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Lactobacillus reuteri strain combination in Helicobacter pylori infection: a randomized, double-blind,
Ruggiero Francavilla1, Lorenzo Polimeno, Antonella Demichina
1*Interdisciplinary Department of Medicine, Clinica Pediatrica "B. Trambusti" †Gastroenterology Unit, Department of Emergency and Organ Transplantation ¶Biomedical Sciences and Human Oncology (DIMO), University of Bari ‡Struttura Semplice Dipartimentale Endoscopia Digestiva Ospedale "Umberto I" Altamura ∥IRCCS "Saverio De Bellis Castellana Grotte, Bari §Gastroenterology Unit, Department Medical & Occupational Sciences, University of Foggia, Foggia, Italy #Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX.
Goals:
The goals of this study were to investigate the role of a new probiotic preparation (Lactobacillus reuteri DSM 17938 and L. reuteri ATCC PTA 6475) in Helicobacter pylori infection.
Background:
Specific probiotic strains play a role in H. pylori infection for their ability to decrease bacterial load and gastritis, prevent antibiotic-associated side effects, and increase the eradication rate.
Study:
This is a prospective, double-blind, randomized, placebo-controlled study in a tertiary care setting. A total of 100 H. pylori-positive naive patients received either L. reuteri combination (2×10 Colony Forming Units) or placebo during a 3-phase study (pre-eradication, eradication, and follow-up). All underwent C urea breath test (C-UBT), blood assessments of gastrin-17 (G17), endoscopy, and the Gastrointestinal Symptom Rating Scale. Eradication was confirmed by C-UBT 8 weeks after the completion of therapy.
Results:
Fifty patients were allocated in each group. During pre-eradication period, C-UBT δ decreased by 13% in L. reuteri combination as compared with a 4% increase in placebo (-13.2±34% vs. 4.3±27%; P<0.03). During eradication, GSRS increased significantly in placebo as compared with L. reuteri combination (6.8±2.9 vs. 4±3.1; P<0.01). Significantly less patients in L. reuteri combination as compared with placebo-reported side effects (40.9% vs. 62.8%; P<0.04). An abnormal G17 value was found in patients receiving placebo as compared with L. reuteri combination (28% vs. 12%; P<0.02). Eradication rate was 75% in L. reuteri combination and 65.9% in placebo (P=NS). L. reuteri combination increased eradication rate by 9.1% (odds ratio: 1.5).
Conclusions:
L. reuteri combination alone is able to exert an inhibitory effect on H. pylori growth, and when administered with eradication therapy, it determines a significant reduction in antibiotic-associated side effects. Moreover, L. reuteri combination was able to decrease serum G17 levels and to (not significantly) increase the H. pylori-eradication rate.
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