affiliation(s)
- Van Huy Tran
- Department of Internal Medicine, University of Medicine and Pharmacy, Hue University, Hue, Vietnam; Gastroenterology and Endoscopy Center, Hospital of University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Thi Mai Ngan Nguyen
- Department of Medical Genetics, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Phan Tuong Quynh Le
- Department of Medical Genetics, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Thi Huyen Thuong Nguyen
- Gastroenterology and Endoscopy Center, Hospital of University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Thi Chau Loan Nguyen
- Department of Internal Medicine, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Thi Minh Thi Ha
- Department of Medical Genetics, University of Medicine and Pharmacy, Hue University, Hue, Vietnam; Institute of Biomedicine, University of Medicine and Pharmacy, Hue University, Hue, Vietnam.
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Shao Y, Lin Y, Fang Z, Yan J, Zheng T, Ye G. Analysis of Helicobacter pylori resistance in patients with different gastric diseases. Sci Rep 2024; 14:4912. [PMID: 38418852 PMCID: PMC10901771 DOI: 10.1038/s41598-024-55589-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 02/26/2024] [Indexed: 03/02/2024] Open
Abstract
Helicobacter pylori (H. pylori) resistance is the most important risk factor for eradication failure. However, in most regions, antibiotic resistance rates of H. pylori in patients with different types of gastric mucosal lesions are still unclear. An 8-year clinical retrospective cohort study involving 2847 patients was performed. In this study, we first summarized and compared the resistance status of H. pylori in different years, ages, sexes, and gastric diseases. The resistance profiles of amoxicillin (AMX), clarithromycin (CLR), levofloxacin (LVX) and furazolidone (FR) and their changing trends in the clinic were described. Then, multiple antibiotic resistance in different gastric diseases and years were described and compared. The relationship between proton pump inhibitor (PPI) medication history and antibiotic resistance in H. pylori was also explored. Finally, an antibiotic resistance risk model was constructed for clinical resistance risk prediction. The overall resistance rates of AMX, CLR, LVX and FR in gastric diseases were 8.18%, 38.11%, 43.98%, and 13.73%, respectively. The mono resistance, double resistance, triple resistance, and quadruple resistance rates were 30.17%, 25.96%, 6.46%, and 0.63%, respectively. Compared with the period from 2014 to 2016, the rates of mono-resistance and multiple resistance all showed relatively downward trends in the past 5 years. Factors including age, sex, type of gastric lesions and recent PPI treatment history are associated with the antibiotic resistance rate of H. pylori. Atrophic gastritis is an important clinical feature of high-risk antibiotic resistance in H. pylori-infected patients. Patients with atrophic gastritis have higher risk of resistant strains infection. In this study, our data provide the association between antibiotic resistance of H. pylori and gastritis pattern, which indicate the higher risk of resistant strain infection if the patients with atrophic gastritis, PPI history and older age.
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Affiliation(s)
- Yongfu Shao
- Health Science Center, Ningbo University, Ningbo, 315211, China
- Department of Gastroenterology, The First Affiliated Hospital of Ningbo University, Ningbo, 315020, China
| | - Yifan Lin
- Department of Gastroenterology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou, 318000, China
| | - Ziyi Fang
- Health Science Center, Ningbo University, Ningbo, 315211, China
- Department of Gastroenterology, The First Affiliated Hospital of Ningbo University, Ningbo, 315020, China
| | - Jianing Yan
- Department of Gastroenterology, The First Affiliated Hospital of Ningbo University, Ningbo, 315020, China
| | - Tuo Zheng
- Department of Gastroenterology, The First Affiliated Hospital of Ningbo University, Ningbo, 315020, China.
| | - Guoliang Ye
- Department of Gastroenterology, The First Affiliated Hospital of Ningbo University, Ningbo, 315020, China.
- Institute of Digestive Disease of Ningbo University, Ningbo, 315020, China.
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Peng J, Xie J, Liu D, Yang K, Wu S, Liu D, Huang D, Xie Y. Impact of Helicobacter pylori colonization density and depth on gastritis severity. Ann Clin Microbiol Antimicrob 2024; 23:4. [PMID: 38217000 PMCID: PMC10785438 DOI: 10.1186/s12941-024-00666-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 01/04/2024] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Helicobacter pylori (H. pylori) infection is the most common etiology of chronic gastric. H. pylori gastritis would gradually evolve into gastric atrophy, intestinal metaplasia, dysplasia and malignant lesions. Herein, this study aimed to investigate the potential impact of H. pylori colonization density and depth on the severity of histological parameters of gastritis. METHODS A prospective monocentric study was conducted from December 2019 to July 2022, enrolling patients with confirmed chronic H. pylori infection via histopathological evaluation. H. pylori colonization status was detected by immunohistochemical staining, pathological changes of gastric specimens were detected by hematoxylin eosin staining. Epidemiological, endoscopic and histopathological data were collected. RESULTS A total of 1120 patients with a mean age of 45.8 years were included. Regardless of the previous history of H. pylori eradication treatment, significant correlations were observed between the density and depth of H. pylori colonization and the intensity of gastritis activity (all P < 0.05). Patients with the lowest level of H. pylori colonization density and depth exhibited the highest level of mild activity. In whole participants and anti-H. pylori treatment-naive participants, H. pylori colonization density and depth were markedly correlated with the severity of chronic gastritis and gastric atrophy (all P < 0.05). H. pylori colonization density (P = 0.001) and depth (P = 0.047) were significantly associated with ulcer formation in patients naive to any anti-H. pylori treatment. No significant associations were observed between the density and depth of H. pylori colonization and other histopathological findings including lymphadenia, lymphoid follicle formation and dysplasia. CONCLUSIONS As the density and depth of H. pylori colonization increased, so did the activity and severity of gastritis, along with an elevated risk of ulcer formation.
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Affiliation(s)
- Jianxiang Peng
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, 17 Yongwaizheng Street, Donghu District, Nanchang, 330006, Jiangxi Province, China
- Jiangxi Clinical Research Center for Gastroenterology, Nanchang, Jiangxi Province, China
| | - Jinliang Xie
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, 17 Yongwaizheng Street, Donghu District, Nanchang, 330006, Jiangxi Province, China
- Jiangxi Clinical Research Center for Gastroenterology, Nanchang, Jiangxi Province, China
| | - Dingwei Liu
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, 17 Yongwaizheng Street, Donghu District, Nanchang, 330006, Jiangxi Province, China
- Jiangxi Clinical Research Center for Gastroenterology, Nanchang, Jiangxi Province, China
| | - Kaijie Yang
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, 17 Yongwaizheng Street, Donghu District, Nanchang, 330006, Jiangxi Province, China
- Jiangxi Clinical Research Center for Gastroenterology, Nanchang, Jiangxi Province, China
- Ganzhou People's Hospital, Ganzhou, Jiangxi Province, China
| | - Shuang Wu
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, 17 Yongwaizheng Street, Donghu District, Nanchang, 330006, Jiangxi Province, China
- Jiangxi Clinical Research Center for Gastroenterology, Nanchang, Jiangxi Province, China
- The Second People's Hospital of Jingdezhen, Jingdezhen, Jiangxi Province, China
| | - Dongsheng Liu
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, 17 Yongwaizheng Street, Donghu District, Nanchang, 330006, Jiangxi Province, China
- Jiangxi Clinical Research Center for Gastroenterology, Nanchang, Jiangxi Province, China
| | - Deqiang Huang
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, 17 Yongwaizheng Street, Donghu District, Nanchang, 330006, Jiangxi Province, China.
- Jiangxi Clinical Research Center for Gastroenterology, Nanchang, Jiangxi Province, China.
| | - Yong Xie
- Department of Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, 17 Yongwaizheng Street, Donghu District, Nanchang, 330006, Jiangxi Province, China.
- Jiangxi Clinical Research Center for Gastroenterology, Nanchang, Jiangxi Province, China.
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Boyanova L, Boyanova L, Hadzhiyski P, Kandilarov N, Yordanov D, Gergova R, Markovska R. Mixed (multiple-genotype) Helicobacter pylori infections in Bulgarian patients. Diagn Microbiol Infect Dis 2023; 107:116073. [PMID: 37717293 DOI: 10.1016/j.diagmicrobio.2023.116073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/22/2023] [Accepted: 08/24/2023] [Indexed: 09/19/2023]
Abstract
The aim of the study was to evaluate the frequency and characteristics of mixed (multiple-genotype) Helicobacter pylori infections (MGIs) in 155 Bulgarian symptomatic patients (21 children and 134 adults). MGIs were common (36.1%), including double-strain (34.8%) and triple-strain infections (1.3%). None of the 8 ulcer patients harbored multiple subtypes. We detected 18 multiple allelic combinations, of which the most frequent subtypes (17.4%) were vacA s1as2 and vacA s1cs2. The 2 patients with triple-strain infections had vacA s1bs1cs2i1i2/iceA1A2 and vacA s1as1cs2 subtypes. They were both adult men with chronic gastritis and both were examined in 2022. The prevalence of MGIs (51.7%) was 2-fold higher in 2020 to 2022 than in 2015 to 2019 (26.3%). Putative factors for the increase may be the patient's characteristics and COVID-19 pandemic-associated factors. MGI rates corresponded to the high infection seroprevalence (72.4% in 2011) in Bulgaria. The evolution and clinical importance of mixed H. pylori infections merit extensive evaluation.
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Affiliation(s)
- Lyudmila Boyanova
- Department of Medical Microbiology, Medical Faculty, Medical University of Sofia, Sofia, Bulgaria.
| | - Liliya Boyanova
- Department of Medical Microbiology, Medical Faculty, Medical University of Sofia, Sofia, Bulgaria
| | - Petyo Hadzhiyski
- Specialized Hospital for Active Pediatric Treatment, Medical Faculty, Medical University of Sofia, Sofia, Bulgaria
| | - Nayden Kandilarov
- Department of General and Hepatobiliary Pancreatic Surgery, Department of Surgery, Medical Faculty, Medical University of Sofia, Sofia, Bulgaria
| | - Daniel Yordanov
- Department of Medical Microbiology, Medical Faculty, Medical University of Sofia, Sofia, Bulgaria
| | - Raina Gergova
- Department of Medical Microbiology, Medical Faculty, Medical University of Sofia, Sofia, Bulgaria
| | - Rumyana Markovska
- Department of Medical Microbiology, Medical Faculty, Medical University of Sofia, Sofia, Bulgaria
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10
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Pereira de Oliveira Borlot JR, Schlittler Dos Santos L, Schwarzt Sampaio GJ, Santos Borges A, Rodrigues RP, de Cássia Ribeiro Gonçalves R, Bezerra Dos Santos R, Kitagawa RR. Synthesis, Docking Studies and Evaluation of Chalcones as Anti-Helicobacter pylori and antitumoral Agents. Chem Biodivers 2023; 20:e202301066. [PMID: 37646700 DOI: 10.1002/cbdv.202301066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 08/30/2023] [Indexed: 09/01/2023]
Abstract
Helicobacter pylori colonizes the gastric epithelium of 50 % of world population and it is the main etiological agent of human chronic gastritis, peptic ulcer, and gastric cancer. In this study, we synthesized and characterized a series of 14 chalcones and evaluated their anti-H. pylori, NO inhibition (in vitro and in silico), and AGS cells cytotoxic effects. Compounds 3b and 3h showed MIC of 8 μg/mL. We observed structure-activity relationships, mainly related to the influence of methoxy substituent at C-2 (3b) and the nitro group at C-4 (3h) in chalcone scaffold. The fourteen chalcones inhibited the NO production in LPS-stimulated macrophages and showed potential for interaction on the active site of the iNOS enzyme. Finally, 3b and 3h showed the highest selectivity to the AGS cell lines. Thus, ours results suggest 3b and 3h as potential candidates for design of new and effective agents against H. pylori and related diseases.
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Affiliation(s)
- Jessica Rodrigues Pereira de Oliveira Borlot
- Graduate Program of Pharmaceutical Sciences, Health Sciences Center, Federal University of Espírito Santo, Avenida Marechal Campos 1468, Bonfim, 29047-105, Vitória, ES, Brazil
- Graduate Program of Chemistry, Exact Sciences Center, Federal University of Espírito Santo, Avenida Fernando Ferrari 514, Goiabeiras, 29075-910, Vitória, ES, Brazil
| | - Luna Schlittler Dos Santos
- Department of Chemistry, Exact Sciences Center, Federal University of Espírito Santo, Avenida Fernando Ferrari 514, Goiabeiras, 29075-910, Vitória, ES, Brazil
| | - Guilherme José Schwarzt Sampaio
- Graduate Program of Pharmaceutical Sciences, Health Sciences Center, Federal University of Espírito Santo, Avenida Marechal Campos 1468, Bonfim, 29047-105, Vitória, ES, Brazil
| | - Augusto Santos Borges
- Department of Pharmaceutical Sciences, Health Sciences Center, Federal University of Espírito Santo, Avenida Marechal Campos 1468, Bonfim, 29047-105, Vitória, ES, Brazil
| | - Ricardo Pereira Rodrigues
- Graduate Program of Pharmaceutical Sciences, Health Sciences Center, Federal University of Espírito Santo, Avenida Marechal Campos 1468, Bonfim, 29047-105, Vitória, ES, Brazil
| | - Rita de Cássia Ribeiro Gonçalves
- Graduate Program of Pharmaceutical Sciences, Health Sciences Center, Federal University of Espírito Santo, Avenida Marechal Campos 1468, Bonfim, 29047-105, Vitória, ES, Brazil
- Department of Pharmaceutical Sciences, Health Sciences Center, Federal University of Espírito Santo, Avenida Marechal Campos 1468, Bonfim, 29047-105, Vitória, ES, Brazil
| | - Reginaldo Bezerra Dos Santos
- Department of Chemistry, Exact Sciences Center, Federal University of Espírito Santo, Avenida Fernando Ferrari 514, Goiabeiras, 29075-910, Vitória, ES, Brazil
| | - Rodrigo Rezende Kitagawa
- Graduate Program of Pharmaceutical Sciences, Health Sciences Center, Federal University of Espírito Santo, Avenida Marechal Campos 1468, Bonfim, 29047-105, Vitória, ES, Brazil
- Department of Pharmaceutical Sciences, Health Sciences Center, Federal University of Espírito Santo, Avenida Marechal Campos 1468, Bonfim, 29047-105, Vitória, ES, Brazil
- Graduate Program of Chemistry, Exact Sciences Center, Federal University of Espírito Santo, Avenida Fernando Ferrari 514, Goiabeiras, 29075-910, Vitória, ES, Brazil
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11
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Wang Y, Du J, Zhang D, Jin C, Chen J, Wang Z, Mei T, Fu K, Qian Q, Pang T. Primary antibiotic resistance in Helicobacter pylori in China: a systematic review and meta-analysis. J Glob Antimicrob Resist 2023; 34:30-38. [PMID: 37315738 DOI: 10.1016/j.jgar.2023.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/25/2023] [Accepted: 05/31/2023] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVES The incidence of Helicobacter pylori (HP) is 25-50% in developed countries and 80% in developing countries, including 56.2% in China. However, antibiotic resistance of HP is a threat to HP control. The purpose of this study was to comprehensively evaluate primary drug resistance of HP in China. METHODS The full text of reports of the primary antibiotic resistance prevalence of HP was obtained from multiple databases (PubMed, Web of Science, Evimed, Cochrane Library, and China National Knowledge Internet). Review Manager 5.2 was adopted for meta-analysis, sensitivity analysis, and bias analysis. The Newcastle-Ottawa Scale was used to assess the article quality. RESULTS In total, 38804 HP samples from 22 trials were extracted. The results suggested that the overall prevalence of amoxicillin, clarithromycin, metronidazole, and levofloxacin resistance among HP in adults was as follows: mean difference (MD) = 1.35%, 95% confidence interval (CI) [1.03%, 1.68%]; MD = 23.76%, 95% CI [20.23%, 27.3%]; MD = 69.32%, 95% CI [64.85%, 73.8%]; and MD = 29.45%, 95% CI [4.90, 176.96], respectively. From the results of sensitivity and publication bias, we find that these results are robust and had little publication bias. CONCLUSION Our research showed that in China, the prevalence of HP resistance to primary antibiotics warrants attention, especially with regard to metronidazole, levofloxacin, and clarithromycin.
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Affiliation(s)
- Yuxiang Wang
- School of Public Health, North China University of Science and Technology, Taiyuan, China
| | - Jinran Du
- Biotecnovo (Langfang) Medical Lab Co. Ltd., Langfang, China
| | - Dayan Zhang
- Wanquan District Hospital of Traditional Chinese Medicine, Zhangjiakou City, Hebei Province, China
| | - Cong Jin
- School of Public Health, North China University of Science and Technology, Taiyuan, China
| | - Jiangpo Chen
- Biotecnovo (Langfang) Medical Lab Co. Ltd., Langfang, China
| | - Zeyuan Wang
- Beijing Sentum Health Co., Ltd., Beijing, China
| | - Tonglin Mei
- Beijing Sentum Health Co., Ltd., Beijing, China
| | - Kaili Fu
- Beijing Sentum Health Co., Ltd., Beijing, China
| | - Qingzeng Qian
- School of Public Health, North China University of Science and Technology, Taiyuan, China.
| | - Tieliang Pang
- Biotecnovo (Langfang) Medical Lab Co. Ltd., Langfang, China.
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12
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Al-Fakhrany OM, Elekhnawy E. Helicobacter pylori in the post-antibiotics era: from virulence factors to new drug targets and therapeutic agents. Arch Microbiol 2023; 205:301. [PMID: 37550555 PMCID: PMC10406680 DOI: 10.1007/s00203-023-03639-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/16/2023] [Accepted: 07/20/2023] [Indexed: 08/09/2023]
Abstract
Helicobacter pylori is considered one of the most prevalent human pathogenic microbes globally. It is the main cause of a number of gastrointestinal ailments, including peptic and duodenal ulcers, and gastric tumors with high mortality rates. Thus, eradication of H. pylori is necessary to prevent gastric cancer. Still, the rise in antibiotic resistance is the most important challenge for eradication strategies. Better consideration of H. pylori virulence factors, pathogenesis, and resistance is required for better eradication rates and, thus, prevention of gastrointestinal malignancy. This article is aimed to show the role of virulence factors of H. pylori. Some are involved in its survival in the harsh environment of the human gastric lumen, and others are related to pathogenesis and the infection process. Furthermore, this work has highlighted the recent advancement in H. pylori treatment, as well as antibiotic resistance as a main challenge in H. pylori eradication. Also, we tried to provide an updated summary of the evolving H. pylori control strategies and the potential alternative drugs to fight this lethal resistant pathogen. Recent studies have focused on evaluating the efficacy of alternative regimens (such as sequential, hybrid, concomitant treatment, vonoprazan (VPZ)-based triple therapy, high-dose PPI-amoxicillin dual therapy, probiotics augmented triple therapy, or in combination with BQT) in the effective eradication of H. pylori. Thus, innovating new anti-H. pylori drugs and establishing H. pylori databanks are upcoming necessities in the near future.
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Affiliation(s)
- Omnia Momtaz Al-Fakhrany
- Pharmaceutical Microbiology Department, Faculty of Pharmacy, Tanta University, Tanta, 31527 Egypt
| | - Engy Elekhnawy
- Pharmaceutical Microbiology Department, Faculty of Pharmacy, Tanta University, Tanta, 31527 Egypt
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13
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Liang B, Yuan Y, Peng XJ, Liu XL, Hu XK, Xing DM. Current and future perspectives for Helicobacter pylori treatment and management: From antibiotics to probiotics. Front Cell Infect Microbiol 2022; 12:1042070. [PMID: 36506013 PMCID: PMC9732553 DOI: 10.3389/fcimb.2022.1042070] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 11/02/2022] [Indexed: 11/27/2022] Open
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.
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Affiliation(s)
- Bing Liang
- Qingdao Cancer Institute, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yang Yuan
- Qingdao Cancer Institute, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiao-Jin Peng
- Qingdao Cancer Institute, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xin-Lin Liu
- Qingdao Cancer Institute, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiao-Kun Hu
- Intervention Neurosurgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Dong-Ming Xing
- Qingdao Cancer Institute, The Affiliated Hospital of Qingdao University, Qingdao, China,School of Life Sciences, Tsinghua University, Beijing, China,*Correspondence: Dong-Ming Xing,
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14
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CHRONIC PERIODONTITIS IN PATIENTS WITH CHRONIC DUODENAL ULCER. WORLD OF MEDICINE AND BIOLOGY 2022. [DOI: 10.26724/2079-8334-2022-1-79-232-236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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15
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Keikha M, Askari P, Ghazvini K, Karbalaei M. Levofloxacin-based therapy as an efficient alternative for eradicating Helicobacter pylori infection in Iran: a systematic review and meta-analysis. J Glob Antimicrob Resist 2021; 29:420-429. [PMID: 34788690 DOI: 10.1016/j.jgar.2021.10.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 10/22/2021] [Accepted: 10/24/2021] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES Despite excessive resistance of Helicobacter pylori to clarithromycin among Iranian population, unfortunately, clarithromycin-based therapy is still prescribed in Iran. Recent studies have shown high rates of H. pylori eradication in patients treated with levofloxacin. The main purpose of this study was to compare the effect of levofloxacin with clarithromycin on the eradication of H. pylori infection in Iranian population. METHODS A comprehensive meta-analysis was done for the relevant cohort studies and clinical trials to compare the therapeutic effects of levofloxacin with clarithromycin in Iranian population. We pooled the data using odds ratio corresponding to 95% confidence intervals to find the clinical efficacy of levofloxacin versus clarithromycin to treat H. pylori infection. The heterogeneity and publication bias were also measured for the included studies. RESULTS A total of 13 studies were included in the quantitative synthesis. Eradication rate in patients receiving levofloxacin and clarithromycin were 75% and 66.3%, respectively (OR: 1.76; 95% CI: 1.40-2.20). In addition, in the subgroup analysis, it was confirmed that cure rate is relatively higher in levofloxacin-treated cases. However, there is significant heterogeneity as well as publication bias, thus, the results need to be interpreted with caution. CONCLUSIONS We found that the success of levofloxacin treatment was significantly higher than that of clarithromycin. Therefore, it is suggested that clarithromycin-based triple therapy be replaced by levofloxacin-based triple therapy in countries with high resistance rate to clarithromycin such as Iran. Nevertheless, findings of the present study need to be approved with larger investigation on Iranian population.
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Affiliation(s)
- Masoud Keikha
- Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Microbiology and Virology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Parvin Askari
- Department of Microbiology, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Kiarash Ghazvini
- Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Microbiology and Virology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Karbalaei
- Department of Microbiology and Virology, Faculty of Medicine, Jiroft University of Medical Sciences, Jiroft, Iran.
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16
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Cerri G, Farina M, Brundu A, Gavini E, Salis A, Dathe W. Antibacterial activity of Zn-loaded Cuban zeolite against Helicobacter pylori in comparison to its Na-loaded and unmodified counterparts. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2021; 43:2037-2048. [PMID: 33244649 PMCID: PMC8081705 DOI: 10.1007/s10653-020-00781-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 11/10/2020] [Indexed: 05/02/2023]
Abstract
Helicobacter pylori can be found in the stomach of about half of the humans, and a large population can be associated with serious diseases. To survive in the stomach H. pylori increases the pH locally by producing ammonia which binds to H+ becoming ammonium. This work investigated the effects on the in-vitro growth of H. pylori of a natural cation-exchanger mainly composed (≈70%) of clinoptilolite and mordenite. The zeolitized material from Cuba was evaluated in its original form (M), as well as in its Na- (M-Na) and Zn-exchanged (M-Zn) counterparts. In the preliminary agar cup diffusion test, H. pylori revealed susceptibility only to M-Zn, with a direct relationship between concentration and width of inhibition halo. Further experiments evidenced that bacterium replication increases when ammonium is supplied to the growth medium and decreases when zeolites subtract NH4+ via ion exchange. Due to the multi-cationic population of its zeolites M was not effective enough in removing ammonium and, in the Minimum Inhibitory Concentration (MIC) test, allowed bacterial growth even at a concentration of 50 mg/mL. Inhibition was achieved with M-Na because it contained sodium zeolites capable of maximizing NH4+ subtraction, although the MIC was high (30 mg/mL). M-Zn evidenced a more effective inhibitory capacity, with a MIC of 4 mg/mL. Zinc has antimicrobial properties and H. pylori growth was affected by Zn2+ released from clinoptilolite and mordenite. These zeolites, being more selective towards NH4+ than Zn2+, can also subtract ammonium to the bacterium, thus enhancing the efficacy of M-Zn.
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Affiliation(s)
- Guido Cerri
- Department of Architecture, Design and Urban Planning - GeoMaterials Lab, Sassari University, Via Piandanna 4, 07100, Sassari, Italy.
| | - Mauro Farina
- Department of Architecture, Design and Urban Planning - GeoMaterials Lab, Sassari University, Via Piandanna 4, 07100, Sassari, Italy
| | - Antonio Brundu
- Department of Architecture, Design and Urban Planning - GeoMaterials Lab, Sassari University, Via Piandanna 4, 07100, Sassari, Italy
| | - Elisabetta Gavini
- Department of Chemistry and Pharmacy, Sassari University, Via Muroni 23, 07100, Sassari, Italy
| | - Andrea Salis
- Department of Chemistry and Pharmacy, Sassari University, Via Muroni 23, 07100, Sassari, Italy
| | - Wilfried Dathe
- Heck Bio-Pharma GmbH, Gerberstraße 15, 73650, Winterbach, Germany
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17
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Zhang T, Zhang T, Li C, Zhai X, Huo Q. Complementary and alternative therapies for precancerous lesions of gastric cancer: A protocol for a Bayesian network meta analysis. Medicine (Baltimore) 2021; 100:e24249. [PMID: 33466209 PMCID: PMC7808479 DOI: 10.1097/md.0000000000024249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 12/17/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Gastric cancer is one of the most common malignant tumors, which seriously affect peoples quality of life and threaten people's health. Precancerous lesions of gastric cancer (PLGC) are a critical stage in the occurrence and development of gastric cancer. Early effective intervention is an important means to prevent and control gastric cancer. In this study, we will evaluate the efficacy and safety of complementary and alternative therapies in the treatment of PLGC by Bayesian network meta-analysis (NMA). METHODS We will search PubMed, Cochrane Library, CNKI and other databases to gather randomized controlled trials (RCTs) on the treatment of PLGC with complementary and alternative therapies. Two reviewers will screen the literature and extract the data according to the inclusion and exclusion criteria, and then assess the quality and bias risk according to Cochrane's Risk of Bias Assessment Tool. Bayesian network meta-analysis will be conducted by Stata16.0 and WinBUGS1.4.3. RESULTS This study will compare and rank the efficacy and safety of different complementary and alternative therapies for PLGC. CONCLUSION This study can provide reliable evidence for the efficacy and safety of complementary and alternative therapies in treatment of PLGC. We expect to provide scientific and rigorous evidence support for clinicians and patients, and then assist them to choose the optimum treatment. PROTOCOL REGISTRATION NUMBER INPLASY2020120077.
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Affiliation(s)
- Tianqi Zhang
- First College of Clinical Medicine, Shandong University of Traditional Chinese Medicine
| | - Tiefeng Zhang
- First College of Clinical Medicine, Shandong University of Traditional Chinese Medicine
- Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine
| | - Chuancheng Li
- First College of Clinical Medicine, Shandong University of Traditional Chinese Medicine
| | - Xixi Zhai
- First College of Clinical Medicine, Shandong University of Traditional Chinese Medicine
| | - Qing Huo
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
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Shi J, Liu L, Li J, Ma X, Qiu H, Shen T. Efficacy and safety of Zuojin Pill for chronic gastritis: Protocol for a systematic review of randomized controlled trials. Medicine (Baltimore) 2020; 99:e21248. [PMID: 32702906 PMCID: PMC7373601 DOI: 10.1097/md.0000000000021248] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Chronic gastritis (CG), as the highest incidence of gastrointestinal diseases, has been gradually increasing around globally. With the obvious disadvantages of standard treatment, more and more people ask the traditional Chinese medicine for help in the treatment of CG. As a traditional Chinese medicine compound, Zuojin Pill (ZJP) has a long history of clinical application in the treatment of digestive system diseases. Whereas, neither systematic nor meta-analysis of randomized controlled trials explain the efficacy and safety of ZJP in treating CG. Thus, we provide a protocol to evaluate the efficacy and safety of ZJP for CG. METHODS From the beginning to December 2019, the following electronic databases will be searched for studies in English or Chinese: the Cochrane Library, Embase, PubMed, Web of Science, the Chinese National Knowledge Infrastructure, the Chinese Biomedical Literature Database, the Chinese Scientific Journal Database, and the Wanfang Database. Clinical efficiency, helicobacter pylori infection clearance rate, quality of life and symptom scores will be measured as primary outcomes. Meta-analysis will be performed using the Stata 15. OUTCOMES This study will provide the current evidence of CG treated with ZJP from the several aspects including clinical efficiency, helicobacter pylori infection clearance rate, quality of life, symptom scores, the 1-year recurrent rate, efficacy under endoscopy and number of reported adverse events associated with the use of ZJP. CONCLUSION The outcomes of this review will be served as a proof to evaluate if ZJP is effective in the treatment of CG. PROSPERO REGISTRATION NUMBER PROSPERO CRD42020155036.
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Affiliation(s)
- Jianglong Shi
- School of Basic Medicine Sciences, Chengdu University of Traditional Chinese Medicine , Chengdu, Sichuan
| | - Liyun Liu
- School of Basic Medicine Sciences, Chengdu University of Traditional Chinese Medicine , Chengdu, Sichuan
| | - Jian Li
- Department of Sports Medicine, Shanghai University of Sport, Shanghai, China
| | - Xiaoju Ma
- School of Basic Medicine Sciences, Chengdu University of Traditional Chinese Medicine , Chengdu, Sichuan
| | - Hairong Qiu
- School of Basic Medicine Sciences, Chengdu University of Traditional Chinese Medicine , Chengdu, Sichuan
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Investigations to Evaluate Gastric Mucoadhesion of an Organic Product to Ameliorate Gastritis. Pharmaceutics 2020; 12:pharmaceutics12040331. [PMID: 32272788 PMCID: PMC7238041 DOI: 10.3390/pharmaceutics12040331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 04/02/2020] [Accepted: 04/03/2020] [Indexed: 11/16/2022] Open
Abstract
Gastritis is an inflammatory disease leading to abdominal pain, nausea, and diarrhea. While therapy depends on etiology, adhesive agents protecting the gastric tissue represent a promising treatment option. Caricol®-Gastro is an organic product that significantly decreased gastritic abdominal pain in a recent clinical study. To investigate whether this beneficial effect can be attributed to the formation of a protective layer covering the gastric mucosa after oral application, several methods were used to determine adhesion. These include macro-rheological measurements and gastric mucin interactions, which were correlated to network formation, examined by Cryo-scanning electron microscopy technique, wettability via sessile drop method on human gastric adenocarcinoma cell layers, and ex vivo adhesion studies on gastric porcine tissue with the falling liquid film technique considering physiological conditions and Franz diffusion cells for quantification. The results showed that Caricol®-Gastro formed a stable viscoelastic network with shear thinning properties. It exhibited high wettability and spreadability and adhered to the excised gastric mucosa. We found that oat flour, as the main ingredient of Caricol®-Gastro, supports the gel network regarding viscoelasticity and, to a lesser extent, adhesion in a concentration dependent manner. Moreover, our data highlight that a variety of coordinated methods are required to investigate gastric adhesion.
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Boyanova L, Hadzhiyski P, Kandilarov N, Markovska R, Mitov I. Multidrug resistance in Helicobacter pylori: current state and future directions. Expert Rev Clin Pharmacol 2019; 12:909-915. [PMID: 31424296 DOI: 10.1080/17512433.2019.1654858] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Introduction: Helicobacter pylori antibiotic resistance has increased worldwide and multidrug resistance (MDR), which seriously hampers eradication success of the frequent chronic infection, has often been reported. Areas covered: H. pylori MDR rates are discussed, mostly from recent articles published since 2015. Present approaches and future directions to counteract the MDR are outlined. Expert opinion: Alarming presence of triple, quadruple and, in some studies, quintuple and sextuple resistance was detected. Primary MDR rates ranged from <10% in most European countries to >40% in Peru. Post-treatment or overall MDR rates were >23-36% in about half of the studies. MDR prevalence has varied both among and within the countries. Factors linked to the MDR are national antibiotic consumption, antibiotic misuse, treatment failures and bacterial factors such as mutations, efflux pumps, and biofilms. Important directions to counteract the MDR increase can be optimization of present and new eradication regimens, wider use of bismuth-containing regimens, assessment of benefit of vonoprazan, new antibiotics such as newer fluoroquinolones and oxazolidinone analogues, adjuvants involving N-acetylcysteine and probiotics, anti-biofilm approaches using anti-biofilm peptides and rhamnolipid and development of vaccines and non-invasive tests for resistance detection. However, more efforts and studies are required. Strain susceptibility testing is increasingly important.
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Affiliation(s)
- Lyudmila Boyanova
- Department of Medical Microbiology, Medical University of Sofia , Sofia , Bulgaria
| | - Petyo Hadzhiyski
- Specialized Hospital for Active Pediatric Treatment, Medical University of Sofia , Sofia , Bulgaria
| | - Nayden Kandilarov
- Department of General and Hepatobiliary Pancreatic Surgery, Department of Surgery, Medical University , Sofia , Bulgaria
| | - Rumyana Markovska
- Department of Medical Microbiology, Medical University of Sofia , Sofia , Bulgaria
| | - Ivan Mitov
- Department of Medical Microbiology, Medical University of Sofia , Sofia , Bulgaria
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21
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Yoon JY, Cha JM, Hong SS, Kim HK, Kwak MS, Jeon JW, Shin HP. Fermented milk containing Lactobacillus paracasei and Glycyrrhiza glabra has a beneficial effect in patients with Helicobacter pylori infection: A randomized, double-blind, placebo-controlled study. Medicine (Baltimore) 2019; 98:e16601. [PMID: 31464895 PMCID: PMC6736393 DOI: 10.1097/md.0000000000016601] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Lactobacillus paracasei and Glycyrrhiza glabra have been reported as having beneficial effects on Helicobacter pylori infection. We aimed to assess the efficacy and safety of fermented milk containing L paracasei HP7 and G glabra in patients with H pylori infection. METHODS This multicenter, prospective, randomized, double-blind, placebo-controlled clinical trial was conducted in 2 hospitals from April to December 2017. Patients with H pylori infection were randomized into either the treatment group (fermented milk with L paracasei HP7 and G glabra) or placebo group (fermented milk only) once daily for 8 weeks. The primary endpoint was the gastric load of H pylori measured by C-urea breath test (UBT). Secondary endpoints were histologic and clinical improvement. RESULTS A total of 142 patients were randomly allocated to the treatment (n = 71) or placebo groups (n = 71). Compared to baseline data, the quantitative value of C-UBT at 8 weeks was significantly reduced in the treatment group (from 20.8 ± 13.2% to 16.9 ± 10.8%, P = .035), but not in the placebo group (P = .130). Chronic inflammation improved significantly only in the treatment group (P = .013), whereas the neutrophil activity deteriorated significantly only in the placebo group (P = .003). Moreover, the treatment group had significant improvement in gastrointestinal symptoms (P = .049) and quality of life (P = .029). No serious adverse events were observed. CONCLUSION The combination of fermented milk containing L paracasei and G glabra reduced H pylori density and improved histologic inflammation. However, their mechanisms of action should be elucidated in further studies.
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Affiliation(s)
- Jin Young Yoon
- Department of Internal Medicine, Division of Gastroenterology, Kyung Hee University Hospital at Gang Dong, Kyung Hee University School of Medicine
| | - Jae Myung Cha
- Department of Internal Medicine, Division of Gastroenterology, Kyung Hee University Hospital at Gang Dong, Kyung Hee University School of Medicine
| | | | - Hyung Kyung Kim
- Department of Medicine, Graduate School, Kyung Hee University, Seoul, Korea
| | - Min Seob Kwak
- Department of Internal Medicine, Division of Gastroenterology, Kyung Hee University Hospital at Gang Dong, Kyung Hee University School of Medicine
| | - Jung Won Jeon
- Department of Internal Medicine, Division of Gastroenterology, Kyung Hee University Hospital at Gang Dong, Kyung Hee University School of Medicine
| | - Hyun Phil Shin
- Department of Internal Medicine, Division of Gastroenterology, Kyung Hee University Hospital at Gang Dong, Kyung Hee University School of Medicine
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22
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Increased anti-Helicobacter pylori effect of the probiotic Lactobacillus fermentum UCO-979C strain encapsulated in carrageenan evaluated in gastric simulations under fasting conditions. Food Res Int 2019; 121:812-816. [DOI: 10.1016/j.foodres.2018.12.064] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 12/07/2018] [Accepted: 12/30/2018] [Indexed: 12/14/2022]
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23
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Xiong Y, Yang Z, Zhang J, Li J, Chen P, Xiang Y. Panning using a phage-displayed random peptide library to identify peptides that antagonize the Helicobacter pylori ArsS acid-sensing domain. Microb Pathog 2019; 135:103614. [PMID: 31255726 DOI: 10.1016/j.micpath.2019.103614] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 05/27/2019] [Accepted: 06/26/2019] [Indexed: 01/01/2023]
Abstract
Helicobacter pylori is an important etiological factor involved in chronic gastritis, peptic ulcer, and gastric cancer. There are currently no optimal preventive or therapeutic interventions for H. pylori infection. H. pylori survives in the stomach by sensing and adapting to the highly acidic environment by using the two-component signal transduction system that contains the most widely known gastric acid receptor, ArsRS (which is composed of ArsS and ArsR). This study aimed to identify peptides that antagonize the acid-sensing domain of H. pylori ArsS. These peptides could be used to block the acid-sensing signal and thereby hinder H. pylori adaption to acidic environments to prevent its survival. Using proSite, the functional domains (including the N-terminal acid-sensing domain) of H. pylori J99 ArsS were predicted. The purified recombinant ArsS N-terminal acid-sensing protein (P-ArsS-A) was used as the target in a panning protocol in which peptides from the Ph.D.-7 Phage Display Peptide Library that could bind to P-ArsS-A were identified. As a result, eight phage clones that could specifically bind to P-ArsS-A were obtained and five amino acid sequences were identified, including P03 (MMSYPKH) and P06 (LTPMPNW). An in vitro minimum inhibitory concentration (MIC) evaluation showed that P03 and P06 significantly inhibited the growth of H. pylori J99. The MIC of P03 was 8 μM, and the MIC of P06 was >16 μM, indicating that P03 is a stronger inhibitor compared to P06. This was confirmed by colony counting on blood agar plates after P03 and P06 administration. Using homology modeling and molecular docking analysis, it was shown that P03 and P06 could bind to the ArsS N-terminal domain, and there were four shared binding sites: TYR25, ASN39, ARG73, and GLU74. Additionally, one hydrogen bond was found between P03 and ArsS, which is more cohesive than other forms of bonding (van der Waals force, other non-covalent bonds).
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Affiliation(s)
- Yuxia Xiong
- Department of Pathogenic Biology, College of Basic Medical Sciences, Chongqing Medical University, Chongqing, 400016, China.
| | - Zhibang Yang
- Department of Pathogenic Biology, College of Basic Medical Sciences, Chongqing Medical University, Chongqing, 400016, China.
| | - Jin Zhang
- Department of Pathogenic Biology, College of Basic Medical Sciences, Chongqing Medical University, Chongqing, 400016, China.
| | - Jinyang Li
- College of Clinical Medicine, Chongqing Medical University, Chongqing, 400016, China.
| | - Pu Chen
- Department of Clinical Laboratory, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
| | - Yu Xiang
- Department of Clinical Laboratory, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
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24
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Hassan AM, Shawky MAEG, Mohammed AQ, Haridy MA, Eid KAEA. Simvastatin improves the eradication rate of Helicobacter pylori: upper Egypt experience. Infect Drug Resist 2019; 12:1529-1534. [PMID: 31239728 PMCID: PMC6556530 DOI: 10.2147/idr.s202346] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 03/28/2019] [Indexed: 12/11/2022] Open
Abstract
Background:Helicobacter pylori infection is one of the most prevalent chronic bacterial human infections worldwide. Helicobacter pylori colonizes the gastric mucosa and causes persistent gastritis that may progress to gastric cancer. Increased resistance of H. pylori presents a major problem in most countries. Statins, including simvastatin, which are currently used to treat hypercholesterolemia, appear to have potential synergistic role to antibiotics. This study aimed to assess the value of adding simvastatin as adjuvant to standard triple therapy in patients infected with H. pylori. Methods: This study was conducted on 100 patients diagnosed with H. pylori by the presence of antigen in stools. All patients were randomly subjected either to the standard triple regimen (clarithromycin 500 mg bid + amoxicillin 1 g bid + omeprazole 20 mg bid) (group 1, N=50) or to the standard triple regimen plus simvastatin (clarithromycin 500 mg bid + amoxicillin 1 g bid + omeprazole 20 mg bid + simvastatin 20 mg bid) (group 2, N=50). Both groups were treated for 14 days and eradication of H. pylori was assessed by a stool antigen test 4 weeks after therapy. Results: Eradication of H. pylori infection was significantly higher in patients treated with the standard triple therapy plus simvastatin (n=41, 82%) than in patients treated with the standard triple therapy (n=31, 62%) (P<0.022). Conclusion: Simvastatin significantly improves the H. pylori eradication rate.
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Affiliation(s)
- Amro Metwaly Hassan
- Hepatology, Gastroenterology and Infectious Diseases Department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | - Muhammad Abd El-Gawad Shawky
- Hepatology, Gastroenterology and Infectious Diseases Department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | - Ahmed Qasem Mohammed
- Hepatology, Gastroenterology and Infectious Diseases Department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | - Mustafa Ahmed Haridy
- Hepatology, Gastroenterology and Infectious Diseases Department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | - Khaled Abd-El-Azeem Eid
- Hepatology, Gastroenterology and Infectious Diseases Department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
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25
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Yan W, Gu L, Ren W, Ma X, Qin M, Lyu M, Wang S. Recognition of Helicobacter pylori by protein-targeting aptamers. Helicobacter 2019; 24:e12577. [PMID: 30950149 DOI: 10.1111/hel.12577] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 01/12/2019] [Accepted: 02/07/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Helicobacter pylori (H pylori) is a disease-causing pathogen capable of surviving under acidic conditions of the human stomach. Almost half of the world's population is infected with H pylori, with gastric cancer being the most unsatisfactory prognosis. Although H pylori has been discovered 30 years ago, the effective treatment and elimination of H pylori continue to be problematic. MATERIALS AND METHODS In our study, we screened nucleic acid aptamers using H pylori surface recombinant antigens as targets. Trypsin was used for separating aptamers that were bound to proteins. Following nine rounds of screening, we performed sequence similarity analyses to assess whether the aptamers can recognize the target protein. Two sequences with desirable recognition ability were selected for affinity detection. Aptamer Hp4 with the strongest binding ability to the H pylori surface recombinant antigen was chosen. After optimization of the binding conditions, we conducted specificity tests for Hp4 using Escherichia coli, Staphylococcus aureus, Vibrioanguillarum, and H pylori. RESULTS The data indicated that the aptamer Hp4 had an equilibrium dissociation constant (Kd ) of 26.48 ± 5.72 nmol/L to the target protein. This aptamer was capable of exclusively detecting H pylori cells, without displaying any specificity for other bacteria. CONCLUSIONS We obtained a high-affinity aptamer for H pylori, which is expected to serve as a new molecular probe for detection of H pylori.
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Affiliation(s)
- Wanli Yan
- Jiangsu Key Laboratory of Marine Bioresources and Environment, Huaihai Institute of Technology, Lianyungang, China.,Jiangsu Marine Resources Development Research Institute, Lianyungang, China.,College of Marine Life and Fisheries, Huaihai Institute of Technology, Lianyungang, China.,Co-Innovation Center of Jiangsu Marine Bio-industry Technology, Huaihai Institute of Technology, Lianyungang, China
| | - Lide Gu
- Jiangsu Key Laboratory of Marine Bioresources and Environment, Huaihai Institute of Technology, Lianyungang, China.,Jiangsu Marine Resources Development Research Institute, Lianyungang, China.,College of Marine Life and Fisheries, Huaihai Institute of Technology, Lianyungang, China.,Co-Innovation Center of Jiangsu Marine Bio-industry Technology, Huaihai Institute of Technology, Lianyungang, China
| | - Wei Ren
- Jiangsu Key Laboratory of Marine Bioresources and Environment, Huaihai Institute of Technology, Lianyungang, China.,Co-Innovation Center of Jiangsu Marine Bio-industry Technology, Huaihai Institute of Technology, Lianyungang, China.,Key Laboratory of Marine Biology, Nanjing Agricultural University, Nanjing, China
| | - Xiaoyi Ma
- Jiangsu Key Laboratory of Marine Bioresources and Environment, Huaihai Institute of Technology, Lianyungang, China.,Jiangsu Marine Resources Development Research Institute, Lianyungang, China.,College of Marine Life and Fisheries, Huaihai Institute of Technology, Lianyungang, China.,Co-Innovation Center of Jiangsu Marine Bio-industry Technology, Huaihai Institute of Technology, Lianyungang, China
| | - Mingcan Qin
- Jiangsu Key Laboratory of Marine Bioresources and Environment, Huaihai Institute of Technology, Lianyungang, China.,Jiangsu Marine Resources Development Research Institute, Lianyungang, China.,College of Marine Life and Fisheries, Huaihai Institute of Technology, Lianyungang, China.,Co-Innovation Center of Jiangsu Marine Bio-industry Technology, Huaihai Institute of Technology, Lianyungang, China
| | - Mingsheng Lyu
- Jiangsu Key Laboratory of Marine Bioresources and Environment, Huaihai Institute of Technology, Lianyungang, China.,Jiangsu Marine Resources Development Research Institute, Lianyungang, China.,College of Marine Life and Fisheries, Huaihai Institute of Technology, Lianyungang, China.,Co-Innovation Center of Jiangsu Marine Bio-industry Technology, Huaihai Institute of Technology, Lianyungang, China
| | - Shujun Wang
- Jiangsu Key Laboratory of Marine Bioresources and Environment, Huaihai Institute of Technology, Lianyungang, China.,Jiangsu Marine Resources Development Research Institute, Lianyungang, China.,College of Marine Life and Fisheries, Huaihai Institute of Technology, Lianyungang, China.,Co-Innovation Center of Jiangsu Marine Bio-industry Technology, Huaihai Institute of Technology, Lianyungang, China
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26
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El-Shouny WA, Ali SS, Hegazy HM, Abd Elnabi MK, Ali A, Sun J. Syzygium aromaticum L.: Traditional herbal medicine against cagA and vacA toxin genes-producing drug resistant Helicobacter pylori. J Tradit Complement Med 2019; 10:366-377. [PMID: 32695654 PMCID: PMC7365789 DOI: 10.1016/j.jtcme.2019.05.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 05/13/2019] [Accepted: 05/14/2019] [Indexed: 12/26/2022] Open
Abstract
The Pan-Drug Resistant (PDR), Helicobacter pylori remains an intractable challenge in public health worldwide and this pathogenicity is mainly due to the presence of a cytotoxin-associated gene A (CagA) and vacuolating cytotoxin A (VacA). On the other hand, plant extracts such as Syzygium aromaticum contain a diverse array of secondary metabolites, which could be potentially used to combat H. pylori pathogens. To our knowledge, this is the first report on the biomedical potential of S. aromaticum extract against cytotoxin-associated genes producing PDR H. pylori. In this investigation, out of 45 gastric antral biopsy specimens of dyspeptic patients, 20 strains were confirmed as H. pylori. Eight (40%) out of 20 strains were PDR H. pylori while the rest of the strains were Multi-Drug Resistant (MDR) strains. Genotypic analyses of PDR H. pylori strains showed that cagA and vacA genes were found to be 75% and 87.5%, respectively and m2s2 was the most common subtype of vacA gene. S. aromaticum showed a significant higher anti-H. pylori activity compared to that of Cinnamomum zeylanicum and Thymus vulgaris. Eugenol was the major phenolic compound (28.14%) detected in the methanolic extract of S. aromaticum. Clearly, results of the toxicological assessment confirmed the safety of S. aromaticum for use. Hence, these results suggest that S. aromaticum could be a new useful natural antimicrobial agent that could potentially combat cytotoxin genes-producing drug-resistant H. pylori. Moreover, these findings provide a scientific basis for the development of antimicrobial agents from traditional herbal medicines for gastroprotection against gastric ulcer. Helicobacter pylori remains an intractable challenge in public health worldwide. CagA and VacA genes are H. pylori pathogenicity dependent. Eight strains of H. pylori were proven to pan-drug resistant. The cagA and vacA genes were found to be 75% and 87.5%, respectively. Syzygium aromaticum extract showed a significant higher anti-H. pylori activity.
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Affiliation(s)
- Wagih A El-Shouny
- Botany Department, Faculty of Science, Tanta University, Tanta, 31527, Egypt
| | - Sameh S Ali
- Biofuels Institute, School of the Environment and Safety Engineering, Jiangsu University, Zhenjiang, 212013, China.,Botany Department, Faculty of Science, Tanta University, Tanta, 31527, Egypt
| | - Hegazy M Hegazy
- Department of Internal Medicine, Faculty of Medicine, Tanta University, Tanta, 31527, Egypt
| | - Manar K Abd Elnabi
- Botany Department, Faculty of Science, Tanta University, Tanta, 31527, Egypt
| | - Asmaa Ali
- Ministry of Health and Population, Chest Directorate Abbassia Chest Hospital, Cairo, Egypt
| | - Jianzhong Sun
- Biofuels Institute, School of the Environment and Safety Engineering, Jiangsu University, Zhenjiang, 212013, China
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27
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Abstract
Transition state theory teaches that chemically stable mimics of enzymatic transition states will bind tightly to their cognate enzymes. Kinetic isotope effects combined with computational quantum chemistry provides enzymatic transition state information with sufficient fidelity to design transition state analogues. Examples are selected from various stages of drug development to demonstrate the application of transition state theory, inhibitor design, physicochemical characterization of transition state analogues, and their progress in drug development.
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Affiliation(s)
- Vern L. Schramm
- Department of Biochemistry, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, New York 10461, United States
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