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World J Gastrointest Pathophysiol. Nov 15, 2014; 5(4): 384-391
Published online Nov 15, 2014. doi: 10.4291/wjgp.v5.i4.384
Use of probiotics in the fight against Helicobacter pylori
Paolo Ruggiero
Paolo Ruggiero, Novartis Vaccines and Diagnostics, Research Center, I-53100 Siena, Italy
Author contributions: Ruggiero P conceived the paper, performed the literature search, and wrote the paper.
Correspondence to: Paolo Ruggiero, MSc, Novartis Vaccines and Diagnostics, Research Center, Via Fiorentina 1, I-53100, Siena, Italy.
Telephone: +39-0577-539320 Fax: +39-0577-539314
Received: January 29, 2014
Revised: March 19, 2014
Accepted: July 15, 2014
Published online: November 15, 2014

After the discovery of Helicobacter pylori (H. pylori), and the evidence of its relationship with gastric diseases, antibiotic-based therapies were developed, which efficacy was however limited by antibiotic resistance and lack of patient compliance. A vaccine would overcome these drawbacks, but currently there is not any H. pylori vaccine licensed. In the frame of the studies aimed at finding alternative therapies or at increasing the efficacy of the current ones and/or reducing their side effects, the investigation on the use of probiotics plays an interesting role. In vitro and preclinical studies have shown the feasibility of this approach. Several clinical trials indicated that administration of probiotics can reduce the side effects of H. pylori eradication treatment, increasing tolerability, and often increases the overall efficacy. The results of these trials vary, likely reflecting the variety of probiotics assessed and that of the eradication treatment, as well as the differences in the geographic area that imply different H. pylori strains distribution, host susceptibility, and therapy efficacy. In conclusion, the use of probiotics appears promising as an adjuvant for the current H. pylori eradication treatment, though it still requires optimization.

Keywords: Helicobacter pylori, Treatment, Probiotics, Lactobacilli, Bifidobacteria

Core tip:Helicobacter pylori (H. pylori) is the only bacterium that has been linked to cancer to date. The efficacy of antibiotic-based eradication treatment is hampered by antibiotic resistance and side effects that may reduce patient compliance. No vaccine is currently licensed. Thus, administration of alternative compounds that may increase the efficacy of the treatment and/or reduce side effects is of particular interest. Administration of probiotics has been proposed to increase tolerability and efficacy of the H. pylori eradication treatment. The results of the most recent clinical trials seem to confirm these hypotheses.