Prevalence of infections by Helicobacter pylori, a pathogen involved in a number of gastrointestinal diseases, remains high in developing countries. Management of infections by eradication is not always an option. Lactobacillus reuteri L. reuteri DSM17648 (Pylopass™) specifically co-aggregates H. pylori in vitro and was shown to reduce 13C urea breath test in vivo. In this pilot study, we tried to replicate previous findings in an independent sample and to evaluate effects of spray-drying vs. freeze-drying of cultures. A single-blinded, placebo-controlled study was done in 22 H. pylori positive, asymptomatic adults. H. pylori levels were determined by 13C-urea-breath method after 14 days of supplementation, as well as after 6, 12, and 24 weeks follow-up. In the test group, but not in the placebo group, a significant reduction of H. pylori was observed. For the first time, spray-dried cells of L. reuteri DSM17648 have been used in a human study and results are in line with the first study results, supplementing with freeze-dried material. This is of special interest as spray-drying results in dead cell material, meaning that the effect of L. reuteri must be independent of its probiotic activity. These results confirm the potential of Pylopass™ L. reuteri DSM17648 as a novel way to reduce the load of H. pylori.
Reducing the amount of Helicobacter pylori in the stomach by selective bacterial–bacterial cell interaction was sought as an effective and novel method for combating the stomach pathogen. Lactobacillus reuteri DSM17648 was identified as a highly specific binding antagonist to H. pylori among more than 700 wild-type strains of Lactobacillus species. Applying a stringent screening procedure, the strain DSM17648 was identified as selective binder to H. pylori cells under in vivo gastric conditions. The strain DSM17648 co-aggregates the pathogen in vivo and in vitro. The specific co-aggregation occurs between Lactobacillus. reuteri DSM17648 and different H. pylori strains
Results: After a 28-day supplementation phase with Pylopass™ there was a trend for reduction of H. pylori load in 62.5% of the subjects and for the overall GSRS scores in 66.7% of subjects.
Conclusion: The results demonstrated that L. reuteri DSM17648 has the potential to suppress H. pylori infection, and may lead to an improvement of H. pylori-associated gastro intestinal symptoms.
The present study included 70 patients diagnosed with Helicobacter pylori infection by the rapid urease test, randomized into two therapeutic regimens: Lactobacillus reuteri DSMZ17648, liquorice and calcium carbonate and classical proton pump inhibitor – amoxicillin – clarithromycin scheme. The eradication efficiency was 54.3% in the Lactobacillus reuteri group vs 77.1% in the antibiotic group (p = 0.042) but with a significantly lower rate of side effects (2.9% vs 17.1%, p = 0.037). Finding new drugs to eradicate Helicobacter pylori with increased efficacy, cost effectiveness ratio and no side effects remains a challenge.
Keywords: Helicobacter pylori, eradication, antibiotic resistance, Lactobacillus reuteri
Results: H. pylori decreased microbial diversity associated with inflammation and focal mucosal atrophy. H. pylori eradication was achieved on Lr monotherapy in 50% after 28 and 60% after 56days, on adjuvant Lr therapy – 60% after 28 and 77.8% after 56days, in placebo group – 68.8% after 28 and 56days. Clinical manifestation, inflammatory and atrophic changes during Lr treatment significantly and reliably decreased.
Conclusion: Lr monotherapy is comparable in effectiveness to a standard eradication therapy.
Keywords: H. pylori, non-Helicobacter gastric microbiota, probiotics, L. reuteri