Helicobacter pylori eradication: developing antibiotic-independent antimicrobial moieties

Area of Science:

• Microbiology
• Infectious Diseases
• Gastroenterology

Background:

• Helicobacter pylori (H. pylori) infection is a primary cause of gastric adenocarcinoma.
• Current standard therapies are increasingly ineffective due to rising antibiotic resistance, side effects, and failure to eradicate diverse H. pylori forms (biofilm-embedded, intracellular, dormant).
• H. pylori infections can also lead to long-term gut microbiome disruption.

Purpose of the Study:

• To highlight the urgent need for antibiotic-independent antimicrobial strategies against H. pylori.
• To explore innovative approaches targeting critical regulatory points in H. pylori infection.
• To review emerging antibiotic-independent antimicrobial moieties and cutting-edge treatments.

Main Methods:

• Review of current literature on H. pylori treatment challenges and emerging therapies.
• Identification of novel therapeutic targets, including urease inhibition, anti-adhesion, and eradication of intracellular/dormant forms.
• Exploration of diverse antibiotic-independent antimicrobial agents and modalities.

Main Results:

• Standard H. pylori eradication therapies are failing due to resistance and inability to target all bacterial forms.
• Multiple antibiotic-independent strategies are under investigation, including urease inhibitors, anti-adhesion agents, and treatments for specific H. pylori forms.
• Promising novel approaches include nanoparticles, antimicrobial peptides (AMPs), vaccines, phage therapy, and intraluminal photoacoustic therapy.

Conclusions:

• The growing ineffectiveness of standard H. pylori treatments necessitates the development of antibiotic-independent alternatives.
• Targeting specific bacterial mechanisms and forms, alongside exploring novel moieties, offers promising avenues for effective H. pylori eradication.
• Innovative treatments show potential for overcoming persistent H. pylori infections with reduced side effects and microbiome disruption.