Innovative approaches in HELICOBACTER pylori therapy: Clinical trials and advancements in Gastro-Retentive drug delivery systems

HELICOBACTER PYLORI (H. PYLORI) identified in 1982, infects more than half of the world's population and is a major cause of gastrointestinal issues like gastritis, peptic ulcers, and an elevated risk of stomach cancer. The infection triggers chronic gastritis through the immune response and bacterial toxins such as VacA and CagA, which harm the stomach lining. This persistent inflammation can lead to peptic ulcers by compromising the protective mucous barrier, allowing stomach acid to create lesions. Prolonged infection with more aggressive strains increases the likelihood of gastric cancer by sustaining inflammation and causing genetic changes in stomach cells. Various symptoms related to gastric inflammation include upper abdominal discomfort, bloating, loss of appetite, nausea, and heartburn. The conventional treatment involves a triple therapy regimen combining Rabeprazole, Amoxicillin, and Clarithromycin with the effectiveness of 10-day versus 14-day courses. However, these treatments come with major drawbacks such as quick elimination of a drug from gastrointestinal tract, short half-life and drug resistance. To overcome all these challenges, there is a need for an alternative approach to deliver drugs. In this review, the pathophysiology of H. PYLORI along with its relationship with gut microbe has been discussed. Further, it also includes conventional treatment, its drawbacks and alternative treatment approaches available. Additionally, it also discussed about various clinical trials that have been reported for the treatment of H. PYLORI.