Low-Molecular-Weight Dextran Sulfate Nanocapsules Inhibit the Adhesion of Helicobacter pylori to Gastric Cells

Effect of daphnetin, the coumarin derivative isolated from Daphne genus, on Helicobacter pylori adhesion to gastric epithelial cells

BACKGROUND

Adherence of Helicobacter pylori to the surface of the gastric mucosa is the initial and crucial step for its survival and colonization in the harsh conditions of the stomach. We had previously demonstrated that daphnetin has anti-adhesion effect.

PURPOSE

This study aims to explore the mechanisms of daphnetin to reduce H. pylori adhesion to gastric epithelial cells (GES-1).

METHODS

Fluorescence microscopy and urease assay were used to observe and validate the anti-adhesion effect of daphnetin. Terminal deoxynucleotidyl transferase dUTP nick end labeling, comet assay and agarose gel-based assay were conducted to evaluate the level of DNA damage. Quantitative real-time polymerase chain reaction, western blotting, electrophoretic mobility shifts assay and enzyme-linked immunosorbent assay were performed to investigate the mechanisms of the anti-adhesion effect of daphnetin.

RESULTS

Our results showed that daphnetin decreased H. pylori adhesion to GES-1 in time- and dose-dependent manners. The mechanisms by which daphnetin inhibits H. pylori adhesion involved the inducing of DNA double-strand breaks, the up-regulating of recA transcription leading to RecA binding at 1018-1597 site in the babA promoter, the decreasing of babA/babB transcription ratio, the decreasing of BabA expression and its interaction with Lewis b antigen.

CONCLUSION

Our results suggested that daphnetin significantly inhibits H. pylori adhesion to GES-1 through the RecA-BabA pathway. To our knowledge, this is the first report on the mechanisms of daphnetin affecting H. pylori adhesion to GES-1.

Opportunities for Helicobacter pylori Eradication beyond Conventional Antibiotics

Helicobacter pylori (H. pylori) is a bacterium known to be associated with a significant risk of gastric cancer in addition to chronic gastritis, peptic ulcer, and MALT lymphoma. Although only a small percentage of patients infected with H. pylori develop gastric cancer, Gastric cancer causes more than 750,000 deaths worldwide, with 90% of cases being caused by H. pylori. The eradication of this bacterium rests on multiple drug regimens as guided by various consensus. However, the efficacy of empirical therapy is decreasing due to antimicrobial resistance. In addition, biofilm formation complicates eradication. As the search for new antibiotics lags behind the bacterium's ability to mutate, studies have been directed toward finding new anti-H. pylori agents while also optimizing current drug functions. Targeting biofilm, repurposing outer membrane vesicles that were initially a virulence factor of the bacteria, phage therapy, probiotics, and the construction of nanoparticles might be able to complement or even be alternatives for H. pylori treatment. This review aims to present reports on various compounds, either new or combined with current antibiotics, and their pathways to counteract H. pylori resistance.

Microparticles and nanoparticles-based approaches to improve oral treatment of Helicobacter pylori infection

Helicobacter pylori is a gram-negative, spiral-shaped, flagellated bacterium that colonizes the stomach of half the world's population. Helicobacter pylori infection causes pathologies of varying severity. Standard oral therapy fails in 15-20% since the barriers of the oral route decrease the bioavailability of antibiotics and the intrinsic factors of bacteria increase the rates of resistance. Nanoparticles and microparticles are promising strategies for drug delivery into the gastric mucosa and targeting H. pylori. The variety of building blocks creates systems with distinct colloidal, surface, and biological properties. These features improve drug-pathogen interactions, eliminate drug depletion and overuse, and enable the association of multiple actives combating H. pylori on several fronts. Nanoparticles and microparticles are successfully used to overcome the barriers of the oral route, physicochemical inconveniences, and lack of selectivity of current therapy. They have proven efficient in employing promising anti-H. pylori compounds whose limitation is oral route instability, such as some antibiotics and natural products. However, the current challenge is the applicability of these strategies in clinical practice. For this reason, strategies employing a rational design are necessary, including in the development of nano- and microsystems for the oral route.

Targeted nanotherapeutics for the treatment of Helicobacter pylori infection

Helicobacter pylori infection is involved in gastric diseases such as peptic ulcer and adenocarcinoma. Approved antibiotherapies still fail in 10 to 40% of the infected patients and, in this scenario, targeted nanotherapeutics emerged as powerful allies for H. pylori eradication. Nano/microparticles conjugated with H. pylori binding molecules were developed to eliminate H. pylori by either (i) blocking essential mechanisms of infection, such as adhesion to gastric mucosa or (ii) binding and killing H. pylori through the release of drugs within the bacteria or at the site of infection. Glycan antigens (as Lewis B and sialyl-Lewis X), pectins, lectins, phosphatidylethanolamine and epithelial cell membranes were conjugated with nano/microparticles to successfully block H. pylori adhesion. Urea-coated nanoparticles were used to improve drug delivery inside bacteria through H. pylori UreI channel. Moreover, nanoparticles coated with antibodies against H. pylori and loaded with sono/photosensitizers, were promising for their application as targeted sono/photodynamic therapies. Further, non-specific H. pylori nano/microparticles, but only active in the acidic gastric environment, coated with binders to bacterial membrane, extracellular polymeric substances or to high temperature requirement A protease, were evaluated. In this review, an overview of the existing nanotherapeutics targeting H. pylori will be given and their rational, potential to counteract infection, as well as level of development will be presented and discussed.

Applications and advancements of polysaccharide-based nanostructures for enhanced drug delivery

Growing demand for highly effective, site-specific delivery of pharmaceuticals and nutraceuticals using nano-sized carriers has prompted increased scrutiny of carrier biocompatibility and biodegradability. To address these concerns, biodegradable natural polymers have emerged as a transformative domain, offering non-toxic, precisely targetable carriers capable of finely modulating cargo pharmacokinetics while generating innocuous decomposition by-products. This comprehensive review illuminates the emergence of polysaccharide-based nanoparticulate drug delivery systems. These systems establish an interactive interface between drug and targeted organs, guided by strategic modifications to polysaccharide backbones, which facilitate the creation of morphologically, constitutionally, and characteristically vibrant nanostructures through various fabrication routes, underpinning their pivotal role in biomedical applications. Advancements crucial to enhancing polysaccharide-based drug delivery, such as surface modifications and bioinspired modifications for enhanced targeting, and stimuli-responsive release, strategies to overcome biological barriers, enhance tumor penetration, and optimize therapeutic outcomes are highlighted. This review also examines some potent challenges, and the contemporary way out of them, and discusses future perspectives in the field.

Dextran Nanocapsules with ω-3 in Their Nucleus: An Innovative Nanosystem for Imiquimod Transdermal Delivery

Transdermal administration of molecules across the skin has gained interest because it can be considered a non-invasive route compared with traditional ones. However, going through the skin is challenging due to the presence of the stratum corneum, the main barrier of substances. For this reason, the goal of this research was the combination of omega-3 (ω-3) and a dextran sulfate assembly in a nanostructure form, which allows passage through the skin and improves the bioavailability and the therapeutic profiles of active molecules, such as imiquimod. Here we report a new colloidal system, named dextran nanocapsules, with ω-3 in its nucleus and a coat made of dextran sulfate with a size ~150 nm, monomodal distribution, and negative zeta potential (~-33 mV). This nanosystem encapsulates imiquimod with high efficacy (~86%) and can release it in a controlled fashion following Korsmeyer-Peppas kinetics. This formulation is stable under storage and physiological conditions. Furthermore, a freeze-dried product could be produced with different cryoprotectants and presents a good security profile in the HaCaT cell line. Ex vivo assays with newborn pig skin showed that dextran nanocapsules promote transdermal delivery and retention 10 times higher than non-encapsulated imiquimod. These promising results make this nanosystem an efficient vehicle for imiquimod transdermal delivery.

Features of diet therapy for H. pylori associated diseases of the gastrointestinal tract

This review of the literature is devoted to the importance of nutritional support in the treatment and prevention of diseases of the gastrointestinal tract associated with Helicobacter pylori. Modern data on the biological properties of H. pylori and the mechanisms of colonization of the microorganism in the gastrointestinal mucosa are presented. Information is provided on the virulence factors and factors that promote adhesion, depolymerization and dissolution of protective mucus, damage and circulatory disorders of the gastrointestinal mucosa, secreted by H. pylori (lipopolysaccharides and proteins of the outer shell of the bacterium, enzymes – mucinase, protease, phospholipase, urease, VacA cytotoxin). The article pays special attention to the issues of diet therapy, the role of various foods and their components in the dietary correction of disorders in gastrointestinal diseases associated with H. pylori. The causes of nutritional disorders in patients with gastrointestinal diseases are described and a detailed description of food products and their biologically active components with anti-Helicobacter activity is given. A special section is devoted to the use and effectiveness of specialized dietary products for therapeutic and preventive nutrition of domestic production (LLC “Leovit nutria”) and the features of use in diseases of the gastrointestinal tract mediated by H. pylori. The authors provide information on the composition of dietary products, their anti-inflammatory, antioxidant, immunotropic and other activities that underlie clinical efficacy. The article provides detailed recommendations on the use of specialized dietary foods for this pathology.

Orally administrated chitosan microspheres bind Helicobacter pylori and decrease gastric infection in mice

Persistent Helicobacter pylori (H. pylori) infection is related to 90% of gastric cancers. With bacterial resistance rising and treatment inefficiency affecting 15% of the patients, alternative treatments urge. Chitosan microspheres (ChMics) have been proposed as an H. pylori-binding system. This work evaluates ChMics biocompatibility, mucopenetration and capacity to treat H. pylori infection in mice after oral administration. ChMics of different size (XL, ∼120 µm and XS, ∼40 µm) and degree of acetylation (6% and 16%) were developed and revealed to be able to adhere both human and mouse-adapted H. pylori strains without cytotoxicity towards human gastric cells. Ex vivo studies showed that smaller (XS) microspheres penetrate further within the gastric foveolae, suggesting their ability to reach deeply adherent bacteria. In vivo assays showed 88% reduction of infection when H. pylori-infected mice (C57BL/6) were treated with more mucoadhesive XL6 and XS6 ChMics. Overall, ChMics clearly demonstrate ability to reduce H. pylori gastric infection in mice, with chitosan degree of acetylation being a dominant factor over microspheres' size on H. pylori removal efficiency. These results evidence the strong potential of this strategy as an antibiotic-free approach to fight H. pylori infection, where microspheres are orally administered, bind H. pylori in the stomach, and remove them through the gastrointestinal tract. STATEMENT OF SIGNIFICANCE: Approximately 90% of gastric cancers are caused by the carcinogenic agent Helicobacter pylori, which infects >50% of the world population. Bacterial resistance, reduced antibiotic bioavailability, and the intricate distribution of bacteria in mucus and within gastric foveolae hamper the success of most strategies to fight H. pylori. We demonstrate that an antibiotic-free therapy based on bare chitosan microspheres that bind and remove H. pylori from stomach can achieve 88% reduction of infection from H. pylori-infected mice. Changing size and mucoadhesive properties, microspheres can reach different areas of gastric mucosa: smaller and less mucoadhesive can penetrate deeper into the foveolae. This promising, simple and inexpensive strategy paves the way for a faster bench-to-bedside transition, therefore holding great potential for clinical application.

Smart drug delivery against Helicobacter pylori: pectin-coated, mucoadhesive liposomes with antiadhesive activity and antibiotic cargo

The first step in the development of Helicobacter pylori pathogenicity is the receptor-mediated adhesion to the gastric epithelium. Inhibition of outer membrane proteins of H. pylori (e.g. BabA) by antiadhesive drugs will contribute to reduced recolonization and infection. Pectin from apple inhibits the BabA and LPS-mediated adhesion of H. pylori to human stomach cells. Pectin-coated liposomes with encapsulated amoxicillin were characterized for polydispersity, zeta potential, encapsulation efficiency, stability, and amoxicillin release. Coated liposomes did not influence the viability of AGS and HT29-MTX cells up to 100 μg/mL but exert cytotoxicity against H. pylori at 10 μg/mL. Pectin-coating of liposomes provoked direct interaction and subsequent binding of the particles to surface structures of H. pylori, and interaction with mucus from porcine stomach and mucus secreted by HT29-MTX cells. Laser scanning microscopy of H. pylori and AGS cells together with liposomes indicated co-aggregation. The mucoadhesive effect seems interesting as stomach cells are covered by a mucus layer. H. pylori is able to penetrate and cross the mucin rapidly to reach pH-neutral epithelium to escape the acidic environment, followed by interaction with epithelial cells. In summary, all experimental evidence is consistent with a specific interaction of pectin-coated liposomes with mucins and surface structures of H. pylori. As the coated liposomes show mucoadhesion to the negatively charged mucins, docking to stomach mucin, mucus penetration, and recognition of and adhesion to H. pylori, they can be considered a novel type of multifunctional drug carriers for local antibiotic therapy against H. pylori. KEY POINTS: • Smart, multifunctional mucoadhesive liposomes • Specific targeting against BabA/LPS of Helicobacter pylori • Inhibition of bacterial adhesion of H. pylori to human host cells • Release of antibiotic cargo.